To Treat or Not To Treat Telogen Effluvium: Do I need to treat it?

To Treat or Not To Treat Telogen Effluvium

 
I’ve selected this question below for this week’s question of the week. It allows us to review some concepts in the treatment of telogen effluvium.

Question

Do I have to correct a telogen effluvium? I thought it always just runs its course and resolves.

Answer

Thanks for the question.

No. you are incorrect. Telogen effluvium does not always run its course and resolve.

An important key here is whether the trigger is removed. Unless the trigger is removed, the hair shedding does not stop.

Telogen effluvium triggered by a fever will stop on its own. A fever in February may trigger shedding in April or May and then shedding stops by September, October or November. No treatment is needed.

However, telogen effluvium that is caused by a new drug started in February will never stop until the drug is stopped.

Telogen effluvium caused by a thyroid disorder that starts up in February does not stop until the thyroid disorder is addressed.

Telogen effluvium caused by anorexia does not stop until the weight comes back up.

Some telogen effluviums need the trigger addressed before shedding stops! Some triggers resolve on their own.

But the answer to your question is no - not every telogen effluvium just resolves on its own. I have many patient with chronic nutritional issues (from cancer and other diseases), eating disorders like anorexia nervosa, chronic medication use that they just can’t stop (ie heart medications or seizure medications), high stress. This patients keep shedding because it’s challenging to fix the triggers.