Minoxidil for Treating Telogen Effluvium: Forever?
Telogen effluvium (TE) is a hair shedding condition. Individuals with telogen effluvium experience increased daily shedding than they may have normally experienced. Rather than losing 50-100 hairs per day, affected individuals lose well over 100 hairs and some lose upwards of 400-1000. The main causes of TE are low iron levels, thyroid problems, stress, crash diets, illness within the body (Systemic illness), medications. These are all 'triggers' for TE.
Is minoxidil a treatment for TE?
Before addressing whether minoxidil is a trigger for TE or not, let's look at the primary treatment for TE. TE is best treated by addressing the trigger for TE. If low iron is the cause of the TE, the iron must be replaced. That is the primary treatment. If hypothyroidism (low thyroid hormone levels) is the primary cause of a TE, the affected patient needs thyroid replacement as their primary treatment.
Minoxidil is not the first choice for TE, but certainly can be a choice in those individuals for which the diagnosis can't be found. For 50 % of individuals with TE, we can't find the cause of the TE. For some people, despite the blood tests, and review of their history, a clear 'trigger' can't be identified. Minoxidil can help the hair cycles return to normal and facilitate the establishment of more normal shedding patterns. Minoxidil helps some people with such unknown shedding but not all.
Is the use of minoxidil life long for TE?
Minoxidil is well known for being a 'lifelong' treatment for patients with androgenetic alopecia (male and female pattern hair loss). If someone with androgenetic alopecia uses minoxidil and gets a benefit and then decides to stop the treatment, they will lose all the benefits they gained by using the treatment. Their use is lifelong. For patients with androgenetic alopecia, minoxidil can not be stopped.
These same rules do not apply to all patients with TE. In many cases minoxidil can be tapered and then stopped as hair follicles regain normal cycling patterns. If an individual decides to use minoxidil to treat their TE from their crash diet, the minoxidil can be tapered and stopped once a normal diet resumes. The use in these situations is not lifelong.
For patients with a true TE, minoxidil use is typically not life long. After the trigger for the shedding is fixed, shedding will often return to normal and minoxidil can be stopped
Dr. Jeff Donovan is a Canadian and US board certified dermatologist specializing exclusively in hair loss. To schedule a consultation, please call the Whistler office at 604.283.1887