April 13, 2015
It isn't a fun visit when I have a hysterical or depressed patient in my examining room who is losing his or her hair. It causes extreme stress and anxiety for both men and women when they realize their hair is either falling out or they've begun to see bald patches.
Most people within their lifetime will experience a telogen effluvium, which is an acute onset, but temporary, thinning hair and shedding of the hair. Telogen effluvium hairs are identified as having a white bulb on the end of the hair removed from the scalp.
Telogen effluvium often follows a sickness or hospitalization, surgical procedure, or emotional or physical stressor, or the delivery of a baby. People who lose a significant amount of weight in a short time frame can also experience an abnormal shedding of hair. Telogen effluvium can also occur when a patient has an underlying medical condition that is unresolved such as chromes disease or any other nutritional compromising illness.
When hair follicles sense stress, they will shed atypical amounts. Hairs that shed at an abnormally high-rate often are in a resting phase, known as a telogen state, and will naturally fall out to make way for new hair growth. During an effluvium, it is common to lose between 500 to 600 hairs per day. It is normal for people not suffering from telogen effluvium to shed on average 100 to 150 hairs per day.
As you can imagine, this is quite alarming to most patients who experience hair loss!
I offer patients, diagnosed with telogen effluvium, guidelines to a support system for their hair follicles and as a hair loss treatment. This may be as simple as positive reassurance that their hair will grow back, and advising them on the importance good rest, taking a multivitamin and eating a well-balanced nutritional diet, especially during this episode. Sometimes, I will incorporate a topical treatment such as Rogaine or Ducray to remind the hair follicles that a safe environment has been created for them to grow in and to stimulate hair regrowth.
Sometimes blood work is completed to document results. However, most of the time it is found unhelpful.
Telogen effluvium always resolves itself, although the hair may not grow back in as thick as it once was prior to the episode.
According to the American Hair Loss Association, telogen effluvium is probably the second most common form of hair loss dermatologist.