Telogen effluvium.. Bless you!

What is telogen effluvium?

Telogen effluvium is the significant or noticeable TEMPORARY hair loss/shedding that is experienced after a significant stress to the body such as surgery, pregnancy, illness (can be chronic such as diseases including autoimmune, thyroid disease, iron deficiency, hormonal imbalances, stress; or it can be acute such as severe infection, crash dieting, severe trauma, etc.); additionally, this may be a side experience of some medications. This hair loss is not noticed immediately after the event but is usually noticed 1-6 months (average of 3 mos.) after the fact. Hair growth usually begins to resume about 6 mos. after the cause with the results being seen in an additional 3 mos. (especially for hairs on the head due to the longer length we grow). 

A large quantity of the hairs that are in the anagen/growth phase suddenly become telogen/resting - these now telogen hairs do not grow which means they are not going through the hair growth cycles for an average of three months - this is not yet noticed by the individual experiencing telogen effluvium. The hairs do return to the hair growth cycle and re-enter the anagen phase. When the hairs resume the anagen phase the hairs that had been stuck in the telogen phase are released and then the shedding is observed by the individual.

In a normal healthy person’s scalp, 85% of the hairs are in the anagen phase and 15% are in the telogen phase. A few hairs are in the catagen phase. A stress to the body may cause 70% of the anagen hairs to switch to the telogen phase which causes the hair loss. 

Make it make sense:

Most commonly, women experience significant hair loss about 3 mos. after delivering their baby. They are usually shocked, unhappy and experience distress over this because sometimes the hair comes out in frequent medium sized clumps. They do report seeing “baby hairs” regrowing in about 6+ mos. from the noticed hair loss. 

Also, people that undergo a surgery may notice some hair loss 2-6mos. later, but do not complain long-term of hair loss. 

In pregnancy and surgery, our bodies are putting the focus on healing which includes getting rid of edema (swelling), inflammation, and regulating our daily vital functions like blood pressure, oxygen retention, heart rate in addition to returning our organ functions to their baseline such as liver, kidneys, etc. that are affected from surgery/anesthesia. The least important in the grand scheme of these things is growing the hair on our heads and it is not given priority but will resume once our bodies are functioning in harmony again.  

How do you treat it?

-Telogen effluvium is usually a survival response of the body. Our bodies are making it a priority to heal and growing our hair is not at the top of its list at this time, it will return to growing our hair after inflammation has subsided and the body is regulated and back to its baseline. 

-If the cause is from a medication, hair growth will resume once that medication is stopped. Follow your prescribing doctors recommendation on medication usage. Discuss the hair loss you are experiencing after starting medication(s) with your doctor as there may be an alternative. 

-If the cause is hormonal or from diet/dietary changes, the hair growth will resume once the cause is corrected. 

-There is no need for hair transplantation if you are experiencing telogen effluvium as the hair growth will resume. 

-Topical and/or minoxidil may be used at your discretion, there is no evidence that it will speed up the growth of the hair. This is because of the timeline of hair loss being noticed and at the time it is noticed the follicles have already begun to regrow. 

 Important takeaways:

Telogen effluvium is a temporary and reversible hair loss/shedding as a survival response to a major life event such as surgery, pregnancy, chronic stress, etc. No treatment is needed as the hairs resume regrowing. 

How does it relate to electrolysis?

I find that since we are literally shocking hair follicles and disturbing them especially in the first few treatments many people experience a “false positive” result, where they report not having the hair regrow for a few weeks and I believe “if it is too good to be true, then it probably is” and to achieve permanent hair removal in less than 10 sessions is not impossible but rare (too many perfect conditions need to be in place such as: perfect probe insertion, perfect amount of energy placed into the hair follicle, a blood supply for the hair follicle that is not too large, hair in the anagen phase, etc.) so these clients are likely experiencing telogen effluvium. Clients will say that they thought they were done after a few treatments and then return when these hairs have resumed their normal (for now) growth cycle and they think there are more hairs since it has been a few weeks without. Electrolysis is a big direct shock to the individual hair follicle and those hairs go into a telogen effluvium reaction that is extremely short lived compared to when the body undergoes a chronic systemic stress but essentially the same localized response. 

Terminology

Acute - any condition that lasts 6 months or less

Chronic - any condition that lasts longer than 6 mos. 

Phases of hair growth:

All hairs all over the body cycle through the phases of hair growth. How long is a hair in each phase? This is dependent on the area and can be anywhere from days to weeks, and it is extremely important to note that not all of the hairs in one area (for example: the head) are in one phase (this is why we have many hairs on our head that grow and shed and we only experience minimal hair loss and maintain the majority of our hairs); in other words all of the hairs on our head are cycling through the hair growth phases on a continuous basis at different times - again look at all this work our body is doing just to grow hair!!

Anagen - the hair is attached to the blood supply (hair is actively growing); this new hair is coming in and pushes the old hair (which is currently in the telogen phase) out of the follicle to enter its new home and shedding may be noticed

Catagen - the hair is beginning to separate from the blood supply but there is still some connection to the blood supply (hair is grown and may have some minor growth still occur before entering the telogen phase)

Telogen - rest phase; hair is separated from the blood supply and is shed from the follicle to allow new hair to grow in its place (this happens to hair all over our body, more commonly seen with hair on the head since they are generally grown long and shedding is visualized with brushing and washing the hair)