Telogen Effluvium and Other Effluviums
Treatments for Telogen Effluvium continued...
Before leaving the subject of TE, here are a few words about natural hair
shedding. Everyone sheds hair and you may see more hair shed at certain times
of the year. Studies show that humans, at least in Northern Europe away from
the equator, shed more hair in the fall and to a lesser extent in the
This temporary increase in the number of telogen hair follicles and shed
hair is probably due to changes in hormones in response to changes in daylight
exposure. Studies in mink and other mammals show that daylight exposure
significantly alters prolactin levels and that prolactin has a significant
effect on molting. As with mink and other mammals, humans probably have much
the same molting response. Such hair loss should be temporary.
Anagen effluvium is a diffuse hair loss like telogen effluvium, but it
develops much more quickly and can cause individuals to lose all their hair.
Anagen effluvium is most frequently seen in people taking cytostatic drugs for
cancer or those who have ingested toxic products like rat poison.
Substances of this type inhibit rapid cell proliferation. This is a
desirable factor if you are trying to block the development of a cancer, but
the cells of hair follicles are some of the most rapidly proliferating,
noncancerous cells the body has. Hair fiber from scalp hair follicles grows at
up to 0.4mm a day and that rate of growth requires a lot of cell proliferation.
Cytostatic cancer drugs and various toxins and poisons inhibit rapid cell
growth, including the proliferation of cells in the hair follicles. The result
is a sudden shut down of hair fiber production.
The onset of anagen effluvium is very rapid. Some individuals who start
taking anti-cancer drugs can literally pull their hair out in clumps within the
first two weeks. Because these drugs act so quickly and are so potent, the hair
follicles have no time to enter into a telogen resting state, as with telogen
effluvium, a response to a more moderate environmental challenge.
Instead, in anagen effluvium the hair follicles enter a state of suspended
animation, frozen in time. The hair fibers fall out quickly, but instead of
looking like typical telogen hairs with little bulbs of keratin on the root
end, the hairs that fall out are mostly dystrophic anagen hairs with a tapered
or sometimes feathered root end.
With cytostatic anti-cancer drugs, the degree of hair loss varies from
person to person. Some people may have a mixture of anagen effluvium and
telogen effluvium and have more limited hair loss.
Some cancer treatment centers try to block the hair loss using a cold
therapy. More popular in Europe than North America, cold therapy involves
covering the scalp with ice packs or using a special hood filled with cold
water while the anti-cancer drugs are given. The cold sends the hair follicles
into suspended animation prior to contact with the drug. This stops the hair
follicle cells from taking up the drug and being damaged by it. The result is
much less drug-induced hair loss. However, doctors worry that any cancer cells
in the skin may also avoid the anti-cancer drugs if cold therapy is given
during drug treatment.