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Dr. Bertram Medical Hair Transplant
眉 髮 醫 學 移 植 中 心 ( 香 港 ) |
( 852 ) 3421-1138
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Hair Loss in Women - Telogen Effluvium
Telogen Effluvium ( TE ) is the second most common form of hair loss in female.
Causes
TE is from disturbance of the normal hair cycle. A significant number of actively growing anagen follicles are shifted into the resting telogen state. An abnormal high number of normal hairs become "club hairs" (see "Hair Cycle". Club hairs remain in the resting follicles for 3 to 4 months before shedding. Diffuse hair loss occurs when all these club hairs are shed simultaneously.
Source of picture - clevelandclinicmeded.com
Clinical Presentation
TE appears as a diffuse thinning of hair, affecting mainly the top and sides of the scalp but sparing the hairline. The shedding is more than the usual 100 hairs per day. Typically there is never complete loss of all scalp hair.
There are three basic ways TE can develop :
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1. An acute event that "shocks" the growing hair follicles into a resting state for a while (see below). Hair loss is noticeable one or two months after the events. On removal of the triggering factors, the hair follicles re-grow so the hair loss lasts less than six months. The patient will have a normal scalp hair density again within a year.
2. In the second form there is a persistent trigger factor. Hair loss develops more slowly and persists longer. Progressively fewer anagen hair follicles are left to grow hair and with a much noticeable hair shedding.
3. In a third type of TE, the hair follicles do not stay in telogen but enter into shorted cycles. The individual experiences thin scalp hair and persistent shedding of short, thin hair fibers.
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Triggering Factors
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Short term shock to the scalp hair follicles
- Soon after giving birth ( postpartum alopecia )
- Vaccinations
- Crash dieting
- Acute blood loss
- Physical trauma, accident, surgery and general anesthesia
- Acute psychiatric Illness or significant emotional stress
- Physical illness especially with prolonged and high fever
- Discontinuation of the Oral contraceptive pills
Persistent insult to the scalp hair follicles
- Chronic illness such as thyroid disorders
- Chronic stress
- Diet deficiency - A lack of a mineral, vitamin, or protein
- Prolonged exposure to toxins
- Widespread skin disease
- Drug therapy - see the Full Drug List.
- Chronic idiopathic form of TE in middle-aged women. There is no known cause. The onset is sudden lasting 6 months to 6 years or more. Good prognosis of regrowth.
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Treatments for Telogen Effluvium
How TE is treated depends on what has activated it.
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Type 1 : Short-term TE triggered by an acute event
The best response is to wait for the follicles to recover.
Type 2 : Persistent TE
Identify and remove the causal factors.
Type 3 : No specific causal factor can be identified
Treatment options is Minoxidil, a direct hair growth stimulator. It can work well for some individuals with TE but must be continued if the underlying cause is still present, With removal of the trigger, minoxidil can be stopped.
Diet and Supplement
When dietary deficiencies are suspected, supplements may be taken. However, excessive supplements themselves can cause problems. Our bodies can only process so much iron each day. At high doses, iron is toxic and this can itself cause hair loss. Excessive vitamin A can also be toxic and can cause a TE reaction in some individuals.
Vegan vegetarians or any patient on a very restricted diet are at risk for diffuse hair loss from deficiencies of protein, iron, zinc, and fatty acid.
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Prognosis
Whatever form of hair loss TE takes, it is fully reversible in the majority of cases. The hair follicles are not permanently or irreversibly affected; there are just more hair follicles in a resting state than there should normally be.
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