Dealing with Acute Telogen Effluvium: Causes, Symptoms, and Management Strategies
Hair shedding is an inherent and essential part of the hair growth cycle.
Individuals typically shed 50-100 hair strands everyday unknowingly as new hair continues to grow in its place.
However, more noticeable and unusual shedding may indicate an underlying condition contributing to excessive hair loss.
Telogen Effluvium is one such condition when abnormal shedding occurs because of an aberration in the hair growth cycle.
It is considered an acute condition if it persists for less than six months; if it continues beyond that, it is said to be a chronic condition.
Continue reading to better understand Acute Telogen Effluvium, including its causes and effective management strategies.
Acute Telogen Effluvium: Understanding the phenomenon
The life cycle of a hair follicle encompasses three phases: the growth phase (anagen), the regression phase (catagen), and the resting phase (telogen).
The anagen phase typically lasts two to five years, during which approximately 90% of scalp hair is actively growing.
In contrast, the catagen phase is much shorter, spanning only three to six weeks.
During this phase, the hair follicles undergo a process of programmed cell death known as apoptosis.
Finally, the follicles enter the resting state, which extends for three to five months, with around 10% of scalp hair in this resting phase (telogen).
The cycle begins again with the end of the resting phase, and the hair follicle transitions to the catagen phase (anagen).
The hair strands in the resting phase (telogen) mature and are expelled from the follicle to make room for a new strand, and hair shedding is observed.
Telogen Effluvium develops when there is a disruption in the normal hair growth cycle, causing a higher number of follicles to enter the telogen phase at a time.
Various factors can cause follicles to enter or stay in the telogen phase abnormally.
If the telogen follicles exceed 15%, it suggests the presence of Telogen Effluvium (TE), whereas a proportion exceeding 25% is considered a definitive indicator of TE.
Acute Telogen Effluvium symptoms
The primary indicator of Acute Telogen Effluvium is increased hair shedding.
One notices more than usual hair on their pillows, in the shower drain, or on the hairbrush.
Hair thinning may also be observed around the crown and top of the head.
Trichodynia (Cutaneous Dysesthesia Syndrome) is another major symptom of Acute Telogen Effluvium.
Trichodynia is a sensation of pain, tenderness, and itching on the scalp.
The causes behind Acute Telogen Effluvium
As mentioned previously, any disturbance in the hair growth cycle that results in a greater proportion of follicles in the Telogen state can lead to hair shedding.
Several factors, such as metabolic stress, hormonal fluctuations, or specific medications, can contribute to this disruption.
A nonscarring shedding from the scalp occurs around three months after a triggering event.
Below are the triggers behind Acute Telogen Effluvium:
Physiological stress
Various medical events can cause considerable physiological stress in an individual.
Surgical procedures, systemic illnesses, high fevers, and hemorrhages can all contribute to physiological stress, resulting in the development of Acute Telogen Effluvium.
Hormonal changes
Certain hormonal changes are also associated with the onset of Acute Telogen Effluvium.
Childbirth and discontinuation of Estrogen-containing medication result in hormone fluctuation, particularly a decrease in Estrogen, which can lead to hair shedding.
Hypothyroidism, as well as Hyperthyroidism, can be a trigger factor for Acute Telogen Effluvium.
Emotional stress
Stress is one of the major triggering factors for Acute Telogen Effluvium.
Any form of emotional or mental stress can cause more than usual hair shedding.
Medical conditions
Numerous medical conditions have been associated with Acute Telogen Effluvium.
Some of these include:
- Systemic Amyloidosis (a protein called Amyloid builds up in organs)
- Hepatic failure(Acute liver failure)
- Chronic renal failure,
- Inflammatory bowel disease
- Lymphoproliferative disorders(related to defects in the immune system)
- Dermatomyositis(muscle inflammation)
- HIV
- Syphilis(bacterial infection usually spread through sexual contact)
- Psoriasis(skin disease)
- Seborrheic dermatitis(skin condition mainly affecting the scalp)
Nutritional condition
Ensuring proper nutrient supply is essential for maintaining overall health and impacts the hair’s health.
Inadequate supply of certain nutrients, such as protein, iron, zinc, and vitamin D, can contribute to the development of Acute Telogen Effluvium.
Crash dieting, starvation, and caloric deprivation can lead to a deficiency of nutrients.
In rare cases, B vitamin biotin can potentially trigger telogen hair shedding.
Medications
Several drugs have been found to be a triggering element for Acute Telogen Effluvium.
Most common of these include beta-blockers, retinoids (including excess vitamin A), anticoagulants(Heparin), Propylthiouracil, Carbamazepine, and immunizations.
Other medications linked to Acute Telogen Effluvium may include:
- Oral contraceptive pills
- Androgens
- ACE (Angiotensin-converting Enzyme) inhibitors, primarily used to treat high BP
- Anticonvulsants(used to treat seizures)
- Antidepressants
Medications can induce hair loss by either abruptly stopping the growth of cells or causing hair follicles to prematurely enter a resting phase.
You must inform the doctor about all the medications you are taking while getting an opinion on hair shedding.
Acute Telogen Effluvium treatment options
The treatment approach to Acute Telogen Effluvium involves identifying the triggering element and managing the same.
Acute Telogen effluvium is a self-correcting condition that typically resolves on its own.
No additional treatment is necessary if the triggering event has been identified through medical history and appropriately addressed.
One may expect the shedding to cease within 3-6 months.
The patientâs drug and medical history help determine the course of action.
Depending upon the underlying cause following steps can be considered:
- Treating causative conditions such as high fever, psoriasis, Seborrheic dermatitis
- Correcting the nutrient deficiencies
- Regulating the hormone levels
A few measures can be supplementary aid to the natural cessation of Acute Telogen Effluvium.
- FDA-approved Minoxidil and Finasteride can be considered to promote hair growth; however, their efficacy is limited.
- Topical Minoxidil can be a reasonable drug in case of stress-induced Acute Telogen Effluvium.
- Stress coping strategies can also aid in recovery.
- Topical Corticosteroids can effectively alleviate Trichodynia symptoms, i.e., pain and itching on the scalp
- If hair thinning is observed, CNPDA (a combination of caffeine, niacinamide, panthenol, dimethicone, and an acrylate polymer) is an effective treatment.
Additionally, if the patient remains frustrated and worried, it may add to the stress and potentially slow recovery.
Providing reassurance and counseling to the patient can positively impact their recovery.
Summary
Acute Telogen Effluvium is the more-than-normal shedding of hair caused by the disruption in the hair follicle life cycle.
When a higher proportion of hair follicles remain in the resting phase, i.e., telogen at a time, it leads to an increase in hair loss.
The good news is that it is a self-correcting condition that typically goes away in 3-6 months.
Several factors can trigger Acute Telogen Effluvium.
These include hormonal disbalances, emotional and physiological stress, nutrient deficiency, and consumption of certain medications.
The treatment of Acute Telogen Effluvium involves identifying and addressing the root cause.
This may involve lifestyle changes, managing stress levels, improving nutrition, treating underlying medical conditions, or adjusting medications.
Medications such as Minoxidil and Finasteride may be prescribed to support the recovery process, although their effectiveness may be limited.
It is essential to consult with a medical expert who can provide personalized advice and treatment options based on your specific situation.
Frequently Asked Questions
How do you recover from Acute Telogen Effluvium?
Acute Telogen Effluvium is a self-limited condition and needs no additional treatment if the underlying cause is identified and appropriately addressed. Minoxidil and Finasteride drugs can support recovery; however, their efficacy is limited. Your medical and medicine history will help your doctor find the cause and appropriate treatment.
What is the meaning of Acute Telogen Effluvium?
Telogen Effluvium means excessive hair shedding due to a higher number of hair follicles remaining in the resting phase, known as telogen. It is classified as acute if it lasts for less than six months. This condition is commonly caused by a notable physical or emotional stressor, leading to a temporary phase of excessive hair shedding.
How long does Acute Telogen Effluvium last?
Acute Telogen Effluvium resolves once the underlying trigger is addressed, usually within six months. However, if it persists for over six months, it can become a chronic condition characterized by abrupt, excessive, and diffuse hair shedding that fluctuates over several years.
How do you treat Acute Telogen Effluvium?
The treatment for Acute Telogen Effluvium involves addressing and resolving the underlying cause. This may include lifestyle changes, stress management, improving nutrition, treating medical conditions, or adjusting medications. Medications like Minoxidil and Finasteride may be prescribed, but their effectiveness is limited. Consulting with a medical professional for personalized advice and treatment options is important.
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