Telogen Effluvium and Other Effluviums
Telogen Effluvium continued...
2. The second form of TE develops more slowly and persists longer. The hair
follicles may not all suddenly shed their hair fibers and enter a resting
telogen state. Rather, the follicles may enter a resting state as they normally
would, but instead of returning to a new anagen hair growing state after a
month or two, they stay in their telogen state for a prolonged period of
This results in a gradual accumulation of hair follicles in a telogen state
and progressively fewer and fewer anagen hair follicles are left growing hair.
In this form of TE, there may not be much noticeable hair shedding, but there
will be a slow thinning of the scalp hair. This form of TE is more likely to
occur in response to a persistent trigger factor.
3. In a third type of TE, the hair follicles do not stay in a resting state
but rather cycle through truncated growth cycles. When this happens, the
individual experiences thin scalp hair and persistent shedding of short, thin
Causes of Telogen Effluvium: Stress and Diet
What are the trigger factors for TE? The short answer is many and varied.
Classic short-term TE often happens to women soon after giving birth. Called
postpartum alopecia, the sudden change in hormone levels at birth is such a
shock to the hair follicles that they shut down for a while. There may be some
significant hair shedding, but most women regrow their hair quickly.
Similarly, vaccinations, crash dieting, physical trauma such as being in a
car crash, and having surgery can sometimes be a shock to the system and a
proportion of scalp hair follicles go into hibernation. As the environmental
insult passes and the body recovers, the TE subsides and there is new hair
Some drugs may also induce TE, especially antidepressants. Often a switch to
a different drug resolves the issue.
More persistent insults can result in more persistent TE. For example, a
chronic illness may lead to TE. Arguably, the two most common problems are
chronic stress and diet deficiency. Many dermatologists believe chronic stress
can gradually exert a negative effect on hair growth and lead to persistent TE.
Research with animal models has provided evidence to back up this claim. There
does indeed seem to be a link between stress, a change in hair follicle
biochemistry, and more hair follicles entering a telogen resting state.
Whether dietary problems are causing TE in North America is hotly argued
among dermatologists. A lack of a mineral, vitamin, or essential amino acid can
certainly cause TE, such as with people in third world countries where diets
can be completely deficient in one or more nutrients. Animal experiments also
provide supporting evidence.