Acute and chronic telogen effluvium - what's the difference?


There are a lot of misconceptions about telogen effluvium (sometimes called acute telogen effluvium or just "TE") and chronic telogen effluvium or "CTE". They are very different conditions.

 TE is extremely common and occurs in all ages. It's often results from one or more of the four big categories of 'triggers' -  low iron, stress, endocrine problems (thyroid problems) and medications (especially birth control). However, in one half of cases, the cause is not found. Blood tests are often abnormal in TE and so everyone with TE needs blood tests. 

What about CTE? There is quite a bit of misunderstanding even among physicians about CTE. Some physicians call it when the TE simply goes on more than 6 months. I think that's wrong. For example if you have low iron and develop shedding of hair, we call it 'acute telogen effluvium'. If it goes on for 7 months and the iron has not been replaced then I strictly call it "acute telogen effluvium" from low iron that has not yet been addressed. I don't simply call it CTE once it passes the 6 month mark.   CTE is a condition unto itself.

CTE develops in women 35-60 who often had massive amounts of hair at one time. These women develop shedding when all the blood tests you can order are just perfect. This is CTE. The temples can show recession more than other areas and some days have lots of shedding and other days not so much. Many women with CTE have symptoms (burning, tingling, crawlers). CTE is not just TE that passes the 6 month anniversary.  CTE is very different! Women with CTE once had massive amounts of hair and even when they lose a lot of it - it still looks like they have a lot of hair. 

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

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