Telogen effluvium is common, frightening and usually temporary. The biology, the timeline, the red flags and the conversations that help.
From the editors
Few things bring clients to us as quickly as sudden shedding. They arrive with hair in a sandwich bag, or photographs of the plughole, or simply the fear that it will not stop. Many will have searched online first and found the worst possible explanations.
Often, what they are experiencing is telogen effluvium: a shift in the hair cycle that causes more hairs than usual to shed at once, typically some weeks after a trigger such as illness, childbirth or a stressful event. It is common, and it usually settles. But it is not the only cause of shedding, and it can sit alongside other conditions. That is why a careful history and a clear sense of the red flags matter in every discipline.
This edition sets out what telogen effluvium is, how to draw its timeline with a client so that the delay between trigger and shedding makes sense, and the red flags that mean a GP or dermatologist should be involved. We describe the blood tests a doctor may consider, without straying into medical advice, and we look at aftercare conversations: what to say, what not to say and how to support someone while they wait.
That word, wait, is doing a lot of work. Much of the care in shedding is helping someone through the months when nothing seems to be happening. Calm, accurate information is one of the most useful things any of us can give.
As always, this is education for professionals, not a diagnostic guide. Work within your scope, and refer when in doubt.
The Trichollective editorial team
The basics
What it is, what tends to trigger it, and why it looks so alarming when it is usually temporary.
Photograph Mohamed B. / Unsplash
Words by the Trichollective editorial team
Telogen effluvium, often shortened to TE, is a form of diffuse hair shedding. It happens when a larger proportion of scalp follicles than usual move from the growth phase, anagen, into the resting phase, telogen, at around the same time. Because telogen lasts roughly three months, the hairs are released some weeks after whatever caused the shift, and they tend to fall together.
The result feels sudden and dramatic. Clients find hair on the pillow, in the shower and on their clothes. The hair may look thinner overall, though often less so than the client fears. Crucially, the follicles are not destroyed. They are resting.
“The follicles are not destroyed. They are resting.
Sometimes no trigger is found, and sometimes there is more than one. A careful history, taken month by month, often surfaces something the client had not connected with their hair.
In acute telogen effluvium, shedding usually settles within around six months once the trigger has passed, and regrowth follows. When shedding continues for longer than six months, it is often described as chronic telogen effluvium, which can fluctuate over a long period and may need further medical assessment. Regrowth takes patience: scalp hair grows at roughly a centimetre a month, so it can be many months before length and density look recovered.
Diagnosis belongs to a doctor or, within their scope, a trichologist assessing the history and the scalp. Everyone else plays a vital part by noticing, listening and helping the client find the right person quickly.
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Next · Edition 03
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The craft behind the calm.