Stress is something that everyone experiences but some stress is so severe that without even realizing it, it could cause a number of other side effects like overeating and unnecessary hair loss. Hair loss can be difficult and challenging to deal with but if it is diagnosed correctly by identifying the type, it can be treated and managed much faster. Telogen effluvium is one such type of hair fall caused due to severe stress and shock to the body. Read more to find out all about Telogen effluvium (TE).
What is Telogen Effluvium?
A certain type of hair fall where the hair first gets thin and the scalp gets scanty with hair fall from the temples or near the forehead is called telogen effluvium. It was first described in 1961 by Kligman. This type of hair loss is very common and doesn't occur gradually with stages unlike pattern hair loss or genetic hair loss. Telogen effluvium rather occurs as a side effect of severe stress or shock that the body has gone through, this reflects as severe hair shedding either within 3-4 months of a triggering event or sometimes even after 6 months. A good example of telogen effluvium type of hair fall is when most people post-COVID were experiencing severe hair shedding, it was due to telogen effluvium that was acting up.
Normally every hair strand has a cycle called a hair cycle. This hair cycle typically has 4 main phases called anagen, catagen, telogen, and exogen and each phase has an important role to play in the life cycle of a single hair strand.
- Anagen, also called the growth phase of the hair, is where the hair follicles get all the nutrients rich blood supply for ideal hair growth due to which the hair is actively growing. This lasts for around 4-6 years.
- The Catagen phase is also called the transition phase because here is when the hair strand is transitioning from the growth to the rest phase. Although the hair is growing, it is moving into the next main stage of the cycle. This lasts for just a few months.
- Following catagen is immediately the Telogen phase of the cycle. This is called the resting phase because the hair has now come out of the follicle but has still not fallen off the head. It is still resting on the scalp waiting for a trigger for it to fall as simple as combing or washing hair.
- Next comes the exogen phase. This phase indicates that the hair has finally fallen off the scalp even without an external trigger. In this normal hair cycle, hair fall that is between 50-100 strands is considered to be regular hair fall. This hair was meant to fall off and there would be nothing you can do to save it because it's the natural hair cycle hair that falls off.
With every end of the hair cycle, the old telogen hair is pushed out by a new anagen hair. This is why after the hair cycle, it is not visible as hair fall or alopecia because it has been replaced by a new stronger hair strand.
However, what happens in telogen effluvium is that the anagen phase where the hair is actively growing is made to slow down due to severe stress and shock to the body. This means that just a few hairs enter into the next stages of catagen and telogen. In such a situation, only 30% of hair follicles go into the telogen phase, which indicates that hair shedding will occur. In a scientific sense, it means that during Telogen effluvium, the follicles remain prolonged in the growth phase instead of transitioning and moving into the rest phase. But, when these same follicles are released from the growth phase, the clinical sign of increased hair shedding of the same telogen hair is found.
What Is Chronic Telogen Effluvium?
If telogen effluvium is not catered to on time, then there are chances that the condition can progress into a chronic telogen effluvium where hair shedding continues to be greater than normal conditions for a prolonged period of time, sometimes as long as years. However, this condition is said to be present mostly in women with longer hair due to the fact that they would be the ones to notice hair shedding more visibly in comparison to females with fine or shorter hair. In reality, telogen effluvium is not meant to cause baldness, but rather just a severe form of hair thinning. Although many times it has unmasked a genetic tendency to balding caused by genetics which is commonly called pattern hair loss in both men and women. A person is said to have chronic telogen effluvium if they experience hair shedding consecutively for a period of more than 6 months. But, the important thing to remember is that telogen effluvium is 96% of the time-reversible if taken care of in the right manner.
Causes Of Telogen Effluvium
If you have recently experienced a drastic triggering effect of maybe losing a loved one or hormonal changes from delivering a baby, then you are someone who’s going through telogen effluvium. Here is a list of reasons why someone could be prone to telogen effluvium.
- Severe Stress: This is more on the physical trauma aspect. This is because environmental trauma could be due to financial stress, breakup stress, career stress, or losing a loved one. Such a change causes hair follicles to enter the telogen phase. Although this type of telogen effluvium occurs faster than the others, you still won’t expect hair fall until two months later but if treated on time, it can go back to how it was in no time which means your hair will return to its ideal state within a year.
- Poor Diet: Hair needs nourishment too. The loss of necessary nutrients to the body like vitamins and others causes a negative effect on the hair and causes it to enter this type of hair fall. Deficiencies such as iron, zinc, vitamin B-6, and vitamin B-12 cause hair thinning. Maintaining a healthy diet can instantly get the hair back to a normal state. However, various kinds of crash diets must be avoided to prevent further hair loss and damage since it is known to cause Telogen effluvium.
- Sudden Weight Loss: As mentioned earlier, severe caloric reduction or even calorie restriction like crash diets and anorexia nervosa affects the quality of the hair and causes it to first thin and then fall off. In such cases, if the hair condition is not treated, it may cause the hair to not grow back on time.
- Pregnancy And Childbirth: During pregnancy, the mother’s body goes through severe stress of carrying another human being altogether inside the body. The hormonal fluctuation accompanied by severe stress to the body pushes more of the hair strands into the growth phase for longer. Once the baby is delivered, the mother's hormones tend to fluctuate; this happens around 3-6 months after childbirth. This hormonal shift now pushes all the hair from the anagen or actively growing phase to the telogen phase with rapid and severe hair loss. This is called postpartum or post-pregnancy hair fall or post-pregnancy telogen effluvium.
- Menopause: Sometimes menopause could occur as early as the age of 40. During this phase, along with severe mood swings, female hormone levels drop. This increases the hormones like testosterone and DHT in the body. This leads to follicle shrinkage and hair fall by the hormone DHT. This hair fall is called telogen effluvium.
- Medications: Antidepressants, antihypertensives, or even contraceptives and other medical treatments lead to telogen effluvium. Especially if you have just started a new medication, you might experience severe hair fall. Sometimes even vaccinations can cause a certain type of shock to the body and put the hair follicles in a state of rest a.k.a the telogen phase. This takes about a few months for the hair to get back to normal.
- Illness: Fever is a very common cause of such a hair fall condition. This is because, during a fever, the body is in such a severe state of stress and shock that then reflects on the hair health. Dengue, malaria, and especially COVID cause telogen effluvium.
- Surgery: Depending on the type of surgery, the duration of the procedure, the type of procedure, time of stay in the hospital post-surgery, the amount of post-surgery care, medication, and overall nutritional status is dropped. It takes a toll on hair health and causes hair thinning accompanied by hair fall.
- Metal Intoxication: Construction workers are more prone to coming in contact with toxic chemicals in metals like lead. These intoxicating chemicals have a negative impact on hair health.
How Do I Know If I Have Telogen Effluvium (Signs and Symptoms)
Most of the time, Telogen effluvium is very easy to detect. It's best to watch out for these signs and symptoms. Firstly, hair appears very scanty on the scalp because of hair thinning. However, this hair thinning could either be limited to just a single area on the scalp or even all over the head. But even if it does cause thinning all over the scalp, you will notice that some areas are more affected than the rest of the scalp. Many cases have been shown to cause hair fall on the crown in men, rarely it causes the hairline to recede or hair to fall from the temples. But in women, unlike pattern hair loss where hair falls from the partition, here women notice receding hairline or forehead hair loss due to severe pulling of hair. Lastly, in some rare cases, people have also seen hair falling out from other parts of the body apart from the head, such as eyebrows or pubic hair.
Few Things You Can Do To Avoid This Hair Condition.
Firstly, hair is very fragile, so much so that a simple running of fingers through the hair and the hair could fall off. Wearing tight hairstyles such as tight ponytails or high buns or braids can cause tension in the hair strands and pull the hair follicles causing them to fall off. The next thing to remember is that irritation in the scalp followed by constant itching and scratching prompts more hair follicles to be released off the scalp.
Who Is More At Risk Of Telogen Effluvium?
Although Telogen effluvium is said to affect both men and women, it is seen that most cases are observed largely in women, especially those with thick and long hair since the hair thinning would be very easily noticed. It is also observed that because of the hormonal fluctuation in women especially during the menopausal phase or post-pregnancy, hair fall related to the Telogen phase is more common in women. Lastly, due to the different hairstyles experimented on women, this hair fall becomes more common in them. The level of shedding is usually high during the early stages and the hair may come out in clumps. If the person experiences telogen effluvium hair loss consistently over a period of 6 months it could become a case of chronic telogen effluvium, and at the time could extend to 7 years. The best thing would be to diagnose this at the right time and get the right hair fall treatment plan that would help manage telogen effluvium.
Treatment Options For Telogen Effluvium
Thankfully, there are a number of dermatological drugs that are clinically tested. These drugs or natural ingredients could be available in the form of a serum, foam booster, spray, or even tablets. These include the following:
This is an FDA-approved drug to treat hair loss. This is known as a stimulator, which means it stimulates or promotes hair growth. Here’s how it reverses the effect. Minoxidil, once applied, penetrates the scalp and carries out a vasodilating effect by which it increases the diameter of the blood vessels and promotes nutrient-rich blood flow to the scalp. This increases the diameter of the hair follicles giving stronger and thicker hair growth. It is a topical medication which means it has to be applied and not consumed. It is also available as an OTC (over-the-counter) medication in concentrations of 2% or 5%. However, the stronger dose is given only to men and not women.
Finasteride is now a DHT-blocker. It is available as a topical medication and in the form of tablets. It works by blocking the enzyme 5 alpha-reductase that converts testosterone to DHT. This in turn reverses the shrinking of hair follicles caused by the hormone DHT. Finasteride is also an FDA-approved medication to treat male pattern hair loss or hair loss caused due to the effect of the DHT hormone. Here, it is important to note the side effect of consuming the finasteride tablets, which can cause erectile dysfunction and decreased sex drive. On the other hand, the topical form is completely safe to use.
This is now a powerful tool when it comes to Telogen effluvium. It helps to get the hair cycle back into function and also improves stem cell renewal of hair cells thus bringing back stronger and thicker hair growth.
In a few cases where telogen effluvium is the result of an inflammatory condition in the body, corticosteroids may help in managing the condition. It sometimes also serves as a painkiller to the pain accompanied by Telogen effluvium.
- Ayurvedic Treatments :
Shiroabhyanga is a massage therapy using medicated and essential ayurvedic oils on your scalp, neck, and shoulders and could work wonders for telogen effluvium regrowth. Blood circulation improves as the oils penetrate the scalp tissues and rejuvenate them.
Shiro Lepa is the application of herbal paste on the scalp and helps in minimizing stress problems by deep conditioning your hair. The appropriate formulation needs to be selected on the basis of your dosha levels and your skin type. This is a very effective telogen effluvium cure.
Telogen Effluvium Diet Tips
Like every underlying health condition needs a specific diet to be maintained, likewise, a healthy diet is crucial for keeping this type of hair fall under control and thus stimulating the growth of new hair follicles.
- Increase Intake Of Vitamins
Among others, biotin is one of the main vitamins responsible for hair growth. This along with other vitamins helps to produce keratin which is the main protein required for ideal healthy hair growth. For vitamin B6, you can opt for chicken, and fish while B12 is available in eggs, meats, poultry, and milk. Vegans can look at fried beans, bananas, and potatoes as good sources of Vitamin B6.
Deficiencies of Vitamin C and D are said to cause Telogen effluvium and also make it difficult for hair to grow back again. Vitamin C is available in citrus fruits like oranges and kiwi while vitamin D can be found in dairy products.
- Include Zinc And Iron-Rich Foods
Micronutrients like iron and zinc are very important for healthy hair growth. Iron is required by the body as it is present in the blood in the form of hemoglobin carrying oxygen and other nutrients to the hair cells while zinc has been used to treat patients with Telogen effluvium. Foods rich in iron that one can incorporate into their diet include - green leafy veggies, red meat, liver, and lentils. Zinc-containing foods are pumpkin seeds and beef.
- Consume Foods Rich In Lysine
An essential amino acid that the body cannot produce on its own but can be acquired through foods rich in lysine. This specific amino acid helps in easier and faster absorption of iron and zinc in the hair thus leading to faster hair growth. One can simply have nuts, and sardines.
- Include Spinach In Your Diet
Spinach is very rich in folic acid, iron, and vitamins like A and C that promote hair growth. Vitamin A helps in producing sebum and thus moisturizes the scalp giving better hair growth.
Telogen effluvium is a very common type of hair fall mostly seen in women and less observed in men. It occurs due to severe stress or shock to the body. It could be due to a traumatic event or as simple as a fever. It commonly occurs within 3-6 months after a triggering event has occurred. It is mostly observed at the hairline or temples in most women due to constantly pulling or braiding hair. This type of hair fall, if treated on time, can be easily managed within 6 months. In most cases, no more than 50 percent of the hair is lost. Fixing diet is a must if one experiences hair fall of Telogen effluvium.
Q1 - How Do I Know If I Have Telogen Effluvium?
Ans - Most of the time, Telogen effluvium is very easy to detect. Hair appears very scanty on the scalp due to severe hair thinning. However, this hair thinning could either be limited to just a single area on the scalp or even all over the head.
Q2 - What Are The Main Causes Of Telogen Effluvium?
Ans - Telogen effluvium is a very common type of hair fall mostly seen in women and less observed in men. It occurs due to severe stress or shock to the body. It could be due to a traumatic event or as simple as a fever.
Q3 - How Long Does A Telogen Effluvium Last?
Ans - If treated on time, Telogen effluvium can be easily managed within 6 months. In most cases, no more than 50 percent of the hair is lost.
Q4 - What Is The Best Treatment For Telogen Effluvium?
Ans - There are a number of dermatological drugs that are clinically tested. These drugs or natural ingredients could be available OTC as well. Minoxidil, redensyl are some commonly used serums for telogen effluvium. However, even ayurvedic treatments that tackle internal root causes and maintain a healthy diet serve as important as dermatological treatments.