What Is Telogen Effluvium? Symptoms, Causes And How To Treat

Telogen effluvium is a scalp disorder which causes temporary hair loss due to shedding of Telogen Phase hair after some shock to the system. It is the second most common form of hair loss and both of Androgenetic Alopecia account for about 95% of all hair-loss cases. Unlike Androgenetic Alopecia, this condition causes diffuse/generalised thinning, instead of localised baldness.

The life cycle of a hair plays out in three stages. A normal healthy person has about 85% to 90% of the hairs in Anagen Phase and some 10% to 15% in Telogen Phase, while about 1% will be in Catagen Phase of hair growth. Typically, a hair is in the Anagen for two to four years, then enters the Telogen phase, rests for about two to four months, and then falls out and is replaced by a new, growing hair. Thus, it is normal to lose up to about 100 hairs a day on one's comb, brush, in the basin or on the pillow, as a result of the normal scalp hair cycle.

If there is some shock to the system, about 30% even as much as 70% of the hairs stop growing and go into the Telogen, then shed in large numbers of hair.

What Is Telogen Effluvium? Symptoms, Causes And How To Treat

1. Anagen Phase

About 85-90% of our hair and is the Anagen in the process, during which cells in the follicle root divide and form a fledgling hair. This new hair continues to grow and pushes the old hair above it up the follicle and out. The new hair will grow at about half an inch per month during this phase, which lasts anywhere from 2 to 4 years. Anagen hair has a pointed or tapered tip.

2. Catagen Phase

At any one time, 1-3% of our hair is in Catagen. Growth stops and it enters a 2 to 3 week transitional phase, the outer layer of the hair root withers or shrinks, wrapping around the root to form a bulb. Here the root sheath in the follicle shrinks and attaches to the base of the hair.

3. Telogen Phase

About 10-15% of hair is typically in Telogen. The hair is no longer attached to a blood supply, it stops growing and then rests for two to four months, after which it loses the old hair as a new hair shaft grows and pushes out its predecessor. Telogen hair has a bulb or club-shaped tip.

If there is some shock to the system, as many as 70% of the scalp hairs stop growing and go into the Telogen, then shed in large numbers about 2 months after the shock.

Five Mechanisms Can Occur

  1. Immediate Anagen Release - Drug-induced
    Follicles that would normally complete a longer cycle of Anagen prematurely Telogen telogen. Typically immediate anagen release has a short time to onset of 3 to 5 weeks from the inciting factor. Drug-induced telogen effluvium may account for it.
  2. Delayed Anagen Release - Postpartum
    Hairs are maintained in anagen for longer than usual and then are released into telogen phase at the same time. Postpartum TE is the most common type of this TE in which hairs are kept in anagen during pregnancy then released into telogen after childbirth when there is a rapid TE after delivery.
  3. Shortened Anagen
    If anagen is shortened by 50%, there is a corresponding doubling of telogen hairs. Etidronate may cause of it.
  4. Immediate Telogen Release
    Hairs that would normally remain in telogen for the typical 4 to 12 weeks are cycled into anagen within a few days. Minoxidil is an example of a medication that can cause TE by moving the hairs prematurely into anagen phase.
  5. Delayed Telogen Release
    Telogen is prolonged and there is slightly more synchronicity in cycling so that scalp hair falls out at the same time.

Diagnosis

There are two simple test that you can do at home to check to see if there is a TE for you can be done in seconds.

1. Hair-pull Test

Of note, the individual should not shower for at least one day prior to the pull test.

  • Grab a small portion of your hair, so around 60 strands of hair.
  • Holding firmly on the hair, slowly pull just lightly all the way until you no longer have your hair anymore BUT keep holding on to the hairs that you pulled out.
  • Count how many hairs you pulled out.
  • There should be between 0 - 6 hairs. If there is more then 10% then you may have hair loss caused by stress.

2. Hair Pluck Test

Uses a tweezer to forcefully pluck 5 hairs and see if the hairs that are shed have clubbed shafts or the little bulb thingy at the end of your hair shaft. If it is bulb-shaped and have a gel-like covering around that means your hair is strong and healthy, Anagen hair has a pointed or tapered tip. If there is no bulb or if the section is puny, your hair is damaged. Telogen hair has a bulb or club-shaped tip.

TE Is Divided Into Two Different Types

1. Acute TE - (Symptoms, Causes And How To Treat)

It has an abrupt onset, the active shedding lasts 1 to 4 months and can lead to thinning of the hair over the entire scalp.

2. Chronic TE - (Symptoms, Causes And How To Treat)

Chronic TE is the most common type of hair loss in women and approximately 30% of menstruating women are affected. It is defined as increased shedding lasting at least 6 months, but usually greater than one year.

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