Telogen Effluvium:

loss from sudden severe stress

Delayed Shedding:  Telogen effluvium is when a sudden severe stress causes noticeable shedding of hair after the stressful event.  The hair loss is always delayed, usually 3-4 months after and sometimes 5 or 6 months after the stressful event.  The event can be a physical stress such as a heart attack, a severe illness with a high fever, a sudden weight changes, or a major surgical procedure.  Sudden severe emotional stress can also trigger telogen effluvium, including the death of a loved one, a divorce, or a job termination.

All Together Now: (Transition to Resting Phase):  In telogen effluvium, the sudden stressful event causes a high proportion of hair follicles to halt their growth phase prematurely, and to begin a transition to the resting phase at the same time.  Three to four months after the stressful event, a high proportion of follicles shed their hairs all at about the same time, as they prepare for a new cycle of growth.

Confusion:  Hair loss from telogen effluvium is often confusing, because the stressful event that triggered the loss occurred 3-4 months before the loss of hair.  Frequently the person losing hair has recovered from the event, and then they start shedding their hair in clumps!  The condition is usually temporary, and new hairs soon grow back in.  Within a few more months the normal random cycle of hair follicle growth and rest resumes.

Randomly Distributed Hair Loss:  Usually telogen effluvium results in random hair loss from all over the scalp.  Often the effect is not noticeable to others, although seeing the increased quantities of shed hairs is disturbing to their owner.  Treatment for telogen effluvium includes waiting for the new hairs to grow in, styling to give a fuller look, and counseling to address the stressful event, if appropriate.

Hair Loss after Childbirth:  childbirth, termination of pregnancy, and discontinuation of birth control ills, can also be severe stressful events and can trigger telogen effluvium primarily because of hormone level changes.  During pregnancy, a higher proportion of hair follicles continue growing hairs, and do not enter the resting state.  Some pregnant women notice that during their pregnancy their hair seems fuller than before, and this pleasant effect is because more of their hair follicles are growing hairs.  Shortly before childbirth however, the hair follicles that had delayed entering the resting stage over several months during pregnancy begin to make the transition to the resting stage all at the same time.  As a result, within a few months of childbirth, some women will experience increased shedding of hair, sometimes in alarming amounts.

Hair Loss from Other Pregnancy Terminations:  In addition to childbirth, other forms of pregnancy termination, including miscarriages and abortions, can also result in telogen effluvium, if a high proportion of the women's hair follicles had begun to postpone entering the resting stage during the pregnancy.  Most birth control pills work in part by adding hormones to fool a women's reproductive system into thinking g it is already pregnant.  The hormones added can affect hair growth.  In some cases, discontinuation of birth control pills can trigger telogen effluvium, similar to that suffered after childbirth.

Micro graft Hair Shedding:  Telogen effluvium also usually affects newly transplanted hair follicles in micro graft and mingraft procedures. Surgery is a sudden shock to the individual follicles.  The newly transplanted follicles make a transition to the resting stage shortly after they are transplanted, and 3-4 months later begin to grow new hairs.

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