Telogen hairs: Not only in Telogen Effluvium

What are telogen hairs? When does one find them?
 

Telogen hairs are hairs that are shed from the scalp because they are done their growing. If you reach up and run your hands gently through your own hair, you’ll likely remove a telogen hair. (If you forcefully pluck hairs from the scalp you’ll remove a completely different type of hair called an anagen hair). Between 30-70 telogen hairs normally fall out of the scalp every day. On shampooing days (days that one shampoos the scalp), even more wiggle out so the number can reach well over 100 for some individuals. If one shampoos the scalp everyday, they remove telogen hairs on a consistent basis and so the loss each time remains much lower than if one shampoos once per week.

Telogen Hairs can be a Normal Finding

The finding of telogen hairs can be completely normal but an increased number of telogen hairs lost from the scalp compared to what one usually loses, is not normal. If one normally loses 40 hairs per day and now loses 80, this is not normal provided the frequency of shampooing remains the same. A common mistake that individuals make is assuming that the finding of increased shedding of telogen hairs confirms a diagnosis of “telogen effluvium.” This is not accurate. Individuals with a range of hair loss conditions will shed more telogen hairs than they normally do including the following: telogen effluvium, chronic telogen effluvium, androgenetic aloepcia, alopecia areata, as well as the many scarring alopecias and the inflammatory scalp diseases (such as seborrheich dermatitis). The finding of increased numbers of telogen hairs coming out from the scalp could mean the patient has a diagnosis of telogen effluvium - but does not necessarily mean this is the only diagnosis to consider.