From the Guidelines
Telogen effluvium treatment should prioritize addressing the underlying cause and supporting hair regrowth with autologous platelet-rich plasma (PRP) or platelet-rich fibrin (PRF) injections, as they have shown significant increases in hair density and thickness in recent studies. The primary approach is to identify and eliminate the trigger, which may include stress, medications, nutritional deficiencies, or illness. Most cases resolve spontaneously within 6-9 months once the trigger is removed. Nutritional support is important, so taking a daily multivitamin containing iron, zinc, biotin, and vitamins D and B complex is recommended 1. For iron deficiency, supplementing with ferrous sulfate 325mg daily until levels normalize can be beneficial. Minoxidil 5% solution applied to the scalp twice daily may help stimulate regrowth in persistent cases, though results take 3-4 months to appear.
Some key points to consider in telogen effluvium treatment include:
- Gentle hair care is essential—avoid harsh styling, heat treatments, and tight hairstyles
- Use mild shampoos and limit washing to 2-3 times weekly
- Stress management techniques like meditation, adequate sleep (7-8 hours nightly), and regular exercise can help, as stress is both a common trigger and consequence of hair loss
- Patience is crucial as hair regrowth is a slow process, with new growth typically appearing as short, fine hairs along the hairline and gradually thickening over time
- Recent studies have shown that PRP combined with topical minoxidil is the most effective treatment modality, while PRP alone and topical minoxidil alone are more effective than placebo 1
- PRF has also shown great potential in treating androgenetic alopecia, with studies demonstrating an increase in hair density and patient satisfaction 1
It's worth noting that the effectiveness of PRP and PRF can vary depending on factors such as platelet concentration, treatment frequency, and individual genetics. However, the current evidence suggests that these treatments can be a useful adjunct to traditional therapies for telogen effluvium and other forms of hair loss 1.
From the Research
Telogen Effluvium Treatment Options
- The treatment of telogen effluvium involves identifying and removing the causative factors, as well as using medications such as corticosteroids, minoxidil, and novel treatments like CNPDA (caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer) 2.
- Iron replacement therapy is commonly prescribed, with 37.5% of total prescriptions being for iron replacement 3.
- Vitamin D replacement therapy is also frequently prescribed, especially for women 3.
- Other treatment options may include addressing nutritional deficiencies, such as zinc, vitamin B12, and folate deficiencies, although the prevalence of these deficiencies may vary 4, 5, 3.
Diagnostic Approaches
- Diagnostic tests for telogen effluvium include hair wash test, trichogram, phototrichogram, and scalp biopsy 2.
- Laboratory parameters, such as serum ferritin level, complete blood count, and screening for vitamin and mineral deficiencies, thyroid function, and ANA titers, may also be evaluated 3.
- A detailed anamnesis and physical examination are essential in investigating other causes of telogen effluvium and creating individualized treatment options 5.
Nutritional Deficiencies and Telogen Effluvium
- Nutritional deficiencies, such as iron, vitamin B12, and zinc deficiencies, have been associated with telogen effluvium 4, 5, 3.
- However, a study found that nutritional deficiencies are not as common as thought in patients diagnosed with telogen effluvium, and other causes should be investigated 5.
- Zinc, copper, and selenium levels have been found to have statistically significant diagnostic performance in predicting the diagnosis of chronic telogen effluvium 5.