Telogen effluvium is the second most common form of hair loss after androgenetic alopecia, and one of the most alarming. It causes sudden, diffuse shedding across the scalp, typically triggered by events that put extreme stress on the body such as illness, surgery, childbirth, or emotional trauma. The good news is that it’s usually temporary, resolving within six months in most cases. Below we break down the types, triggers, and treatment options
Types of Telogen Effluvium
Telogen effluvium can be split into two different types of hair loss: active telogen effluvium and chronic telogen effluvium, defined by their duration.
In 95% of cases, telogen effluvium resolves on its own. If it doesn’t, it may turn into chronic telogen effluvium. Interestingly, in many cases (especially with females) telogen effluvium can co-present with androgenetic alopecia, meaning many women will have two types of hair loss.
Learn more: Why am I losing so much hair as a female?
Acute Telogen Effluvium
This type of hair shedding doesn’t usually last longer than 6 months. It generally begins 2-3 months after the trigger (we discuss these below) before resolving on its own within 6 months.
Chronic Telogen Effluvium
You may have guessed it. Chronic telogen effluvium lasts longer than 6 months and mostly presents in middle-aged women. Hair continues to shed in greater volume for a long time — sometimes even for years.
We don’t know enough about telogen effluvium to understand why this occurs but it shouldn’t lead to complete balding.
What Are the Signs of Telogen Effluvium?
The defining characteristic of telogen effluvium is diffuse thinning all over the scalp.
Though it affects both males and females, it may have a higher incidence rate in females. A lot of women notice their ponytails becoming significantly smaller.
Unlike androgenic alopecia, the onset of telogen effluvium hair loss can be sudden and alarming with clumps of hair falling out in one go.
In severe cases, hair loss can also occur in other areas of the body, such as the eyebrows or the pubic region.
| Signs of telogen effluvium | Things that won’t generally happen with TE |
|---|---|
| Thinning all over | Receding hairline |
| Sudden hair loss over weeks or months | Gradual hair loss over years |
| Healthy scalp | Scalp rash, itching, burning, flaking, or pain |
| Improves after a few months | Bald spots over time |
What Causes Telogen Effluvium Hair Loss?
To learn more, read our guide to what thinning hair looks like.
When the body experiences severe stress, it doesn’t care about hair. It diverts energy from hair production and puts it all into self-preservation mode, protecting vital organs and recovery.
You can think of it as stress ‘shocking’ the hair follicles into hibernation — or the resting phase (telogen phase) of the hair growth cycle.
More hairs than usual get pushed into this phase when the body is under stress. The stage also lasts longer than usual.
When you have hundreds of hairs prematurely entering the resting phase, it means you’ll eventually have hundreds of hairs falling out — far more than the 50-150 hairs you would usually shed each day.
Here are some of the leading causes of telogen effluvium — but remember, telogen effluvium is rarely caused by one trigger alone. Several of these factors may be at play at the same time and in about 33% of cases, the cause is never known.
Physiological and Emotional Stress
The overriding cause of telogen effluvium can be severe stress. It may be stress brought on by traumatising events like the death of a loved one, a divorce, or a big career change. Or it can be physiological stress — things like childbirth, severe illness, or surgical trauma.
The stress of COVID-19 is also emerging as a possible trigger for telogen effluvium, with 27% of people recovering from COVID reporting hair loss as a lingering problem.
It’s natural to overlook a stressful event as a cause of telogen effluvium because the hair loss typically becomes apparent about 3 months after the stressful event has occurred.
Medical Conditions
Here are some medical conditions that may lead to telogen effluvium:
- Hyperthyroidism
- Hypothyroidism
- Hepatic failure
- Chronic renal failure
- Inflammatory bowel disease
- Lymphoproliferative disorders
- Systemic amyloidosis
- Chronic infections like HIV
- Psoriasis
- Seborrheic dermatitis
Hormonal Issues
Sudden hormonal changes may be behind short-term telogen effluvium. The most common example is when women experience dramatic changes to their hormone levels after giving birth.
Diet
Some cases of telogen effluvium may be caused by the following dietary deficiencies:
- Iron
- Zinc
- Protein
- Essential fatty acid
- Vitamins B6 and B12
- Biotin
Crash dieting and chronic starvation may also contribute to telogen effluvium.
Medications
The following medications may cause telogen effluvium:
- ACE inhibitors
- Anticonvulsants
- Anticoagulants
- Androgens
- Antidepressants
- Antihypertensives
- Oral contraceptives
- Retinoids
- Beta-blockers
The signs of telogen effluvium from medication usually start to show about 3 months after you began the new treatment. Dose changes can also trigger TE.
Telogen Effluvium Hair Loss Treatment Options
The best telogen effluvium treatment is patience. In most cases, TE is temporary and your hair will regrow on its own within 6-12 months.
If you’d like to speed up the process or you need treatment for chronic telogen effluvium, there are treatment options available to you.
Reduce Stress & Anxiety
The first thing to do if you have telogen effluvium is to make sure the trigger — the stressor — is gone.
If it’s physiological stress, your hair loss should start to improve as you begin to recover from the event.
It may be harder with ongoing, severe emotional stress. Here are some popular stress management techniques:
- Meditation
- Yoga
- Counselling
- Cognitive Behavioural Therapy
- Exercising (even just gentle walks)
Hair Loss Medication
Some people look into hair loss medication to help support recovery from telogen effluvium. If you’re considering this route, it’s worth speaking with a doctor who can advise on options suited to your circumstances and whether medication is appropriate given the underlying cause.
Adjusting Your Diet and Addressing Deficiencies
As with many parts of a healthy lifestyle, a nutrient-rich diet may help promote hair regrowth. A well-balanced, nutritious diet is one that contains plenty of lean proteins, whole grains, fresh fruits and vegetables, and healthy fats.
Experts agree that nutritional supplements (such as zinc, calcium, iron, selenium, folic acid, and amino acids) may help treat TE.
However many other supplements (such as biotin or protein powders) are only effective as telogen effluvium treatments if you’re addressing a related deficiency.
If you believe a deficiency is causing telogen effluvium, it’s important to confirm this with your doctor. They can find out your vitamin and mineral levels through a simple blood test.
What Does Telogen Effluvium Regrowth Look Like?
As your body recovers from telogen effluvium, you should start to notice regrowth, with your hair usually returning to its normal levels of thickness within a year.
Here are some signs that your TE is improving:
- Your hair fall lessens
- Short, fine new frontal hairs (flyaways or baby hair) appear
- Your hair gradually thickens
How much your hair regrows depends on a variety of factors, including age, genetics, hormone levels, and general health.
Middle-aged men and women may experience less regrowth than younger people since the total number of active follicles reduces with age.
When to See a Doctor
If your hair loss persists beyond six months, or you’re concerned about the cause, it’s worth speaking with a doctor. They can help confirm whether it’s telogen effluvium, chronic telogen effluvium, or another condition, and advise on what’s appropriate for you.
