Telogen Effluvium: Causes, Treatment, Prevention, and Regrowth

Telogen effluvium woman looking at hair

Have you ever noticed a sudden increase in the amount of hair shedding when you comb or shampoo? It could be a temporary hair loss condition known as Telogen Effluvium, which is caused by stress or hormonal imbalances.

This condition may not be as well-known as common baldness, but it can be just as distressing.

Let’s delve into the intricate world of hair growth cycles to understand Telogen Effluvium better.

Short Summary

  • Telogen Effluvium is a temporary hair loss condition caused by stressors or hormone imbalances.

  • Identifying and eliminating underlying causes, correcting nutritional deficiencies, employing gentle hair care techniques, and using medications can help manage symptoms of telogen effluvium.

  • Implementing healthy lifestyle changes such as reducing stress levels and avoiding potential triggers are effective strategies for preventing telogen effluvium.

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Understanding Telogen Effluvium

There are different types of hair loss.

Telogen Effluvium is a condition characterized by temporary hair loss caused by stressors or imbalances in hormones, affecting the hair follicle.

This condition disrupts the normal hair cycle, leading to temporary scalp hair loss.

As you may suspect, it’s not just emotional stress that can trigger this condition. Several medical conditions such as:

  • Hyper- and hypothyroidism

  • Medications

  • Iron deficiency or excess

  • Nutritional deficiencies or excesses

Certain factors can induce telogen effluvium, which may be a result of a prolonged telogen phase.


The hair growth cycle comprises three stages:

  1. Anagen phase: the active growth phase, during which only anagen hair shaft matures.

  2. Catagen phase: a transition period.

  3. Telogen phase: the final stage during which the telogen hair, also known as club hair, is released from the follicle, leading to diffuse telogen hair loss in cases of Telogen Effluvium.

It is estimated that in a healthy individual’s scalp, approximately 85% of the hair follicles are in the active growth phase (anagen), and approximately 15% are in the resting phase (telogen).

Headington has proposed five distinct functional types of telogen effluvium, based on alterations in specific phases of the follicular cycle, including the anagen phase.

Understanding these types can help us differentiate between acute and chronic forms of the condition. The five types are:

  1. Anagen effluvium

  2. Telogen effluvium

  3. Chronic telogen effluvium

  4. Acute telogen effluvium

  5. Diffuse alopecia areata

These types and telogen effluvium treatment will be discussed in the following subsections.

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Acute Telogen Effluvium

Imagine you’re going through an extremely stressful period or recovering from a major illness.

Then suddenly, you notice an increase in hair shedding. If this sounds familiar, you may have experienced acute telogen effluvium.

Acute telogen effluvium symptoms are characterized by sudden hair shedding following a triggering event, this condition is a response of your hair follicles to the stress your body has undergone.

Common causes of acute telogen effluvium include having a surgery, sudden loss of weight, divorce, or high levels of stress.

Good news! Acute telogen effluvium can be reversed in most cases (95%). Positive prognosis and improvement is expected. So, for most people, this hair loss is only temporary.

However, it can be quite alarming when it occurs, especially if you’re not aware of the cause.

Tools like video dermoscopy can help in diagnosing this condition by enabling a detailed inspection of the scalp and hair.

Chronic Telogen Effluvium

On the other hand, chronic telogen effluvium is a more drawn-out condition.

Chronic telogen effluvium symptoms involve extended periods of hair shedding without full baldness.

This form of telogen effluvium is typically observed in women aged 30-60, who have thick and moderately long hair.

Examining the scalp carefully reveals that the area in the front and on both temples has shorter hair that is beginning to regrow.

The rest of the scalp, however, shows normal thickness of hair, indicating that hair loss varies in this condition.

Chronic telogen effluvium does not cause complete baldness.

However, it can indicate a hereditary tendency to baldness, such as female pattern hair loss in women or male pattern hair loss in men.

It has been reported that the anagen:telogen ratio in chronic telogen effluvium is 8:1 as opposed to the 14:1 ratio observed in normal scalp biopsies.

This shift in ratio signifies a delay in the transition from telogen to anagen phase, prolonging the resting phase and resulting in increased shedding.

Let's explore the causes of chronic telogen effluvium.


Identifying Causes of Telogen Effluvium

Now that we have understood the types of telogen effluvium, let’s delve into the triggering factors.

Telogen effluvium is caused by a sudden shock to the hair follicles, such as a major illness, surgery, or a change in hormones.

This shock pushes a large number of hair follicles into the telogen phase prematurely, resulting in increased shedding.

Apart from physical stressors such as surgical trauma or chronic systemic illness, mental stressors like emotional trauma, depression, and anxiety can also trigger this condition.

Additionally, certain nutritional deficiencies can induce telogen effluvium.

Severe protein, fatty acid and zinc deficiency, chronic starvation, caloric restriction, and even vitamin D and biotin deficiency can all play a role.

Telogen effluvium treatment consists of balanced diet, stable body weight,stress management and diagnosis of the underlying causes.

Symptoms and Signs of Telogen Effluvium

Telogen effluvium manifests as an increase in the amount of hair shed, resulting in thinning hair on the scalp.

This thinning is typically diffuse, meaning that it occurs all over the scalp rather than in patches.

It’s important to note that the thinning may not be noticeable until the hair loss is substantial.

Another symptom that some individuals with telogen effluvium may experience is trichodynia. Trichodynia is characterized by symptoms such as:

  • tenderness

  • pain

  • burning

  • itching

  • stinging

  • tingling

These symptoms can add to the distress caused by the hair loss, making it even more important to seek treatment and manage the condition effectively.

It's important to differentiate telogen effluvium from traction alopecia, which is a different type of hair loss caused by pressure on the hair follicles.

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Diagnosing Telogen Effluvium

Diagnosing telogen effluvium symptoms involves a physical examination, a pull test, and a thorough review of the individual’s medical history.

In cases where there is excessive shedding of hair that lasts longer than six months, it is advisable to undergo a scalp biopsy.

This will help diagnose the underlying cause of telogen loss.

The pull test involves gently pulling on the hair to see how many hairs come out.

If more than ten hairs are removed, the test is considered positive for telogen effluvium.

Diagnostic tests such as the hair pull test, hair pluck test, and wash test are utilized to confirm the diagnosis of telogen effluvium.

Moreover, a trichogram, a plucking of hair in a defined area, and the modified wash test, are also used to determine the presence of telogen effluvium or androgenetic alopecia, as well as the severity of such conditions.

Telogen Effluvium Treatment Options

Once it has been diagnosed, telogen effluvium treatment can begin. Treatment options for telogen effluvium include:

  • Identifying and eliminating any underlying causes

  • Correcting any nutritional deficiencies through dietary changes

  • Employing gentle hair care techniques

  • Trying out any relevant over-the-counter products

By addressing the root cause, the hair growth cycle can be restored, leading to a reduction in hair shedding and an increase in hair growth.

Medical professionals may also prescribe topical minoxidil or oral finasteride, especially in more severe cases of telogen effluvium.

These medications can help stimulate the hair follicles and promote hair growth. However, they should be used under the guidance of a healthcare provider to ensure safety and efficacy.

Medications and Topical Treatments

Corticosteroids and minoxidil are commonly employed to treat telogen effluvium.

Corticosteroids can help to reduce inflammation and stimulate hair growth, while minoxidil works by prolonging the growth phase of the hair follicles, leading to thicker, fuller hair.

It’s important to note that some medications can actually trigger telogen effluvium. These include:

  • Oral contraceptive pills

  • Androgens

  • Retinoids

  • Beta-blockers

  • ACE inhibitors

  • Anticonvulsants

  • Antidepressants

  • Anticoagulants (heparin)

If you suspect that your hair loss may be linked to a medication you’re taking, it’s important to speak with your healthcare provider about possible alternatives.

Lifestyle Changes and Stress Management

In addition to medications and topical treatments, lifestyle modifications and stress management techniques can assist in alleviating telogen effluvium symptoms and promoting hair regrowth.

It is essential to reduce stress levels and implement relaxation techniques such as yoga, meditation, and deep breathing.

Consuming a balanced diet and obtaining sufficient sleep can also be beneficial.

Ensuring that you’re getting enough protein, iron, and other essential nutrients can help support healthy hair growth.

Additionally, avoiding harsh hair treatments, heat styling, and coloring or bleaching the hair can also help to prevent further hair loss and promote hair regrowth.

Prevention Strategies for Telogen Effluvium

Preventing telogen effluvium involves:

  • Maintaining a healthy diet

  • Managing stress

  • Avoiding potential triggers

  • Consuming a nutrient-rich and balanced diet

  • Managing stress levels

  • Abstaining from harsh hair treatments

These practices can assist in decreasing the likelihood of telogen effluvium.

Maintaining healthy lifestyle and hair is the optimal method of preventing telogen effluvium.

Strategies to achieve healthy hair include sustaining a nutritious diet, managing stress levels, and avoiding potential triggers.

By taking these preventive measures, you can help preserve the health of your hair and reduce the risk of experiencing telogen effluvium.

Telogen Effluvium Treatment and Hair Growth

The prognosis of telogen effluvium is generally optimistic, with hair growth observed in approximately 6 to 8 months.

So, if you’ve been diagnosed with telogen effluvium, rest assured that your hair will regrow following the condition.

The rate of hair regrowth can vary from person to person, and it may take several months to a year for the hair to return to its previous thickness.

Factors such as overall health, nutritional vitamins, and stress management can influence the rate of hair regrowth.

Therefore, it’s important to focus on overall health and wellbeing during the recovery period.

Telogen Effluvium vs. Androgenic Alopecia

While telogen effluvium and androgenic alopecia are both hair loss conditions, they have distinct differences.

Telogen effluvium does not cause hair loss in the form of bald patches, as seen with male and female pattern hair thinning.

Instead, it leads to greater overall shedding or thinning of the hair on the scalp.

Hair loss is one of the common problems faced by a lot of people. It produces overall thinning of hair and diffuse hair loss.

Telogen effluvium is caused by a sudden shock to the hair follicles, such as a major illness, surgery, or a change in hormones.

On the other hand, androgenic alopecia, or male or female pattern baldness is caused by a combination of genetics and hormones.

Telogen effluvium is marked by widespread hair loss, while androgenic alopecia is identified by bald patches on the scalp.

Treatment options for these conditions also vary.

Telogen effluvium treatment options include medications, lifestyle modifications, and stress management.

As for androgenic alopecia, medications, topical treatments, and hair transplantation are available treatments.

This highlights the need for correct diagnosis to ensure appropriate treatment.


Understanding the intricacies of the hair growth cycle and the role of stress and other factors in disrupting this cycle can give us great insight into conditions like telogen effluvium.

We’ve learned that telogen effluvium, whether acute or chronic, can be triggered by various physical, mental, and chemical stressors.

We have also seen that it is a temporary condition, with the hair typically regrowing within a few months.

While telogen effluvium can be distressing, it’s important to remember that it’s usually temporary, and with the right treatment and lifestyle changes, your hair and hair can return to its normal growth cycle.

So, keep calm, manage stress, and nourish your body with a balanced diet to ensure healthy, vibrant hair.

Frequently Asked Questions

How do you know if you have telogen effluvium?

If you are experiencing increased hair loss and thinning of the scalp, as well as dry hairs that come out easily, it is likely that you have telogen effluvium.

To confirm the diagnosis, collect 100 or more hairs in a 24-hour period for three or four weeks. If diagnosis is confirmed, it is best to start telogen effluvium treatment quickly to address the underlying causes.

What does hair loss from telogen effluvium look like?

Telogen effluvium generally causes diffuse hair loss that produces a thin look throughout the scalp, leaving the hairline intact but reducing the overall hair count.

This type of hair loss is usually temporary and can be caused by a variety of factors, such as stress, hormonal changes, or certain medications.

Treatment for telogen effluvium usually involves addressing the underlying cause and managing the symptoms.

Does your hair fully recover from telogen effluvium?

In 95% of cases, telogen effluvium can be fully recovered from when the triggers are identified and it typically does not last longer than 6 months.

Should you cut your hair if you have telogen effluvium?

Given that a haircut can help disguise the hair loss and thinning associated with telogen effluvium, it may be beneficial to consult a hairstylist for a cut that works best with your hair texture while waiting for regrowth.

This cut should be tailored to your individual needs and should be easy to maintain.

It should also be designed to minimize the appearance of thinning hair and to make the most of the hair you have.

What is the fastest way to cure telogen effluvium?

The fastest way to cure telogen effluvium is through diet modifications, gentle hair care practices, over-the-counter medications, hormone replacement therapy, and stress management.

Telogen effluvium treatment can be tricky as you have to methodically work through the different reasons behind it.

What are some telogen effluvium symptoms?

Telogen effluvium symptoms include excessive hair shedding from the scalp, often noticed while washing or brushing the hair.

This condition may result in diffuse thinning across the whole scalp but typically doesn't cause complete baldness.

How long does telogen effluvium treatment last?

Treatment duration for telogen effluvium varies based on the underlying cause.

Once the cause is addressed, hair typically starts regrowing in 3-6 months. However, it may take 6-12 months or more for the hair to regain its normal fullness.

Are there any other types of hair loss types?

The other types of hair loss include alopecia areata, traction alopecia and scarring alopecia.