Telogen Effluvium
Telogen Effluvium is a common form of non-scarring alopecia characterized by the premature transition of hair follicles from the growth phase (anagen) to the resting phase (telogen), resulting in diffuse shedding.
Key Triggers
Typically occurs 2–3 months following a significant physiological or psychological stressor:
- Severe illness/Surgery: High fever, major operation.
- Endocrine/Metabolic: Childbirth (postpartum alopecia), thyroid disorders, severe protein or iron deficiency.
- Medications: Retinoids, beta-blockers, anticoagulants.
Clinical Presentation
- Diffuse Shedding: Hair density is decreased, but there is no inflammation, erythema, or scalp pain.
- Pull Test: Positive (hair strands come out easily from all areas of the scalp).
- Regrowth: Hair regrowth usually begins within 6 months once the underlying trigger is addressed.
High-Yield Exam Pearl:
- Diagnosis: It is a diagnosis of exclusion. Ensure you rule out iron deficiency, hypothyroidism, and other systemic causes before settling on a diagnosis of telogen effluvium.
- Microscopy: Telogen hairs are identified by a club-shaped root, confirming they were in the resting phase at the time of shedding.