Telogen Effluvium: Dealing With Rapid Unexplained Hair Loss
A Guide to Dealing With Excessive Hair Shed
I am a woman in my early 40’s and, about a year and a half ago now, I was met with a surprising health issue that seemed to come out of nowhere for me. My hair started falling out suddenly, and seemingly, with no easy explanation. I was informed, upon seeking the attention of a doctor, as well as reading on this subject as much as I could, that this is something that happens to many people and can be not only physically alarming, but a horrible mental game as well.
Over the past year, several doctor visits, and much research, I have acquired quite an arsenal of useful information that I would love to share with others that may be dealing with this problem. It is not an easy fix for certain, but there are many things one can do to help alleviate the symptoms of rapid, all-over hair loss, or more specifically, hair shed, as they wait for it to pass.
Telogen Effluvium Is Usually Temporary
If you truly do have telogen effluvium (rapid, unexplained hair loss), or are experiencing what seems like a more than usual amount of hair shedding that endures over an extended period of time, the good news is that yes, it likely will resolve in time. Most cases do, as evidenced in the abstract Diffuse Hair Loss in an Adult Female: Approach to Diagnosis and Management found in the National Institutes of Health Library of Medicine’s online resource—usually, in fact within 6 months of onset.
In my own darkest hour, however, this opinion was less than comforting to me as I found myself facing the reality that, not only is there a lack of information on this subject, but it is sometimes vague, and often suggests the condition is medically untreatable. This was difficult to accept and became my motivation for offering what I have found and sharing my own experiences in working towards stopping—or limiting—hair loss.
Defining Telogen Effluvium
What Exactly Is Telogen Effluvium?
First, I would like to define telogen effluvium, because there are several types of hair loss and I can only speak to this particular type. (See the video I've included, which discusses the specifics of telogen effluvium.)
As evidenced in the article on Medscape, "Telogen Effluvium: Background," this condition results in hair loss which is uniform (not patchy)—so much so, that an overall thinning of the hair is soon visible. The loss of hair is obvious and spontaneous, and the hairs fall out from the root with a tell-tale white bulb often visible at the end. You find fallen hairs all over: in the drain, and when you brush your hair, or just as you are standing still. One may wonder if it is in their head, but this is soon ruled out as the hair fall continues and a reason seems elusive. It usually does not last beyond 6 months and you will never reach the state of complete baldness.
Unfortunately, my experience lasted much longer and is still occasionally present today. Two years later, it has become chronic, as explained in Web MD’s article, "Telogen Effluvium and Other Effluviums." Because I have a long-term case, I feel the information I am able to offer is even more comprehensive and represents the combination of bits of wisdom from several sources on this subject. At this time, I am happy to report that I am miles from where I was during this dark period of my life, and my hair is steadily, although slowly, returning to a normal state. Most very likely, yours will as well.
Some Potential Causes of Telogen Effluvium:
Low Thyroid Disease
Allergic Reaction to a Food or Product
Traumatic Physical Event (sometimes relating to a prior fever)
Deficiency of Some Nutrient or Vitamin, Such as Vitamin D3 or Iron
Too Much Vitamin A
Lack of Protein
Although feelings of direness accompany this problem, as at first, not much seems to help, I must assert that there are things you can do to minimize your hair loss and which will help you feel a little more proactive in dealing with this problem, in general. However, do not expect a definitive cure-all, as sadly, it often doesn't occur that way. Rest assured, that time is your best friend in dealing with telogen effluvium, and although this is difficult to accept, in the end, you will likely admit this as well. This said, here are ten positive and empowering things you can do if this is happening to you:
Strategies to Minimize Hair Loss:
Here are some common strategies that can help to minimize hair loss:
Check Your Vitamin D3 Levels
See a Doctor to Rule Out More Serious Health Issues
Make Sure You Are Not Taking Too Much Vitamin A
Take a Multi-vitamin
Eat More Protein
Rule Out Allergies to Certain Hair Products or Foods
Reduce the Use of Chemicals on Your Scalp
Reduce Stress Levels
Handle Hair with Care
Wash Hair Every Other Day
Avoid Products Containing Keratin
1. Go to a Doctor
The first thing I have to strongly suggest is to go to a doctor. There are several diseases that are symptomatic with hair loss and you need to rule them out. These include hormonal imbalances, systemic illness, thyroid problems, and lupus. The doctor will run a blood test panel checking for deficiencies, disease, or other issues. My doctor did not believe me at first. She thought that perhaps it was in my head, but within a few months, she was proved wrong and so much of my hair was gone.
I was referred to a dermatologist who gave me the courtesy of listening and caring. You should seek a doctor that will truly try to understand and acknowledge your difficulty. This is imperative to keep up your own mental stamina as you traverse this issue. The dermatologist diagnosed me as having telogen effluvium and offered to give me a scalp biopsy. However, I did not take this option. It would be useful in confirming the diagnosis, but since there is no real treatment, that is as far as it would take me. I opted out. The most difficult part of this experience is living with the fear that your hair loss will be permanent or will eventually be complete. That is why telogen effluvium patients so desperately seek help.
The Emotional Side of Hair Loss: Don't Give Up!
2. Try to Determine a Cause
Potential causes for telogen effluvium can include a recent physical trauma (including having had a baby or a fever illness) or occurrence of a traumatic event or loss which happened in the few months prior to the onset of shedding hair. A deficiency could be a cause, such as a vitamin deficiency, a protein deficiency, or an iron deficiency. Many believe hormonal changes could be a cause as well. An allergic reaction to food or a reaction to a product could perhaps have brought on an episode of telogen effluvium. Stress could also be the culprit.
Determining a cause, if you can, is a first line defense because you can remove the problem. However, I must warn you, a great majority of people can never say for sure what the cause was. I am among these people. Although I have my suspicions, I don't have 100% certainty. I did experience a great loss just prior to my hair loss and then, after and during the loss, I experienced continued bouts of more-than-normal stress. It is difficult to control stress in life today, so removing a stressor is not always a plausible solution.
If you can determine, however, what initiated the onset of your hair falling out, you should do everything you can to eliminate this stimulus as soon as possible to more towards healing. See the video to the upper right about the emotional side of hair loss. It outlines why finding a cause can be so important in your fight.
3. Take Vitamins and Add Protein to Your Diet
Telogen effluvium is a sign perhaps that your body is in need of some nutrient that you are missing. It is a good reason to amp up your health, regardless if this is a primary cause of your hair loss or not.
Make sure you are eating enough protein and getting the proper amount of iron; eat healthfully. Consider taking a fish oil supplement to amp your body’s vigor, and try a vitamin for hair such as Super Hair Energizer, available on Amazon.com. This did seem to help things for me after a month or so’s time insofar as new hair growth was concerned.
However, I do have to add an important warning. Do not overdose on any one vitamin. I am referring especially to vitamin A. Too much vitamin A, in fact, could be the cause of your problem! I was taking both a multi-vitamin and eating Luna Bars for women to improve my nutrition and this was giving me more than the recommended amount of vitamin A which can be toxic… especially to hair! If you happen to be sensitive to vitamin A, this could perpetuate your cycle of hair loss rather than help it. As suggested in several articles I came across, including "Does Vitamin A Cause Hair Loss?," this could have contributed further to my problem or at least hindered my recovery from it.
4. Take Biotin
One vitamin that needs to be mentioned in its own section (because of its importance) is biotin. Begin taking daily biotin supplements immediately upon hair loss. It will improve hair and nail health, which won't hurt you during this struggle. It should make your hair grow faster and give it a nice, healthy sheen, so you may want to consider this one for life! It will not, however, stop your hair loss. But it is a positive step you can take toward building your hair back up for the future. See what Dr. Oz says about Biotin in the video below and how it is imperative to your hair health.
5. Try Vitamin D3
I believe vitamin D3 was the crux of what helped me. I read so many materials on telogen effluvium and finally, something resonated with me one day. Vitamin D3 supports the processes in your body including, and most relevantly here, the cycles of your hair.
There are 3 phases of hair growth as explained in detail in the article "Pathophysiology of Telogen Effluvium" found on Medscape. Telogen is the resting phase of hair, when a hair that is done growing remains at rest in the follicle before it is pushed out by a new hair. In telogen effluvium, a majority of hair remains in this phase longer than the usual 3 months and are not properly followed by the growth phase. I feel that D3 helps your hair cycles transition between phases. In telogen effluvium, or at least in my particular case, I experienced shortened cycles. I would have anaphase, or a growth phase, and then a long period in the telogen phase. It was far before it was time to enter this phase, and I would stay there too long. This resulted in an inordinate amount of my hair being in the telogen phase at any given time. (Only about 10-20% should be in this phase at any given time according to sources like WebMD.) The D3 allowed me to get back to the normal phase more quickly, which truly helped me.
It was a Godsend, I believe. I strongly encourage anyone who is perplexed with this problem to try a D3 supplement after consulting their doctor. It is not usually dangerous to take a D3 supplement, but one should check with a medical professional just to ensure the safety of this recommendation in each individual scenario. I do not pretend to be a doctor! I read in the article "Vitamin D and Hair Loss" at Livestrong.com, and the Dermatology Online's Journal article, "Does D Matter? The Role of Vitamin D in Hair Disorders and Hair Follicle Cycling," that Vitamin D3 could help in transitioning your hair's cycles from one phase to another.
6. Massage the Scalp
Another thing that seemed to help me was massaging my scalp gently. I would put pressure on my scalp and, without moving my fingers through my hair, but by keeping them firmly in place, I would manipulate the scalp. I think this helped to stimulate a change and it felt good!
7. Treat Your Hair With Kid Gloves
If your hair is falling out to the degree that mine was, you will not want to touch it too much. If I had brushed my hair, I think it would have all come out. I gently shampooed my hair and cut down to doing so every three days at the worst point. (See the Dr. Oz video below on how to have healthy hair.) This was actually healthy for my hair, and I am glad to have started this habit. I also did as little as possible to style my hair or pull it back. I did not go to the salon because I think their treatment could only have resulted in the most unimaginable loss of hair. These are the fears of someone suffering from this problem. I only colored my hair when absolutely necessary and I did so with semi-permanent dye to reduce the chemical effect on my scalp should my problem have been a result of a hair dye allergy.
8. Trim Your Hair Often
Trimming my hair often helped to make it appear thicker. Because of biotin, your hair will grow faster, so you may need to trim quite frequently.
9. Stop Using Harsh Products Such as Keratin and Dyes
When I began my battle with this condition I had strong suspicions that keratin was the culprit, and perhaps, initiated my problem. Avoid harsh chemicals like keratin in your everyday hair regimen. They are stronger than you think and you could have a counter-indication to them. Never get a keratin treatment. You can read online about the problems with hair loss that so many have experienced following such treatments. In my case, I was using a daily keratin shampoo and conditioner. I believe it may have been just too harsh for me. I began checking all my hair products and surprisingly, keratin was a main ingredient in so many of them. The ironic part is that keratin is touted as a means of improving the health and beauty of your hair. If you are having trouble with hair fall, I strongly recommend cutting out this use of this ingredient in your hair care regimen.
Also, during the time you are experiencing increased hair loss, be very careful of the way you color or highlight your hair. If you can cut it out altogether, I would recommend this option. Telogen effluvium does happen to women after they have a baby. This is thought to be due to the trauma that their bodies experience during birth or to the drastic change in hormone levels that occur. It begins about a month after birth. If you are young, and have no grays, lay off the chemical processing until you return to your normal hair cycles of growth and fall. If however, you are like me and have grays, you may not want to forgo coloring. As an alternative I use Natural Instincts semi-permanent hair color. It is less harsh, and I color my hair myself to ensure the gentlest touch, less I lose more of what I do have!
10. Remain Positive and Have Faith
Telogen effluvium is said to resolve on its own over time. I have had a struggle with this problem for almost two years now, but it is finally getting better. I no longer experiencing so much hair loss and there are so many new, short hairs sprouting out of my head that there is no way I could ever doubt that I truly did experience severe hair loss those many months ago. If you truly have telogen effluvium, be confident that this issue does resolve. It takes time, but it does resolve. Especially if you follow the above strategies to amp up your health, things do get better. Remember that most people see improvement within 6 months, and for more severe cases like my own, perhaps it will be an ongoing issue that you can hopefully manage in the long term.
Be Careful of Options Like Rogaine
My personal opinion is that I do not think one should jump too quickly into using hair regrowth products on the market (such as Rogaine and the like). Such treatments can come with new sets of problems and symptoms that the person taking them must then deal with as well. Make sure you know exactly what you are getting into before you make any flash decisions about buying and using these products. They are definitely helpful for some types of hair loss, but perhaps, not the best solution for all individuals. Insofar as telogen effluvium is concerned, you may not need such interventions in the end so make this decision very carefully if you are leaning toward such an option. Again, be sure to get the advice of a medical professional.
Ways to Make Thinning Hair Look Fuller
In my article, "Women’s Health and Beauty: Ways to Make Thinning Hair Look Fuller," you can find some strategies I found helpful for making thinning hair look fuller.
Further Resources on Telogen Effluvium:
If you would like to read more about potential causes of telogen effluvium hair loss, you may find the following resources helpful:
The American Osteopathic College of Dermatology's website: Telogen Effluvium Hair Loss Article
Web MD: Hair Loss Health Center Page on Telogen Effluvium
American Hairloss Association: The Effluvium Page
Web MD: Women and Hair Loss: Possible Causes
Review of Important Information on Telogen Effluvium
After trying the “tricks" above, a better understanding of telogen effluvium may help you the most, as it will assist you in truly dealing with this issue and understanding that it could be a few years before you are completely through this rough patch. (No pun intended.) Here are the basic facts I have garnered about telogen effluvium. They are reinforced in my article, “Telogen Effluvium: What Finally Helped Me,” which I wrote as I was just stumbling out of the most difficult times of this condition. You may also want to read my article “Telegen Effluvium: Waiting for it to Pass,” if you would like further detail on my journey and what emotions you may be feeling, as well as sources for more information.
Telogen effluvium is an upset in the normal cycling of your hair growth and fall out patterns.
It can lower your self-esteem and try to steal your thunder, but you will come through.
It usually resolves on its own after a period of time.
Chronic telogen effluvium occurs when it goes beyond 6 month’s time but is less common than a normal six-month recovery.
Keeping a healthy attitude is the most important thing as you deal with this difficult situation.
Amping up your general health can only aid in restoring your hair, emotional wellness, and body, to a healthy state.
Good luck! I truly wish you well and hope to encourage you in your struggle with this very real problem. Better days ahead!