It’s normal to lose 100 hairs throughout the course of a day. But what if you begin to find more hair in the shower drain or your brush?This may be due to telogen effluvium, a common condition that causes increased hair shedding.
Each hair follicle goes through a cycle of growth (anagen phase) and rest (telogen phase). Usually 10-15% of the hairs on your head are in the resting telogen phase, and these are the hairs that we lose on a daily basis. However, many triggers can cause a shift in the hair cycle, with 20-30% of the hair follicles entering the telogen phase. This results in 2-3 times more shedding than normal.
Telogen effluvium can usually be diagnosed by a patient’s history and physical exam. Your dermatologist will likely perform a pull test to get an idea of the degree of hair shedding that you are experiencing. He or she will also look for signs of other hair loss conditions, to rule out an inflammatory or scarring process. Occasionally a scalp biopsy may be necessary. Once telogen effluvium has been diagnosed, your dermatologist will ask questions to try to uncover the trigger, and may order laboratory tests to rule out reversible causes of telogen effluvium, such as thyroid disease or low iron stores.
What are some of the triggers for telogen effluvium?
- Hormonal changes following pregnancy or discontinuation of hormone replacement therapy
- A serious illness, trauma, hospitalization or surgery
- Thyroid dysfunction
- Chronic illnesses such as anemia or systemic lupus erythematosus
- Medications, especially certain blood pressure medications or blood thinners
- Rapid weight loss
- Major stress
Management of telogen effluvium involves 3 key steps:
- Treatment of any reversible triggers
- Supporting hair growth with minoxidil (Rogaine) and supplements
- Patiently waiting, while reassuring yourself that you will NOT go bald
There is a new supplement available called Viviscal that contains vitamins, minerals, and a fish-derived protein complex. The studies performed by the company look promising. I have just started recommending Viviscal to my patients with telogen effluvium, and am excited to get their feedback!
By: Allison K. Arthur, MD