The hair loss seen in telogen effluvium is sudden and diffuse over the scalp with noticeable thinning. This usually begins several weeks to months after the stressor. While most hair loss is on the scalp, some people may also notice hair loss on other parts of the body. Most of the hair shedding is noticed when shampooing or combing the hair. This process usually slowly decreases over 6-9 months once the stressor is no longer present. Over time, the hair regrows and the scalp hair will thicken back to normal. However, this may take months to years since hair grows only by about ½ inch per month.

Most cases of telogen effluvium are acute as described above. However, chronic telogen effluvium can occur. In this case, hair shedding continues for long periods of time, sometimes for years. Most often, this occurs in women who previously had very thick hair in youth and still have an apparently normal head of hair. It usually affects women between the ages of 30 and 60, starts suddenly but waxes and wanes over years. The shedding is most severe at the onset. It does not cause complete baldness and usually does improve with time.

Nail growth can also be affected by the same stressors as the hair. A halt in nail growth can present with a groove across the nail called Beau’s line. This groove will gradually grow out once the stressor is gone.

Common stressors that may result in telogen effluvium are as follows:

• Illness with high fever
• Childbirth
• Surgical operation
• Accident
• Severe psychological stress such as death of a loved one
• Crash diet or significant weight loss
• Certain medications
• Discontinuation of birth control pill
• Travel resulting in jetlag
• Thyroid disease

A dermatologist is usually able to make the diagnosis of telogen effluvium by taking a complete history and performing a physical exam. Your doctor will want to know any new or existing health problems you have, all medications you are on and will ask about any stressful events in your life related to family, home life or work. Any recent illnesses, pregnancies or dietary changes should be reported.

The dermatologist will carefully look at your hair and scalp. During the exam, the dermatologist may pull on your hair or even pull out a hair to examine the root. The loose hairs will have club-shaped roots typical of resting or telogen hairs and may be easily identified under a microscope. A biopsy, which is the removal of a small piece of scalp skin for examination under a microscope, may be needed to help make a diagnosis. A dermatologist can quickly and safely perform a biopsy during an office visit. Blood tests may be done if the cause is not obvious.

Telogen effluvium is a self-limited condition and is not affected by any treatments currently available for other forms of hair loss.  The hair loss experienced usually resolves over 6-9 months. However, because hair grows by only ½ inch per month, it may take months to years before the hair returns to normal.