Hair Loss (cont.)
Gary W. Cole, MD, FAAD
Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.
Nili N. Alai, MD, FAAD
Dr. Alai is an actively practicing medical and surgical dermatologist in south Orange County, California. She has been a professor of dermatology and family medicine at the University of California, Irvine since 2000. She is U.S. board-certified in dermatology, a 10-year-certified fellow of the American Academy of Dermatology, and Fellow of the American Society of Mohs Surgery.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Hair loss facts
- What are causes of hair loss?
- How do physicians classify hair loss?
- What is alopecia areata?
- What is traction alopecia?
- What is trichotillomania?
- What is tinea capitis?
- What is generalized (diffuse) hair loss?
- What is telogen effluvium?
- What is androgenetic alopecia ("male-pattern baldness," "female-pattern baldness")?
- What treatment is there for hair loss in men?
- What other options do people have for hair loss?
- Is hair loss in women different than men?
- What about pregnancy hair loss?
- What specific treatments are there for hair loss in women?
- What vitamins are good for hair loss?
- Can itchy scalp cause hair loss?
- How do people prevent hair loss?
- View Hair Loss Pictures - Slideshow
- Hair and Scalp Pictures - Slideshow
- Take the Hair Loss Quiz!
- Hair Loss FAQs
- Find a local Dermatologist in your town
What is telogen effluvium?
Under normal conditions, scalp hairs live for about three years (the anagen, or growing, phase); they then enter the telogen, or resting, phase. During the three-month telogen period, the hair root shrivels up into a small white "club," then the hair falls out. It is therefore normal to lose about 100 hairs every day, more of them on days when shampooing loosens the hairs that are ready to fall out. The hairs are then replaced by the body.
Sometimes people who worry about losing their hair start noticing hairs on their pillow or in the sink, not realizing that they've always been there. A close look at these will usually reveal the white club at the end, showing that these hairs were already dead. Normally, about 10% of scalp hairs are in the telogen phase.
There are several circumstances that produce a "shock to the system" that alters the hair growth rhythm. As a result, as much as 30%-40% of the hairs can cycle into telogen. Three months later, hairs come out in a massive shedding (effluvium), especially near the front of the scalp. These include
- high fever,
- sudden weight loss (crash dieting),
- severe illness,
- severe emotional stress or loss.
None of these need be life-threatening, nor does hair loss usually follow them. (Moreover, it can happen after one pregnancy, but not the next.) But when the hair falls out, it's all over the place -- covering the pillow, clogging the drain, and so forth. Paradoxically, the more dramatic the hair loss, the better the prognosis, because when the body gets back into normal rhythm, most if not all of that hair comes back; these people need no special treatment. Normal shampooing can continue, because this only loosens hairs that were going to come out anyway.
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