From the Guidelines
The term for stress shedding of hair is telogen effluvium. This condition is characterized by a significant increase in hair shedding, typically occurring 2-3 months after a stressful event, as a result of the stress pushing a large number of hair follicles into the resting (telogen) phase prematurely 1.
Key Features of Telogen Effluvium
- Diffuse thinning of hair rather than patches of baldness
- Increased hair shedding during washing or brushing
- Common triggers include major surgery, severe illness, significant weight loss, childbirth, severe psychological stress, and certain medications
- Usually temporary, with hair regrowth occurring naturally within 6-9 months once the stressor is removed or managed
Diagnosis and Treatment
Telogen effluvium can be difficult to diagnose, especially in its early stages, and may be confused with other conditions such as alopecia areata, tinea capitis, or anagen effluvium 1. Treatment focuses on addressing the underlying cause of stress, ensuring proper nutrition (particularly adequate protein, iron, zinc, and vitamin D), and gentle hair care practices. In persistent cases, a dermatologist may recommend blood tests to rule out other causes like thyroid disorders or nutritional deficiencies.
Physiological Mechanism
The physiological mechanism of telogen effluvium involves stress hormones disrupting the normal hair growth cycle, causing follicles to enter the shedding phase prematurely. This disruption can be triggered by a wide range of stressors, including physical and emotional stress, and can have a significant impact on an individual's quality of life.
From the Research
Definition and Causes
- Telogen effluvium is a scalp disorder characterized by excessive shedding of hair, which can be caused by various factors such as physiological stress, emotional stress, trauma, and drugs 2, 3, 4, 5, 6.
- The condition can present as acute or chronic hair fall, with symptoms such as trichodynia, and can be triggered by events like childbirth, sudden weight loss, or crash diets 2, 3, 4, 6.
Diagnosis and Treatment
- Diagnostic tests for telogen effluvium include hair wash test, trichogram, phototrichogram, and scalp biopsy 2.
- Treatment options for telogen effluvium involve identifying and removing the causative factors, and using drugs such as corticosteroids, minoxidil, and novel treatments like CNPDA (caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer) 2, 3.
- In some cases, a course of topical corticosteroids may be tried, although there is no documented etiopathogenesis for the condition 3.
Characteristics and Impact
- Telogen effluvium is a common cause of diffuse non-scarring hair loss, which can significantly impact an individual's quality of life 4, 5.
- The shed hairs in telogen effluvium do not exhibit telogen roots, but mostly exogen ones, and the condition can be chronic but intermittent, with apparent remissions being irregularly intermitted by relapses 3.