What are the aims of this leaflet?  

This leaflet has been written to help you understand telogen effluvium. It tells you what telogen effluvium is, what causes it, and how it can be treated. It also tells you where you can get more information about it.  

What is telogen effluvium?  

Telogen effluvium is a condition where more hair than usual falls out from your scalp. This happens because of illness, stress or major changes in the body disrupting the normal hair cycle.   

Most people lose between 30 and 150 hairs from their scalp every day. This is completely normal and part of the hair’s natural life cycle. New hairs grow to replace the ones that fall out, and the total number of hairs on the scalp usually stays the same.  

Hair grows in cycles:  

• Growth Phase (Anagen) – Around 85% of follicles on a person’s scalp are actively growing hair.  

• Shedding Phase (Telogen) – Around 15% of follicles on a person’s scalp are resting and getting ready to shed (fall out).
   

When a hair follicle enters the shedding phase it stops growing, rests for two to four months and then a new hair begins to grow. The new growing hair pushes out the old hair, causing it to shed.
In Telogen effluvium, there is a large increase in the number of hairs in the shedding phase. This can be caused by physical or mental stress on the body. 

Normally only 15% of the scalp hair is in the shedding phase, but in telogen effluvium this increases to 30% or more. This increase in shedding often happens suddenly. It can occur around 3 months after a trigger. 

What causes telogen effluvium? 

Increased hair shedding in telogen effluvium occurs due to a disturbance of the normal hair cycle. Common triggers of telogen effluvium include:  

• childbirth,  

• severe trauma or illness (especially if a high fever occurs),  

• stressful or major life events,  

• surgical procedures,  

• marked weight loss and extreme dieting,  

• severe skin problems affecting the scalp,   

• starting new medications or  

• stopping a hormone treatment (such as coming off the contraceptive pill).  

For 1 in 3 people diagnosed with telogen effluvium, no cause can be found.  

Does telogen effluvium run in families?   

Telogen effluvium affects all age groups and both sexes equally. It does not run in families or have a genetic cause.  

What are the symptoms of telogen effluvium?  

Most people become aware of losing hair when the amount increases. This is most noticeable after washing or brushing. More hair is usually found in the bath/sink drain of the shower/bath, or on your hairbrush/comb. Some people will notice increased hair on the pillow in the morning or around the house. The onset of hair loss is typically sudden and without warning. Usually there are no other symptoms, but occasionally telogen effluvium can be accompanied by tenderness and altered sensations in the scalp. This is known as trichodynia. 

What does telogen effluvium look like?  

Hair shedding in telogen effluvium usually occurs from all over the scalp. You may notice a decrease in hair thickness and loss of hair volume rather than patches.    

How is telogen effluvium diagnosed? 

A diagnosis is usually made by looking at the scalp appearance and taking a medical history.  

A hair pull test can be carried out. This is where the hair can be gently pulled to see if more hair comes out than usual. If the hair has been washed within 48 hours beforehand, this test may be falsely negative). 

Hairs can be plucked from the scalp to be looked at under a microscope (a type of equipment used to diagnose skin conditions).Very rarely a skin biopsy may be required where diagnosis is uncertain. This is when a dermatologist takes a small sample of skin to look at in the laboratory. A blood test may be carried out to exclude other possible causes of hair loss. These causes can include thyroid conditions and iron deficiency.   

Can telogen effluvium be cured?   

Telogen effluvium usually gets completely better without any treatment. The shedding (hair loss) phase in the hair cycle lasts between 3 to 6 months. After this, new hair starts to grow. It may take many months for your hair to return to normal volume and thickness. Telogen effluvium can reoccur if the possible underlying cause such as iron deficiency is not treated. Telogen effluvium is considered chronic (long term) if it lasts for more than 6 months.  

How can telogen effluvium be treated? 

There is normally no treatment required for telogen effluvium as the hair will naturally start to grow back. Taking medication does not speed up the process of hair regrowth.   

What if the scalp starts to become visible because of thinning of the hair? 

This can happen in very severe cases of telogen effluvium. There are various options for helping disguise the ha ir loss which you can talk about with your doctor. Potential options include:  

• Using camouflaging hair fibre powder or spray (the fibres stick to existing hair) 

• Using a volumizing shampoo 

Use of either of these will give the appearance of greater hair thickness and disguise areas of visible scalp.  

It is very unusual for telogen effluvium to cause hair thinning severe enough to require the use of a wig. However, if needed, wigs are available with a consultant prescription on the NHS. This may need a financial contribution from you towards the cost of the wig.   

Other types of hair loss  

There are many other causes of hair thinning, including male and female pattern hair loss (known as androgenetic alopecia). These may appear in a similar way to telogen effluvium. Sometimes both of these conditions appear around the same time.   

In some cases, telogen effluvium can lead to an early diagnosis of androgenetic alopecia (male and female pattern hair loss).   

Self-care (What can I do?)  

• Avoid harsh brushing or combing of hair. 

• Limit the use of heated hair tools such as hairdryers, straighteners, or curlers 

• Avoid hair bleaching/relaxing techniques or any treatment that uses harsh chemicals 

• Limit use of tight hairstyles.  

• If you smoke, you can consider stopping. Cigarette smoke can worsen hair loss. If you would like to stop smoking, your GP can provide help and support with this.  

• Eating a balanced diet including food rich in iron, protein, fresh fruit and vegetables may be helpful.  

• Consider taking supplements if your diet is restricted (for example vegan or vegetarian).   

• If hair shedding does not get better, then it is recommended that you see your doctor to rule out other causes of hair loss.  

• Some people find it helpful to join a patient support group and meeting other people with telogen effluvium or similar condition. 

Where can I get more information about telogen effluvium?  

Patient support groups providing information:  

Most hair loss support groups focus on alopecia areata but can offer useful advice for all patients affected by hair loss.  

Alopecia UK
Web: www.alopecia.org.uk 

E-mail: info@alopecia.org.uk  

Weblinks to other relevant sources: 

DermNetNZ: www.dermnetnz.org/topics/telogen-effluvium 

Patient Info: www.patient.info/skin-conditions/telogen-effluvium 

Alopecia UK: www.alopecia.org.uk/telogen-effluvium 

Jargon Buster:  www.skinhealthinfo.org.uk/support-resources/jargon-buster/  

Please note that the British Association of Dermatologists (BAD) provides web links to additional resources to help people access a range of information about their treatment or skin condition. The views expressed in these external resources may not be shared by the BAD or its members. The BAD has no control of and does not endorse the content of external links.   

This leaflet aims to provide accurate information about the subject and is a consensus of the views held by representatives of the British Association of Dermatologists: individual patient circumstances may differ, which might alter both the advice and course of therapy given to you by your doctor.  

This leaflet has been assessed for readability by the British Association of Dermatologists’ Patient Information Lay Review Panel  

BRITISH ASSOCIATION OF DERMATOLOGISTS PATIENT INFORMATION LEAFLET

PRODUCED | DECEMBER 2013 

UPDATED | DECEMBER 2016, MAY 2020, OCTOBER 2025 

NEXT REVIEW DATE | OCTOBER 2028 

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