Hair Loss appears in many patterns and paths as well as pathologies.
Today, our spotlight on hair health focuses on a particular type of hair shedding which causes people of all ages
and backgrounds stress, and ironically, arises from various presentations of stress.
How does the hair growth cycle work? When hair grows normally, it typically grows for 4 years and then rests for four months. New hair then grows under the resting hair, pushing it out. This kind of loss is normal and is more obvious when hair is kept long – making the typical 100 hairs a day shed from the scalp look more remarkable – not to mention troublesome. There are many different kinds of hairloss, but today, we will shine a spotlight on one which we see commonly. Telogen Effluvium is a type of temporary hair loss which occurs due to excessive shedding of telogen (resting phase) hair after experiencing a shock to your system. Hair loss exceeds the average 100 hairs per day. Normally, 85% of the hair follicles on your scalp are actively growing versus 15% in resting phase. The follicle is not damaged and new hair is still able to continuously grow in its place; however, the temporary hair loss can cause considerable emotional and psychological distress depending on the location and amount of loss.
HOW DO I KNOW IF I HAVE Telogen Effluvium? Telogen Effluvium is typically evidenced by general thinning of an area of the scalp or the entire scalp. Fine fringe hairs can be seen in the area of loss which is frequently (but not always) along the forehead hairline. These are new, “baby” hairs which are growing in to replace some of those which were lost. Loss is often distressing, and it can last for several months; however, it usually tapers back to normal over a period of 6-9 months. Nails can also show related evidence which fit the clinical picture of Telogen Effluvium with what is called a Beau Line. Beau Lines are grooves halfway down the nail which helps a provider infer that a shock must have occurred to the body. They also help to pinpoint about WHEN the shock occurred, which can be verified by the patient.
This type of hairloss needs to be distinguished from alopecia areata, androgenic alopecia, lichnplanopilaris, and different types of anagen phase hairloss as their treatments will be different. This is why it’s important to see a Board Certified Dermatologist to characterize and differentiate your type of hairloss. Clinical experience and occasionally, a simple scalp biopsy, help to narrow down the diagnosis and get you on your way to the correct and most direct treatment.
What causes telogen effluvium? What many patients do not realize by the time they visit the Dermatologist with these concerns is that the culprit they are chasing has most likely already been removed. Such is the case when an acute psychological, emotional or physical stressor has been endured within the past 2-4 months which is typically just shy of the time it takes for patients to recognize a change and schedule an appointment to address their concern. Examples of these acute stressors include:
Oftentimes, the stressor is still present and active as a chronic health problem, and it’s important to us that we address lifestyle choices, and sometimes sensitive personal information with the patient, to help uncover the aggravating cause and come up with a solution to support our patient’s well being and health, holistically. Chronic stressors may include:
- Childbirth: postpartum hair loss, which typically resolves after a few months with some exceptions.
- Surgical operation
- Acute illness, and more commonly one which was accompanied by fever (as we are seeing post-covid infection)
- Physiological or neonatal hair loss
- Car accident or accident causing physical trauma
- Psychological stress
- Discontinuation of birth control
- Overseas travel with associated jetlag
- Rapid weight loss or limited diet
Either extreme acute or chronic shock to the system can cause as many as 70% of anagen (growing) hairs to flip into telogen (resting phase). At first, these hairs remain firmly attached to the follicles; however, as new hairs come up through the scalp, they push out the telogen hairs – at which time, increased hair fall is noticed. The delay in time between hair fall and triggering event can sometimes make pinpointing the cause a little more difficult, but with careful attention to recent history, the cause is often revealed.
- Routine psychological stress
- Feelings of Overwhelm
- Skin conditions which effect the scalp
- Chronic illness with or without Nutritional Deficiencies
- Nutritional Deficiencies (ex. Iron deficiency)
- Medications (specific medications with this as a known side effect)
- Endocrine disorders (ex. Hyper or Hypo -thyroidism)
How is telogen effluvium treated? Telogen effluvium is a self-correcting condition. Your doctor will share recommendations to alleviate excessive hair loss and ensure healthy regrowth and maintenance. Healthy holistic habits include ensuring that handling of the hair is done so very mildly. Combing, brushing, or massaging of the scalp should be minimized, if not, removed from the repertoire. Underlying disorders should be addressed with a clinician, whether they concern conditions of the scalp, hormonal imbalances, or nutritional deficiencies. And proper outlets for stress relief should also be sought. These may include yoga, meditation, regular exercise, group sports, long walks, audiobooks and podcasts focused on mental health and wellbeing, social support groups, and in very extreme cases, professional psychological help or life counseling.
Some of our favorite apps to help with mindfulness and stress relief are: DownDog, CharityMiles, Headspace, The Tapping Solution, Insight Timer, and more. Your provider may be able to offer suggestions depending upon your preferences and likelihood of engaging.
Save Your Money & Your Peace of Mind While we offer many different types of hairloss treatments at Aesthetix Skin & Surgery, such as Platelet Rich Plasma, Xtrac, B12 shots, corticosteroid injections, and prescription treatment plans – each treatment targets a different type or cause of hairloss. It is important to know that if you have been diagnosed with Telogen Effluvium, just because a procedure or product is advertised for hairloss, it will not necessarily work for the specific kind that you have. Some products can even cause a contact dermatitis of the scalp and insight more of a confounded problem. What will work is having a clear diagnosis by a Board Certified Dermatologist and hair specialist, uncovering the cause, and then patiently allowing your body and scalp the time it needs to renew, while having the knowledge to avoid potential stressors in the future. In other words, start with a confident diagnosis, and save yourself additional time and stress by building an efficient and effective treatment plan under medical guidance and clinical experience.