So you wake up the morning, and noticed quite a lot of hairs on your bed sheet. Your comb and your shower sink are recently stuffed with more hair than normal. What is really happening? What is with the sudden hair loss?
To a lot of people, they might link this problem with Pattern Baldness or suspect some other reasons. What you might be having is a quite common condition known as Telogen Effluvium (TE).
What is Telogen Effluvium?
Telogen is the last phase of your hair growth cycle. Every hair follicle’s growth has 3 phases which are
- ANAGEN (Growing phase)
- CATAGEN (Transitional phase)
- TELOGEN (Resting Phase)
Effluvium simply means outflow, so this condition indicates you have a sudden outflow of TELOGEN hairs. How does this happen?
How Your Hair Grows
First and foremost, you must understand your hair growth cycle. A normal person’s hair at any one time has around 100,000 hair follicles. In a normal scalp condition, 85% to 90% of your hair are in the ANAGEN phase. Around 5% percent of your hair will be in the CATAGEN phase and 10% in the TELOGEN phase.
During the ANAGEN phase, your hair will grow and stay healthy. It will look thick, nourished and grows around half an inch a month. This phase will usually last for 2 to 8 years. After that, you hair follicle will enter the CATAGEN phase. Now this is a very short transitional phase as it will usually last for 2 to 4 weeks. At this stage, your hair will shrink in size and disconnected from the blood supply. This is where a new hair follicle will start to grow from under the scalp.
Finally, the TELOGEN Phase. Your hair follicle will be in the resting phase, where there will be no growth at this phase as it is waiting for the new hair follicle to come out from under the scalp. This period will usually last for 3 months and then your hair follicle will fall out and replaced by a new one. During this phase, your hair follicle is weak and you can easily pull it out.
If you factor in that you have 100,000 hair follicles in your scalp and 10 % of it is in the TELOGEN Phase while 1% of those hairs are in the last days of its phase, you will understand why it is normal to shed between 50 to 100 hairs a day.
How Does it Happen?
This condition usually happens out of a sudden, when a significant percentage of your hair follicles in the ANAGEN phase switched to the TELOGEN phase. This situation might involve more than 50% of the growing hair follicles. After 3 months, where the TELOGEN hairs reach the end of its phase, you will suddenly noticed a large portion of your hair falling out without warning.
So What Triggers Telogen Effluvium?
While most cases of TE do not have a specific trigger, it is mainly related to stress. Your body physically or mentally has to go through certain shock in order to trigger the hair follicles from the ANAGEN phase to the TELOGEN phase. Some of the events include
- Psychological Stress
- Bad news
- Lost of relatives/loved ones
- Excessive Travelling/Jet lag
- Down with a medical condition
- Crash Diets
- Hormonal problems
- Post pregnancy
- New medications
Whatever the reason, it’s most important to know that TE must be caused by a trigger like a certain extraordinary and negative event in your life. You won’t have this condition if everything in your life is normal.
During that time, your body is under colossal stress and therefore put itself in the situation where it has to divert it’s energy to other parts of your body to compensate resulting in your huge amounts of your hair follicles to enter the resting phase.
Chronic and Acute Telogen Effluvium
There are actually 2 general types of TE. The most common type is Acute TE where you will notice sudden large amount of hair loss. This condition usually last for a few days to a few weeks depending on the severity of the ‘shock’ your body receives. Acute TE usually is triggered by sudden changes in your life like
- After pregnancy
- Down with a short term illness
- Sudden mental stress
Most importantly, remember that Acute TE only lasts for a short duration usually depending on the shock that you receive.
Chronic TE however is different. It is longer and can even lasts for several years. Most cases of this prolonged condition is reported in women but men is not spared too. Chronic TE occurs when you are undergoing prolonged stress, shock or suffering from iron deficiency.
The reason why it mostly occurs in women is because that most women might change their diet and adapt to a less iron concentrated diet like red meat. Most red meats are a good source of iron, discontinuing from taking sufficient supplies might affect the growth of your hair follicles. One of the other reasons might be irregular blood loss due to menstruation. Women with heavy periods might experience reduced levels of nutrients and iron in the body.
Chronic Telogen Effluvium is a long term condition. Instead of sudden loss of hair, you might experience gradual diffusing of your hair over a period of years.
The Combination of Telogen Effluvium and Pattern Baldness
While TE has nothing to do with others hair loss conditions like Pattern Baldness, sufferers of Pattern Baldness are usually in worse terms when they have TE. As TE causes rapid shedding of your hair, when your hair grows back, it will be shorter and weaker due to minituarization by DHT. Therefore, it is more harder on people who face both of these condition.
Diagnosing Telogen Effluvium
So how do you know whether you are suffering from this condition? Diagnosing this condition is rather simple. A simple ‘hair pull’ by pinching a bunch of your hair between your thumb and middle finger will determine whether majority of your hair are in the Telogen Phase.
Some simple steps that you can do yourself.
- Make sure you wash your hair daily for 1 week. Irregular washing might cause inaccurate diagnosis because more Telogen hair might still stay on your scalp.
- Use your thumb and middle finger and pinch a group of hairs anywhere in your scalp. Usually you will grab around 30-35 hairs per pinch.
- Next give your hair a sharp pull.
- Repeat it in 15 locations all over your scalp.
Usually, in normal conditions, you will manage to pull out 1 to 3 hairs with each pull. That is because 10% of those hairs are in TELOGEN phase. So these hairs are easier to dislodged compare to ANAGEN hairs. However, if you managed to pull out more than 4 to 5 hairs, it might indicate that you have a period of TE.
As TE does not have a specific pattern of hair loss, you will usually face with diffuse thinning all over the scalp region unlike Pattern Baldness.
Crashing Your Way to Sudden Hair Loss
One very certain and sure way to trigger Telogen Effluvium is through an unplanned crash diet. If you want to lose weight immediately by starving yourself and exercise rigorously, you also put your physical and mental health at risk. Without proper planning and understanding on crash diets, you really can place yourself in danger of unwanted hair loss.
Treating Telogen Effluvium
Most cases of Acute TE will go away, you can expect your hair to grow back to it’s full length after 6 months. For chronic TE, the best way to treat it by locating the source of the trigger. Find the cause of this condition by checking back whether you have used any new medications or suffering from an illness.
If you are still unsure, it’s best to get a blood test from your doctor. TE can indicate an underlying disease or illness that you are not aware of. So if you have prolonged diffused thinning and uncertain of any such representing events, see your doctor.
There is one other treatment that you can use. Minoxidil 5% like Rogaine is a hair growth stimulator. It works by stimulating and shocking your hair follicles to grow. Therefore, it is effective in stopping TE or at least slowing it down. But most importantly, if there is another reason behind it, it’s best to stop it and then you can stop TE.
Preventing Telogen Effluvium
There is no way you can prevent TE as it is caused by so many stress related factors as you cannot fully prevent stress. However, you can prepare yourself and reduce the impact. How to do that?