Telogen Effluvium and hair loss.

Published 17/07/2009

22 Votes

What is the Telogen Effluvium and how does it affect hair loss?

The telogen effluvium concept was introduced by Kligman in 1961, when he observed that an increase in the loss of telogen hair could be due to an acceleration of the hair cycle.

And he described it as the loss of normal hairs that follows a premature evolution of the follicles in anagenous phase to telogen phase.

Said hair loss becomes evident after two to five months, while in the anagen effluvium the hair loss manifests after days or weeks.

Hair loss due to telogen effluvium is always diffuse or of masculine distribution; it is never total.

This hair loss can last from 6 months to a number of years providing another triggering agent does not strike.

In fact there are many conditions that can provoke hair loss, and therefore it is important to analyse all possible factors:

In 1993 Headington proposed five mechanisms by which the telogen effluvium may manifest:

Quick passage from anagen to telogen: the follicles enter the telogen phase prior to having completed the anagen phase.
Delay of the anagen phase: Some follicles delay their passage from anagen to telogen; when they finally revert to telogen a situation of acute diffuse alopecia manifests.
Reduction of anagen phase: It manifests with a moderate diffuse hair loss accompanied by a limitation in hair length.
Rapid telogen loss: the telogen hair is lost in a short space of time.
Delay of the telogen phase: Tends to be preceded by a global reduction in the number of hairs, in an insignificant manner.

Common causes of telogen effluvium

There are many potential causes that may provoke telogen effluvium, but the most common are the following:

Dietary deficiencies: such as the lack of vitamins or minerals, particularly iron.
Hormones/Pregnancy/Childbirth: Abnormal levels of hormones in women, especially during pregnancy and thereafter, or lack of nutrients in the embryo.
Alopecia induced by fever: High body temperatures, in response to chronic infectious diseases, to which the hair follicles respond by reducing their activity.
Ultraviolet radiation: Low doses of UV radiation may destroy some of the sensitive cells of the follicles and reduce their activity.
Acute blood loss: Blood loss can empty the follicle of nutrients, forcing it to reduce its activity.
Hyperthyroidism or Hypothyroidism: the thyroid hormones have a profound effect upon follicular activity.
Neonatal effluvium: Newborns can experience a loss of hair in the first months of life.
Extreme physical stress: Surgical interventions.
Emotional stress: Chronic emotional stress, or sudden shocks, can cause adverse effects in the follicles, although the mechanisms that produce them are unknown.
Severe illness: This can change the normal functioning of the body and have an impact on the follicles.
Medications:

Tiempo entre el inicio del tratamiento y el desarrollo del Efluvio Telógeno	Medicamentos	Incidencia (%)
2-3 meses	Acitetrin, heparina, interferon alfa, isotretinoina, litio, ramipril, terbinafina, timolol, ácido valproico, warfarina	>5
	Aciclovir, alopurinol, buspirona, captopril, carbamazepina, cetirizina, ciclosporina, sales de oro, lamotrigina, leuprolido, lovastatina, nifedipina	1-5
	Amiodarona, amitriptilina, azatioprina, dopamina, naproxeno, omeprazol, paroxsetina, prazosina, sertrlina, venlafaxina, verapamil, propanolol, exceso de vitamina A	<1

Treatment

The treatment is the same as for anagen effluvium, providing there is no associated androgenetic alopecia, and is a question of determining the aetiological agent that began this type of baldness, and taking the therapeutic measures necessary.
Once achieved, the hair will grow again as before and we will recover the appearance we had prior to the hair disorder.