Telogen effluvium: Understanding hair loss

The medical term for general hair loss is alopecia. There are different types of alopecias with their own causes and symptoms. All forms of alopecia can be divided into one of two categories, it is either a temporary, or non-scarring (non-cicatricial) form of alopecia, which can be reversed with topical and oral medications, or permanent scarring alopecia (cicatricial). The most common forms of temporary hair loss include telogen effluvium, alopecia areata and androgenic hair loss, which is commonly known as female and male patterned hair loss (typically experienced later in life). Considering there are so many forms of alopecia, it is necessary to specify which condition you are referring to when delving into what the condition is.

Telogen effluvium

This form of hair loss is commonly experienced by people of all ages. It occurs when the hair that is naturally lost in our daily lives is greater than the growth of new hair. An average amount of hair loss to experience per day is around 30 – 150 hairs. Our hair goes through natural stages, telogen is the shedding phase and anagen is the new growth phase. 30 – 150 hairs is equal to around 10% of the hair. In telogen effluvium cases, that 10% goes up to around 30%, meaning more hair is lost than is replaced leading to thinning and loss of hair.

What causes telogen effluvium?

Telogen effluvium occurs when the normal hair growth and shedding cycles are disrupted. Catalysts for this condition include childbirth, extreme dieting and weight loss, sickness or injury, changing medications or weaning from hormonal products, scalp and skin conditions that affect hair growth, severe physical or emotional trauma or life-changing events (like the death of a loved one). Telogen effluvium can occur at any age to both genders and is not hereditary.

The symptoms of telogen effluvium

Hair thins equally all around the scalp, making the overall appearance of the hair meager and minimal. There are no marked patches of baldness.

How is telogen effluvium treated?

This condition generally resolves itself within 100 days, if it lasts longer than 6 months it is considered chronic telogen effluvium. It’s best to understand the cause of the condition in order to ensure it does not recur once it resolves itself. In extreme cases where the loss of hair is severe, medication may help to speed recovery as it can take many months before the entire head of hair regains its former volume and lustre.

Who gets hair loss?

Some forms of alopecia, like alopecia areata and telogen effluvium can occur to anyone at almost any age. Other forms of areata, like androgenetic hair loss tends to happen to people older than 40 or 50 years of age, although male pattern hair loss can occur at any point after puberty. A genetic predisposition certainly plays an important role. Proper hair care can prevent hair loss as some forms of alopecia are linked to tight hairstyles, like braids and weaves.

Hair loss and scalp disorders with Dr. Nokubonga Khoza.

Our hair loss and scalp disorders consultation take about 20-30 minutes. Only conditions relating to the scalp will be discussed during this session. All patients are expected to fill out a pre-assessment form on arrival to the practice. There are many causes of hair loss and scalp disorders and surprisingly they can look similar. Dr. Khoza’s primary goal is to provide the highest level of care when it comes to skin and scalp disorders. Our hair consults focus is on proper diagnosis, non-surgical management, counselling and preventing further disease progression.

During the consultation, Dr. Khoza will review the patients past medical history, medication, hair grooming practices, and styling. She will examine the scalp with the use of dermoscopy and take relevant pictures. Should there be a need; Dr. Khoza may order blood tests, take hair samples and perform a scalp biopsy. Dr Khoza performs the following in-office procedures for hair loss; Platelet rich plasma, micro-needling and intralesional injections.

Please note all procedures are scheduled for a separate appointment and are not performed on the same day as the initial consultation.

Estimated time for procedures:

1. Scalp biopsy – 20 minutes
2. Intralesional scalp injections – 10 minutes
3. Micro-needling – 30 minutes
4. Platelet Rich Plasma – 1hour

How to prepare for your consultation with Dr. Khoza

1. Take careful note of your symptoms. It is important to give Dr. Khoza an accurate description of what you have been experiencing. Has the hair been falling out gradually? Has it been only in certain patches, or has it been a constant and ongoing “loss” from all over the scalp?
2. Think of any changes in your life that may coincide with the hair loss. Have you been taking a new medication, or have you stopped using a medication? Have you changed your level of physical activity? Have you gone through any major stresses, changed your diet, started or stopped taking any vitamins, or used a new hair or skin product, like shampoo?
3. Be prepared for questions. Dr. Khoza will also want to know if hair loss runs in your family, and if so, at what age did your relatives experience hair loss for the first time?
4. Dr. Khoza will examine your scalp during the consultation. Sebum, or oil, can sometimes play an important role in hair loss, so it may be advised to avoid washing your hair for a day or two prior to the appointment.
5. Bring a list of medications used in the last two years.
6. Bring latest bloods if you have done any in the last six months.
7. It always helps to bring all current hair and scalp products.
8. Bring old photos up to 5 years prior if possible.
9. Keep a positive outlook.