Hair loss after stress, illness or having a baby

What is happening to your hair

Most of the hairs on your head are in a growing phase at any one time, and a smaller number are resting before they fall out. A shock to the body can push many more hairs into the resting phase at the same time. A few months later, those hairs shed together.

Doctors call this telogen effluvium. Telogen is the name of the resting phase, and effluvium means shedding. It is not the same as pattern hair loss or patchy conditions such as alopecia areata, and it does not usually cause bald patches.

Common triggers

Triggers can be physical or emotional. They include:

• An illness with a high temperature, including viral infections.
• Surgery, an accident or a stay in hospital.
• Having a baby, which is why many people notice shedding a few months after giving birth.
• A significant stressful event or a long period of strain.
• Rapid weight loss or a very restricted diet.
• Starting or stopping some medicines, including hormonal contraception.

Sometimes there is no single obvious trigger, and sometimes more than one factor plays a part. Low iron stores or a thyroid problem can cause or prolong shedding, which is why blood tests are often useful.

The timing: why it catches people out

Shedding usually begins two to three months after the trigger. By then, the illness or stressful event may have passed, so it can be hard to make the link. It often helps to think back over the previous few months and note anything significant.

You may see more hair in the shower, on your pillow or in your brush, and your ponytail may feel thinner. Hair usually comes out evenly from across the scalp rather than in one area.

It can help to keep a short note of what you have noticed and when. Include the date the shedding started, any illness, operation, stressful event or change in medicines in the months before, and whether anything seems to make it better or worse. This makes it much easier for your GP or a hair professional to understand what may be going on.

How long it lasts

In many cases the shedding settles within about six months once the trigger has passed. Regrowth then follows gradually, and because hair grows slowly it can take many months before your hair looks as full as it did. Short new hairs around the hairline are often an early sign of regrowth.

For some people shedding goes on for longer than six months. This is worth discussing with your GP, as ongoing shedding can sometimes point to another cause that needs attention.

When to see your GP

See your GP if shedding is heavy or lasts longer than about six months, or if you notice any of these signs:

• Patchy loss, smooth bald areas or loss of eyebrows or lashes.
• Pain, burning, marked redness, pus or scarring on the scalp.
• Very rapid loss.
• Other symptoms such as fatigue, feeling cold, palpitations, weight change or irregular periods.
• Hair loss in a child.

Your GP can check for things such as low iron, thyroid problems and other causes, and refer you to a dermatologist through the HSE or the NHS if needed. If you are pregnant or have recently had a baby, your GP, midwife or public health nurse can also help.

Looking after yourself and your hair

Be gentle with your hair while it is shedding. Use a wide-toothed comb, avoid tight styles, and keep heat and chemical treatments to a minimum. Washing will not make the shedding worse.

Regular, balanced meals support your general health. Avoid starting supplements, particularly iron, without advice from your GP or pharmacist. Shedding can be upsetting, and it is fine to ask for support with how it makes you feel.

A trichologist or experienced stylist can suggest ways to care for and style your hair while it recovers. Trichollective's directory lists cosmetic, clinical and medical hair and scalp professionals across Ireland and the UK if you would like that support.