Diffuse Hair Loss (Telogen Effluvium)

There are several situations and stimuli which can induce a large number of hairs prematurely into the resting (telogen) phase. Such a person would lose a large number of hairs from the scalp. This type of excessive loss of hair is called 'telogen effluvium'. The hairs however, are not lost at the time of stress, the hairs on the other hand are lost only when these hairs have completed their telogen phase and new hairs have started growing in these places. Since the duration of the resting phase is three months, the hair loss starts almost three months after the actual cause that triggered the loss of hair. By that tilne most of the individuals tend to forget the actual cause of the hair loss and erroneously incrilninate a variety of factors-like the use of a particular shampoo, ilnpurities in the water, polluted air, change of residence, etc. All these factors actually have no influence on the growth or loss of hair.

Causes of Telogen Effluvium

The various factors which have been found responsible for causing telogen effluvium include.

Pregnancy and other hormone-related situations

During pregnancy there are pronounced changes in the hormonal status of a woman and some of these hormones have a marked effect on the growth of the hair. During pregnancy therefore, the anagen phase of several hairs gets prolonged, but after the completion of pregnancy as the hormonal status of the individual gets restored to the normal level, the hairs enter the telogen phase, after the completion of which these hairs are lost. The woman starts losing a large number of hairs approximately three months after the delivery. This hair loss can continue for a month or so till all the hairs which had been induced into the telogen phase are lost. Subsequently, the rate of loss of hair returns to normal and gradually the new hairs replace the old ones.

A similar situation can also arise if a person undergoes an abortion. The hair loss would start approximately three months after the abortion.

The same can happen even without pregnancy, if a person is being treated with female hormones or with contraceptive pills and the treatment is withdrawn suddenly.

Fever/general illnesses

It is also well known that if a patient develops typhoid fever, he tends to loose an excessive number of hairs, about three months after the fever. This used to be more common when the specific treatment for typhoid was not available and the disease was usually prolonged. Even now however, if the fever is high or prolonged, it often leads to excessive hair loss. Fever due to other causes also can lead to an excessive loss of hair. The fever may be brief but high, as in dengue and other viral fevers including influenza; or low and prolonged as in tuberculosis, or recurrent as in malaria. Several other acute or generalised diseases like tuberculosis or systemic lupus erythematosus (S.L.E.)and cancers which can cause severe physical stress on the body can also lead to excessive loss of hair.

Emotional stress

Severe emotional stress has also been noticed to lead to an excessive loss of hair. Tension may be due to an examination, frustration in a love affair, marital disharmony, maladjustment in the family, stress at the place of work or the impact of war, strife and calamities. Whenever the tension is severe, a large number of the hairs are prematurely induced into the telogen phase and three months later, excessive loss of hair is experienced. The loss gets reduced as the emotional stress disappears, but this can occur again when the emotional stress recurs.

Drugs

In many situations the patients tend to incriminate the intake of drugs, especially the antibiotics, for the increased loss of hairs, ignoring the fact that loss of hair may actually be due to the disease for which the drug was given. There is however, no doubt that some drugs can lead to excessive loss of hair, and these include mostly drugs prescribed for cancers, autoimmune and sometimes, other diseases. Less frequently, some other drugs too can lead to excessive loss of hair.

Excessive dieting

To control their body weight young people, especially girls, often resort to excessive dieting; so do the older individuals, who are over-weight and suffer from obesity. Periods of excessive dieting however, can induce a large number of hairs into the resting phase which is followed by the hair loss after three months. Hair loss due to dieting can be avoided if the process of diet control is slow.

Accidents and injuries

Accidents and severe injuries have also been observed to cause excessive loss of hair after three months of the traumatic incident