telogen effluvium

What is Telogen Effluvium?

Telogen effluvium is a common cause of temporary hair loss due to excessive shedding of resting or telogen hair after some shock to the system [1]. This condition is characterized by an increase in the amount of hair that a person sheds, usually as a result of stress, hormonal changes, or medication [2].

Causes and Symptoms

Telogen effluvium can be triggered by various factors such as:

• Stress: Physical or emotional stress can push hair roots prematurely into the resting state, leading to excessive shedding [3].
• Hormonal changes: Changes in hormone levels, such as those experienced during pregnancy or menopause, can contribute to telogen effluvium [4].
• Medication: Certain medications, including those used for cancer treatment, antidepressants, and birth control pills, can cause hair loss due to telogen effluvium [5].

Symptoms of telogen effluvium include:

• Diffuse hair shedding all over the scalp
• Hair feels thinner
• Increased proportion of hairs shift from the growing phase to the resting phase

Recovery

Fortunately, telogen effluvium is a temporary condition and usually reverses itself over time [6]. In most cases, reassurance and patience are sufficient, and hair growth returns to normal within a few months. However, if there is evidence of a drug etiology or underlying medical condition, further treatment may be necessary [7].

Key Points

• Telogen effluvium is a temporary condition characterized by excessive shedding of resting or telogen hair.
• It can be triggered by stress, hormonal changes, medication, and other factors.
• Symptoms include diffuse hair shedding, thinner hair, and increased proportion of hairs in the resting phase.
• Recovery usually occurs within a few months with reassurance and patience.

References:

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Common Signs and Symptoms of Telogen Effluvium

Telogen effluvium, a condition characterized by excessive hair shedding, can manifest in various ways. The primary symptom is the sudden onset of significant hair loss, which can be alarming for those affected.

• Excessive Hair Shedding: One of the most noticeable signs of telogen effluvium is the sudden increase in hair shedding. This can occur when combing or brushing your hair, and you may notice more hair than usual on your pillow, in the shower, or in your hairbrush [6][7].
• Hair Thinning: As a result of excessive hair shedding, individuals with telogen effluvium may experience noticeable hair thinning. This can be particularly concerning for those who value their hair's appearance and health [7].
• Rapid Hair Loss: Telogen effluvium is often characterized by rapid hair loss, which can occur within a few months after experiencing a significant stressor or trauma [3][4].

Other Possible Signs

While not as common, other possible signs of telogen effluvium include:

• Physical Trauma: Physical trauma, such as being in a car crash, having blood loss, or undergoing surgery, can trigger telogen effluvium [8].
• Exposure to Toxins: Exposure to toxins like heavy metals may also contribute to the development of telogen effluvium [8].

It's essential to note that these symptoms can vary from person to person and may not be present in every individual with telogen effluvium. If you're experiencing excessive hair shedding or other concerning symptoms, consult a healthcare professional for proper evaluation and guidance.

References: [3] - Context 3 [4] - Context 4 [6] - Context 6 [7] - Context 7 [8] - Context 8

Telogen effluvium (TE) is a condition characterized by excessive hair shedding, and various diagnostic tests can help confirm the diagnosis. Here are some common diagnostic tests used to diagnose TE:

• Scalp biopsy: This is considered the most useful test for confirming the diagnosis of telogen effluvium [1]. However, it is seldom necessary if the history is characteristic and a gentle hair pull test reveals an increased number of hairs.
• Blood tests: NYU Langone dermatologists diagnose hair loss based on the results of blood tests, which can help identify underlying conditions that may be contributing to TE [2].
• Hair wash test: This test involves washing the patient's hair with a special shampoo and then examining the hair for signs of telogen effluvium. However, this test is not commonly used in clinical practice.
• Trichogram: A trichogram can help confirm the diagnosis of TE by examining the hair follicles under a microscope [4]. This test can distinguish club-shaped (telogen) hairs from other types of hair.
• Phototrichogram: This test uses photography to examine the hair growth cycle and can help diagnose telogen effluvium [6].
• Scalp biopsy: A scalp biopsy can also be used to confirm the diagnosis of TE by examining the hair follicles under a microscope [5].

It's worth noting that a dermatologist might also be able to diagnose telogen effluvium and offer advice based on other indicators of hair health, such as the appearance of the scalp and the overall condition of the hair [7].

Treatment Options for Telogen Effluvium

Telogen effluvium, a condition characterized by excessive hair shedding due to various triggers, can be challenging to manage. While there are no definitive treatments proven to prevent or stop the shedding once it starts, certain medications and therapies may help alleviate symptoms.

• Minoxidil: Topical minoxidil has been studied for its potential benefits in promoting hair growth in telogen effluvium, although its effectiveness is still theoretical [1]. It is approved by the FDA as a treatment for female pattern hair loss (FPHL) and male androgenetic alopecia [8].
• Finasteride: Oral finasteride, a prescription medication, is primarily used to treat male pattern hair loss (androgenetic alopecia). While it may slow down hair loss in some cases, its effectiveness in treating telogen effluvium is unclear [3].

Other Considerations

It's essential to note that managing underlying triggers and addressing any related health issues can help resolve telogen effluvium. However, medication does not speed up the process of hair regrowth once the trigger is removed [7]. In some cases, a combination therapy like CNPDA (caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer) may be explored as a potential treatment option [6].

Current Understanding

While there are no definitive treatments proven to prevent or stop telogen effluvium shedding, certain medications and therapies may offer some benefits. It's crucial to consult with a healthcare professional for personalized advice on managing this condition.

References:

[1] Context 1: Nov 14, 2024 — Topical minoxidil has not been definitively proved to promote recovery of hair in telogen effluvium, but it has a theoretical benefit and is ...

[2] Context 2: by E Perera · 2017 · Cited by 70 — Oral minoxidil stimulates hair growth, and topical minoxidil is used in the treatment of FPHL and male androgenetic alopecia.

[3] Context 3: Oral finasteride is a prescription medication for men who have male pattern hair loss, or androgenetic alopecia. Finasteride slows the rate of hair loss and ...

[6] Context 6: by F Asghar · 2020 · Cited by 209 — This new treatment named CNPDA comprises a combination of caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer. This ...

[7] Context 7: There is normally no treatment required for telogen effluvium as the hair will start growing back once the trigger is removed. Medication does not speed up this ...

[8] Context 8: This topical telogen effluvium treatment is approved by the U.S. Food and Drug Administration (FDA) to address hair loss. Minoxidil helps to counter hair loss ...

Differential Diagnosis of Telogen Effluvium

Telogen effluvium (TE) is a form of nonscarring alopecia characterized by diffuse hair shedding, often with an acute onset [1]. When diagnosing TE, it's essential to consider several differential diagnoses that can present with similar symptoms.

Common Differential Diagnoses:

• Alopecia Areata (AA): This condition can cause patchy hair loss and may be difficult to distinguish from TE, especially in its initial phase [2].
• Traction Alopecia: Caused by prolonged mechanical stress on the hair follicles, traction alopecia can lead to diffuse hair loss similar to TE.
• Trichotillomania: A psychological disorder characterized by compulsive hair pulling, which can result in patchy or diffuse hair loss.
• Androgenetic Alopecia (AGA): Also known as male/female pattern baldness, AGA can accelerate telogen effluvium and cause diffuse hair loss [4].
• Papulosquamous Diseases: Certain skin conditions like psoriasis, seborrheic dermatitis, or eczema can lead to diffuse hair loss.
• Iron Deficiency and Malnutrition: Protein or caloric malnutrition, as well as iron deficiency, can cause telogen effluvium [3].
• Alopecia Areata Incognita (AAI): A rare form of alopecia areata that presents with diffuse hair loss rather than the typical patchy pattern.
• Psychogenic Pseudoeffluvium: A psychological condition characterized by excessive concern about hair loss, which can lead to a self-fulfilling prophecy.

Clinical Signs and Symptoms

To differentiate between these conditions, clinicians should look for specific signs and symptoms. For instance:

• Hair Regrowth: Clinical signs of hair regrowth after telogen effluvium can help in the diagnosis [6].
• Pull Test: A positive pull test is often indicative of alopecia areata or traction alopecia.
• Trichodynia: This condition presents with an intensely positive pull test and trichodynia but with minimal, if any, hair loss.

Conclusion

Differential diagnoses for telogen effluvium include various conditions that can cause diffuse hair loss. Accurate diagnosis requires a thorough understanding of the clinical presentation, medical history, and laboratory findings. By considering these differential diagnoses, clinicians can provide an accurate diagnosis and develop an effective treatment plan.

References:

[1] [2] [3] [4] [5] [6] [7]