An overview of telogen effluvium - a major alopecia cause

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Telogen effluvium - a major alopecia cause
Telogen effluvium (TE) is one of the most prominent alopecia causes. But it is a poorly defined condition and very little research has been done to understand this major hair disease.

Telogen Effluvium is an abnormal loss of hair which is due to the alteration of the normal hair growth cycle. The alteration of the normal hair cycle can be due to various factors. Normally, most of the hairs are in the growth stage and only around one hundred hairs fall from the scalp each day. When telogen effluvium occurs, a greater proportion of the hairs enter the resting phase of the cycle and hair shedding is greater than normal.

This prominent alopecia cause represents itself as diffuse thinning of hair on the scalp. The thinning may not be even all over. It can be a bit more severe in some areas of the scalp than others. There need not be any particular pattern to the hair thinning, but most frequently, the hair on top of the scalp thins more than it does at the sides and back of the scalp. There is usually no recession in the hair line, except in a few rare cases of chronic telogen effluvium.

In chronic Telogen Effluvium, other hair bearing areas of the body, like eyebrows and pubic hair, get affected. Whatever form of hair loss occurs, telogen efflivium is fully reversible as the hair follicles are not permanently affected.

The causes of telogen effluvium are varied and can be of variable intensity. Some of the common causes of telogen effluvium are temporary and hair growth recovers after a short period of time. Other causes of telogen effluvium are more persistent and consequently the hair loss continues. The causes of telogen effluvium are divided into the following categories:
  • General causes
  • Inadequate diet
  • Stress
General causes
The common causes of hair loss and telogen effluvium are generally due to various reasons like vaccinations, physical trauma like being in a car crash, and having surgery or intake of medicines. These factors can sometime create a shock to the system and a proportion of scalp hair follicles go into hibernation. As the environmental shock is short term the body soon recovers from TE after a period of time and the new hair growth is resumed.

Imbalance in the level of hormones can also trigger Telogen Effluvium. There is a sudden change in hormone levels after pregnancy in women. This sudden hormonal change 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.

A lack of an adequate diet also causes Telogen Effluvium. Also there is a common loss of iron in women at regular intervals as a result of menstruation. Some dermatologists believe that a reduced intake of red meat, a key source of iron, causes increased hair loss. (Read the role of well-balanced diet in hair growth)

Many dermatologists believe chronic stress can gradually exert negative effect on hair growth and lead to persistent Telogen Effluvium.

Long term chronic stress, depression, and sudden intense anxiety may promote the onset of telogen effluvium. The hair loss may develop and become noticeable in a few weeks to four months of time.

The mechanism by which stress affects hair follicles is not known. But it is suggested that hair follicles are surrounded and invaded by an intimate network of nerve cells. Potentially, any adverse chemical activity in the nervous system might send adverse signals to hair follicles.

This major alopecia cause can be of three different types which are divided on the basis of the various time periods. The different types of Telogen effluvium found in human scalp are:
  • Short
  • Long
  • chronic
Telogen Effluvium for a short time period
With a short period of telogen effluvium, the hair shedding becomes easily noticeable in one or two months. In this type of alopecia cause there is an increase in hair shedding and a diffuse thinning of hair is seen in the scalp. This short term hair shedding can be due to common factors like surgery or illness.

But as the intensity of the causal factor is short lived, the hair follicles will return to their growing state and start producing new hair fibers pretty quickly. This form of alopecia cause usually lasts less than 6 months and the affected individual has a normal scalp hair density again within a year.

Long duration of hair loss
There is an another type of telogen effluvium that causes alopecia to develop more slowly and persist for a longer period of time. In this slower developing telogen effluvium the hair loss doesn't occur at an increased rate. Rather the normal hair shedding pattern of hair growth cycles are been followed. But the problem arouses when the hair follicles instead of returning to anagen or growth phase after a month or two, stay in telogen phase for an uncertain period.

This results in a gradual accumulation of hair follicles in a telogen state and progressively fewer and fewer anagen hair follicles are left for hair growth. In this form of telogen effluvium, there may not be much noticeable hair shedding, but there will be a slow thinning of the scalp hair.

Chronic hair loss for unknown period
There is also a third, chronic state of telogen effluvium where hair follicles do not stay in a resting state but rather cycle through improper or truncated hair growth cycles. When this happens, the individual experiences thin scalp hair and persistent shedding of short, thin hair fibers.

Relation to other hair diseases
Telogen effluvium is a major alopecia cause that can occur on its own or it can also occur as part of another disease. The early stages of androgenetic alopecia is effectively telogen effluvium. Androgentic alopecia at an early stage sometimes manifests itself by a large amount of hair shedding which is due to the sudden increase of a number of telogen hair follicles. Telogen effluvium can also be seen as a symptom of other major hair loss causes like alopecia areata.

The treatment of telogen effluvium depends on the causal factors. For example, on diagnosis if it is found that surgery is the reason for the telogen effluvium the best response is to sit tight and wait for the follicles to recover of their own accord. But if stress is the cause, stress reduction is the answer. If a dietary deficiency becomes evident then various vitamins and mineral supplements can work.

But if the cause is not detected on diagnosis then treatments are necessary to prevent the alopecia cause due to telogen effluvium.

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