Telogen Effluvium

Telogen effluvium (TE) is a common, non-scarring alopecia where excessive hair sheds diffusely from the scalp. Normally, 85-90% of scalp hairs grow actively (anagen phase), 10-15% rest (telogen), and daily loss stays under 100 hairs. In TE, stressors disrupt this cycle, pushing up to 70% of follicles into telogen prematurely, leading to noticeable thinning 2-4 months later.

Causes
Triggers include physiological events like postpartum changes or high fever, emotional stress from trauma, severe diets causing nutrient deficits (e.g., iron, protein), thyroid issues, or drugs such as beta-blockers, retinoids, and anticoagulants. Chronic TE, lasting over 6 months, often affects middle-aged women without a clear cause and may overlap with androgenetic alopecia.

Symptoms and Diagnosis

Patients notice increased shedding during brushing or washing, with overall volume reduction but no scalp changes. A positive hair pull test (4-6 hairs extracted) supports diagnosis; blood tests rule out deficiencies or hormones, while a biopsy excludes other alopecias.

Treatment and Recovery

TE is self-limiting, with regrowth in 6-12 months at 1 cm/month; no drugs accelerate it reliably, but addressing triggers (e.g., nutrition, stress management) helps. Minoxidil aids chronic cases symptomatically. Full recovery depends on age and health.