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QUESTION OF THE WEEK


Telogen Effluvium: Is regrowth always possible ?

Is regrowth always possible with a TE?

 

Telogen effluvium refers to a type of hair loss whereby the patient experiences increased daily hair shedding. Telogen effluvium typically occurs after some sort of "trigger" disrupts the delicate balance of hair growth and loss. There are many potential "triggers" that lead to telogen effluvium including stress, low iron, scalp dermatologic issues, thyroid abnormalities, crash diets, delivery, medications and internal illnesses. If a "trigger" can be identified and shut off/dealt with shedding can often return to normal rates and hair density can return for the patient.

For example, if shedding was due to a medication and that medication has now been stopped, it's quite likely that shedding will slow and then return back to normal rates.

 

Not all TE is Self Limiting

Too often a precise "trigger" causing the hair loss can't actually be found. In fact, in up to 50% of women, it's challenging to pinpoint an exact trigger. If a trigger can't be found, there is nothing to 'fix' to stop the shed and the shedding can sometimes just continue.   In addition, even if a trigger is found, it may not be possible to easily 'fix' the trigger. For example, some patients have TE due to a drug and in some cases, it's simply not possible to stop that drug because it's critical to the patient's health. Some patients may have TE due to an underlying medical condition (internal illness). That condition may not be possible to totally eradicate and because of this, shedding may continue.

Many patients with TE eventually experience a cessation of excessive shedding and a slow return to more normal rates of shedding and improved density. However, not all patients do.  The diagnosis of telogen effluvium does not guarantee that the hair loss will be self limiting.

 

Treatment of TE when no trigger is found

The treatment of TE is geared towards addressing the specific trigger that cause the shedding in the first place. If the patient had low iron, iron supplementation is appropriate. If a thyroid abnormality was present, addressing the thyroid issue is important. In cases where not trigger can be found, a variety of options are available, including minoxidil, low level laser, platelet rich plasma, biotin, hair and nail supplements, Lysine, and cysteine.

 

 


This article was written by Dr. Jeff Donovan, a Canadian and US board certified dermatologist specializing exclusively in hair loss.



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