Hair growth and loss is cyclical by nature, this is true of everyone whether they suffer from a hair loss condition or not. There are three main stages which make up our hair cycle; the first of these is the anagen phase, when hair grows. In adults the anagen phase can last anything between three and seven years, depending on the size of the hair follicle.
It is followed rapidly by the catagen, or transitional phase. This is when hair stops growing, and the follicle rapidly regresses in preparation for the shedding phase. In contrast to the anagen phase, catagen typically lasts only a couple of weeks.
The telogen phase then begins. This normally lasts around 100 days at the end of which the hair, which has now ceased to grow, will spontaneously shed, making way for a new hair shaft which is forming within the hair canal during this period.
A normal adult’s head of hair will typically be made up of 90% of follicles in the anagen phase and just 10% in the telogen phase. As these statistics show, the number of hairs in catagen is minimal, normally less than 1%.
Telogen Effluvium occurs when something shocks a large proportion of the 90% anagen phase hairs into prematurely entering the telogen phase. The condition can affect anyone at any age, with several cases noticed in children. It is not more prevalent among one ethnic group than another, although is slightly more common in women, mainly because there are typically more potential triggers in the female lifecycle.
Telogen Effluvium that lasts for more than six months, or recurs periodically, is known as chronic.
What triggers Telogen Effluvium?
Telogen Effluvium is a hair loss condition caused by a systemic shock to the body, usually affecting the hormone balance. It can be something as natural as giving birth or stopping birth control pills, or a more sinister cause, resulting from extreme emotional shock and stress or major physical trauma /surgery. As hair loss is not normally noticed until 100 days after the event, when the induced telogen phase ends and shedding begins, it can sometimes be difficult to pinpoint the exact cause.
Telogen Effluvium and Pregnancy
One of the most common triggers for Telogen Effluvium in women is the end of pregnancy, whether this is through termination, miscarriage or birth. During pregnancy, female hormone levels change dramatically, with levels of oestrogen and progesterone rising in particular.
As a result, a greater proportion of hairs remain in the anagen phase than normal and many pregnant women report their hair as feeling thicker and healthier than pre-pregnancy. Once the pregnancy is ended, however that may occur, the hormone levels drop back to their original levels, causing a major systemic upset.
The shock of the rapid hormone changes is enough to force anagen phase hairs into the telogen phase, and Telogen Effluvium results. Although it is not often spoken about, post-pregnancy hair loss is very common, with anywhere between 20% and 45% of new mothers experiencing a higher level of hair shedding three months after the end of pregnancy.
Telogen Effluvium and Medicine
Any major physical shock, whether it be sustained through accident or surgery, has the potential to cause Telogen Effluvium, in men also. As well as the high-impact physical aspects of undergoing surgery, especially an operation which requires general anaesthesia, Telogen Effluvium can also be triggered by certain medications. Key drugs for the treatment of gout, high cholesterol level and high blood pressure have all had hair loss reported as a side effect among a significant number, although not all, users.
Whether the cause is surgery, physical shock, or medication the effect is the same, any one of these triggers can force hair into the telogen phase, with shedding occurring around three months after the initial incident.
How can Telogen Effluvium be treated?
Telogen Effluvium is an interruption in the normal cycle of hair growth, and usually will right itself naturally as hair re-enters the anagen phase – just like it would have done if the telogen phase had occurred in the normal business of things. It is important to ensure that any underlying cause of Telogen Effluvium is addressed, especially if the problem is the result of long-term psychological or physical issues, as failure to do so may result in ongoing hair loss.
If you are worried about Telogen Effluvium or any other hair loss condition, and would like an in confidence talk about your options for restoring your hair, please contact the Belgravia Centre for an initial consultation or feel free to complete an online diagnostic form.