Telogen effluvium is a common, transient form of abrupt, generalized hair loss that can be due to many different causes: medication, pregnancy, hypothyroidism, emotional stress, hormonal fluctuation, surgery or a severe illness. With one of these stressors, a significant number of hairs convert to the resting (telogen) phase of their growth then fall out- thus the name telogen effluvium. This usually is seen about 3-6 months after exposure to a triggering factor and it usually affects less than 50% of the hairs in the scalp. Some medications that commonly cause telogen effluvium are anti-seizure medications, beta-blockers for high blood pressure, and anti-thyroid medications.
Chronic telogen effluvium may represent a primary disorder or may be secondary to a variety of systemic abnormalities (malabsorbtion, dietary deficiencies, chronic thyroid disease, chronic renal or liver failure, or HIV infection). The condition is characterized by a diffuse loss of telogen hairs involving the whole scalp and continuing for more than 6 to 8 months. Patients (mostly women) report persistent and severe hair shedding that tends to have a fluctuating course for many years. The most common complaint is deepening of the bitemporal recessions and loss of volume of the pony-tail.
Diagnosis is usually made by medical history, (onset of the symptoms 3 to 4 months after major stressful event), clinical evaluation, dermoscopy, pull test and if necessary-biopsy.
Different treatments are available: medical treatment, lasers, PRP or hair restoration, when indicated.