From the Research
Management of telogen effluvium should prioritize identifying and addressing the underlying trigger, with a focus on nutritional support and gentle hair care practices, as evidenced by the most recent study in 2024 1. The first step in managing telogen effluvium is to conduct a thorough history and physical examination to identify potential causes such as medications, nutritional deficiencies, stress, hormonal changes, or illness.
- Laboratory testing may include complete blood count, thyroid function tests, iron studies, and vitamin D levels to rule out common deficiencies, with a significant proportion of patients showing vitamin D deficiency, as seen in a study of 3028 patients 2.
- Once the underlying cause is identified, it should be removed or treated; for example, discontinuing offending medications (with physician guidance), correcting nutritional deficiencies, or managing stress.
- Nutritional support is important, particularly ensuring adequate protein intake (0.8-1g/kg/day) and correcting specific deficiencies with supplements like ferrous sulfate 325mg daily for iron deficiency, biotin 2-5mg daily, or a multivitamin containing zinc and vitamin D, as supported by a comparative evaluation of two nutritional supplements in 2018 3.
- Patients should be counseled that telogen effluvium is typically self-limiting, with hair regrowth usually beginning 3-6 months after removing the trigger, though complete recovery may take 12-18 months.
- Gentle hair care practices should be recommended, including avoiding harsh chemical treatments, excessive heat styling, and tight hairstyles.
- Oral minoxidil has been shown to reduce hair shedding in chronic telogen effluvium, as demonstrated in a retrospective study in 2017 4, and may be considered as a treatment option.
- Regular follow-up appointments every 3-6 months help monitor progress and provide reassurance during the recovery period.
- The use of dietary supplements such as vitamin C, D, lactoferrin, and zinc during active infection may have a preventive value on post-covid hair loss, as suggested by a case-control study in 2024 1.