Hair Therapy & Transplantation
Open Access

Scalp Disorder: Telogen Effulvium

Nooshin Bagherani^{* *}Correspondence: Nooshin Bagherani, Department of Dermatology, Khorramshahr, Iran, Email:

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Introduction

There are three phases of the hair cycle namely:

• Anagen or growth phase.

• Catagen or transitional phase.

• Telogen or resting phase.

Anagen Phase is the phase where hair grows out from the roots and lasts upto 3-7 years.

In Catagen Phase, hair is in slow growth phase and the follicle shrinks. This is usually only for 2-4 months.

In telogen phase the old hair falls out and gives way for new hair to emerge from the roots.

Generally, at any given time, 5-10% of hair is in the telogen or resting phase. But in telogen effluvium, 30% of hair moves into the telogen phase and refuses to shift to the opposite two phases [1].

There are two types of telogen effluvium:

• Chronic Telogen Effluvium

In chronic telogen effluvium, an individual may experience hair shedding that lasts upto 6 months or more. Telogen effluvium is more common in women.

• Acute Telogen Effluvium

Acute telogen effluvium may be a hair loss condition which will remain for fewer than 6 months [2].

Telogen effluvium (TE) is taken into account the second commonest sort of hair loss diagnosed by dermatologists. It occurs when there’s a change in the number of hair follicles that are growing hair, it is a common cause of temporary hair loss due to the excessive shedding of resting or telogen hair after some shock to the system [3]. New hair continues to grow. Telogen hair is additionally referred to as a club hair thanks to the form of the basis. It is a type of scalp disorder characterized by the thinning or shedding of hair resulting from the early entry of hair in the telogen phase (the resting phase of the hair follicle). It is in this phase that telogen hairs begin to shed at an increased rate, where normally the approximate rate of hair loss (having no effect on one's appearance) is 125 hairs per day. At any given time, about 85% to 90% of the hairs on the typical person's head are actively growing (the anagen phase) and therefore the others are resting (the telogen phase). Typically, a hair is within the anagen phase for 2 to four years, then enters the telogen phase, rests for about two to four months, then falls out and is replaced by a new, growing hair. The average person naturally loses about 100 hairs each day .In a person with telogen effluvium, some body change or shock pushes more hairs into the telogen phase. Typically during this condition, about 30% of the hairs stop growing and enter the resting phase before rupture . So if you've got telogen effluvium, you'll lose a mean of 300 hairs each day rather than 100. TE first appears as a thinning of hair on the scalp. This thinning could also be limited to at least one area or appear everywhere . If it does thin in multiple places, you may find that some areas are affected more than others. It affects the top of the scalp most often. Rarely will TE cause your hairline to recede. It’s also unlikely that you’ll lose all of your hair. In some severe cases, TE can cause hair in other areas to fall out, like your eyebrows and pubic region. The main causes of telogen effluvium are Stress, shock or trauma, Pregnancy and childbirth, Menopause, Poor diet, Certain drugs, Surgery, Underlying medical conditions, Experiencing a sudden change in hormone levels can trigger TE hair loss, Treatments for TE are Correcting Nutritional Deficiencies Through Diet, Opt For Gentle Hair Care, OTC Medication, Hormone Replacement Therapy, Management Of Stress, Telogen effluvium is a selfcorrecting. Recommendations include: Gentle handling of the hair, avoiding over-vigorous combing, brushing and any sort of scalp massage, Treat any underlying scalp disorder or hormonal problem determined, if any Ensure a nutritious diet, with plenty of protein, fruit and vegetables, Correct any abnormality in thyroid function, or levels of iron, vitamin B12 and folic acid [4].

References

1. Tosti A, Piraccini BM, Van Neste DJ. Telogen effluvium after allergic contact dermatitis of the scalp. Arch. Dermatol. 2001;137:187-190.
2. Whiting DA. Chronic telogen effluvium: increased scalp hair shedding in middle-aged women. J Am Acad Dermatol. 1996;35:899-906.
3. Malkud S. Telogen effluvium: a review. J Clin Diagnostic Res. 2015;9:1-6.
4. Werner B, Mulinari-Brenner F. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata-part I. An Bras Dermatol. 2012;87:742-747.