Telogen Effluvium

telogen effluvium

Life’s challenges and stressors can cause our bodies to react in different ways. Sometimes, it can literally make our hair fall out. We naturally lose hair. Science estimates that we lose between 50 to 100 strands of hair daily. However, when we start losing a little more than expected, it can be concerning. And if you visit a doctor or dermatologist, based on the circumstance, they may use the term telogen effluvium.

What is telogen effluvium?

Telogen effluvium is a common cause of temporary hair loss. This excessive shedding of resting (i.e. telogen) hairs usually occurs after some shock to the body. The resting hairs are club-shaped at the root. People of all age groups and both sexes can be affected, but longstanding telogen effluvium tends to present in healthy women 30–60 years of age.

What is the cause of telogen effluvium?

In the scalp of a normal healthy person, about 85% of the hair follicles are in the anagen phase – This is the actively growing hair –  about 15% are resting hairs. The hair is usually in the growth phase for about 4 years and then spends 4 months in the resting phase. A new anagen hair forms under the resting telogen hair and then pushes it out. Because of this cycle, it is normal to lose up to 100 or more strands of hair per day.

If there is an illness or shock to your system, up to 70% of the hairs can be pushed into the telogen phase. Common triggers include:

A sudden illness with high fever: 

The stress and inflammation that comes with illness can cause chronic telogen effluvium. Hair shedding might present a few weeks or months after the illness.


During pregnancy, an increase in hormones can actually help with hair growth, including length and thickness. Hair stays in the growth stage for longer during pregnancy. However, after childbirth, hormones can change drastically. Telogen effluvium can happen 3 to 6 months after childbirth or if the woman stops breastfeeding. Like most cases, this is usually temporary.

The side effects of Surgery:

Some surgical procedures can cause physical and hormonal changes to our bodies. These result in hair loss. The subsequent medication, stress or lack of proper diet during recovery can have an adverse effect on hair and cause shedding.

Weight loss or extreme dieting:

While weight-loss diets and other fads can help shed pounds off your waistline, it can also cause some hair shedding. Extreme dieting comes at the expense of vitamins and nutritional deficiencies. These include protein, vitamin B, iron, and zinc. These are critical building blocks for hair growth.

Emotional stress: 

The challenges and stresses of life can cause some hair loss. However, a traumatic event can lead to telogen effluvium, usually lasting several months after the event.


Some medications carry hair loss as a side effect. Speak with your doctor about sudden hair loss while on prescriptions. Some recreational drugs may also cause telogen effluvium.

Metal exposure or toxicity:

Prolonged exposure to metals like lead, mercury, aluminum, copper, and cadmium can cause hair loss. People who work in heavy metals or mining are at risk. Some metals can even affect future hair growth.

Endocrine disorders:

Your endocrine system is responsible for transporting hormones throughout the body. Hormones also play a part in hair growth and maintenance. Conditions like hypothyroidism, diabetes,  growth hormone deficiency, PCOS, and Cushing’s syndrome may cause hair shedding.


During menopause, the body slows down on hormone production like estrogen. In addition to the common symptoms of menopause, some women experience temporary or permanent hair loss.

Are there any symptoms?

The main and only symptom is excess hair shedding. Sometimes, the hair may come out in small clumps. The hair loss typically happens after washing your hair, brushing your hair, or while sleeping. Pay attention to extra clumps of hair on these occasions.

How does it present?

Initially, the resting scalp hairs are firmly attached to the scalp. Then as the new hairs form, they push up through the scalp. This results in increased hair loss about 3 months after the triggering event. Up to 50 % of the scalp hair can be affected.  In telogen effluvium, hair loss is not patchy. Instead, it presents as diffuse thinning of hair all over the scalp. After several months, hair loss lessens, and the hair begins to thicken again. Recovery may be incomplete in some cases.

In some people, the hair shedding may last for many months- even years. In these cases of chronic telogen effluvium, it seems that the hair cycle has been reset with a much shorter growth phase. While the condition does not cause complete baldness, it can unmask other types of hair loss, like male or female pattern hair loss. In any event, a visit to a board-certified dermatologist can help you get to the root of the issue, prevent further hair loss or speed up re-growth.

Is there a treatment for telogen effluvium?

If you suspect that you have telogen effluvium, see your dermatologist immediately. To confirm, your doctor will perform a series of tests including a hair pull test or even a blood test or scalp biopsy. Your dermatologist might even ask detailed questions about your medical history while looking for signs of balding, hair thinning, or the overall appearance of the scalp.

This condition usually resolves on its own over many months. Things you can do at home include:

  • Gentle hair grooming practices- avoiding over-combing or tight hairstyles.
  • Addressing any causes of stress.
  • Eat a nutritious balanced diet, with fruit, vegetables, and protein.
  • Treat any underlying hormonal problem or scalp disorder.
  • Schedule a consultation with a board-certified dermatologist for further treatment.


Telogen effluvium could be a stressful situation. Hair loss of this nature can bring on feelings of panic and make you feel self-conscious. Rest assured, by finding the root cause and then consistently treating the issue, the hair can regrow. If you have hair loss, contact the Hair and Scalp Center at Eternal Dermatology now! Our board-certified dermatologist and hair loss expert can help you.


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