Telogen effluvium. It sounds so much more intriguing than stress related hair loss. Everyone likes cool names. Physicians are no different. The closest I got to taking a Latin class in college was a Classics for Jocks class where a professor fond of helping football and hockey players with a passing grade in a fun class taught a course on the classic Latin and Greek literature. Still, I like the sound of Latin sounding names for medical conditions, especially when I can both remember and spell them.
I enjoy telling my patients who have this condition what is going on because it’s an interesting condition, it’s not serious, it gets better with time and patients can easily understand the cause and course of the problem. This week in the office a very pleasant woman came in with this condition, and although not happy to hear that there was nothing I could do to help, she at least appreciated a diagnosis, and was relieved to hear that her hair would grow back.
Each hair on our body has two major periods in its lifespan. Each hair starts growing and continues to grow for an average of 3 years, the phase called anagen. Then the growth stops, and the hair follicle enters the phase called telogen. At any one time 5-10% of a person’s hairs are in telogen. After about 3 months, and this period of time varies widely from one person to another, the hair in telogen falls out as a club hair. It’s called this because the root of the hair if looked at microscopically has a rounded, thickened, club-like appearance. A hair pulled out in anaphase has a ragged, ripped-out looking root microscopically. On average 1-200 scalp hairs are shed daily. I don’t think I have enough hair left to lose that many.
Certain major stresses and conditions can shock a large percent of the body’s hairs to stop growing and enter telophase simultaneously. This phenomenon is called telogen effluvium. When this happens, a few months later a large percentage of an individual’s hair can be shed as club hairs over a few weeks or months period of time. It can be very disturbing to the person losing their hair. The classic stress to cause this is childbirth, and in the days when I did maternity care it was not uncommon for me to see women in the office a few months after delivery distraught that they were losing lots of scalp hair. Other stresses that can cause this are major surgery, high fever, serious illness, major emotional stress, and rapid weight loss. Medical conditions associated with telogen effluvium are anorexia nervosa, iron deficiency, hypothyroidism, and the sudden conditions mentioned above.
This is a good news/ bad news situation to tell patients about. The good news is that it is completely reversible, and usually resolves in a few months. The bad news is that is quite a while before the hair grows back, and that there is nothing to do to speed the process along. In my experience although many patients come to the office thinking hypothyroidism is the cause of their hair loss this is very rarely the problem. Emotional of physical stresses are more common causes.
If there is anything good about telogen effluvium, it’s that it has a cool name, and you can impress your friends by telling them a snazzy name for your condition. You might as well take advantage of the little things. There’s not much else you can do except wait for your hair to grow back.