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Major stressors can affect your hair — but only temporarily.

Hair shedding is normal. But more-than-usual shedding could be a sign of a condition called telogen effluvium. Learn why it happens and what you can do about it.

What is telogen effluvium?

“Telogen effluvium (TE) is the most common type of temporary hair loss I see that happens after severe stress or a change to your body,” reports Oksana Bailiff, MD, a dermatologist at Geisinger. 

With TE, your scalp sheds a higher-than-normal amount of hair, usually around the top of your head. Because your hair looks thinner, you may worry you’re going bald, but it will grow back in time.

In the normal cycle of hair growth and shedding, the three stages are:

Anagen (growing)

Cells in your hair follicle are quickly dividing in this stage, forming new hair. Once the hair is formed, it pushes out of the follicle and lengthens. A hair follicle can grow hair in this stage for up to four years. About 80% to 90% of your hair follicles are in this stage at any given time.

Catagen (transitioning)

During this stage, your hair stops growing. Less than 1% of your hair is in this stage at a time.

Telogen (resting)

In this stage of the cycle, the hair follicle is inactive and a white bulb of keratin forms at the root to keep the hair in the follicle until it’s ready to be shed. About 10% to 15% of hair is normally in the telogen phase at any given time.

Telogen effluvium happens to your hair during the telogen phase. Some sort of stress or change to your body can result in over 20% of your hair entering the telogen phase prematurely, which causes hair loss. Most healthy people lose up to 100 or 150 strands of hair per day, but if you have TE, you might lose 300 or more strands per day.

What causes telogen effluvium?

When your body undergoes stress, your hair does too. The stressor can be emotional or physical:

  • High fever
  • Childbirth
  • Menopause
  • Severe infection
  • COVID-19
  • Psychological stress
  • Major surgery
  • Hospitalization
  • Hyper- or hypothyroidism
  • Anemia due to iron deficiency
  • Discontinuing birth control pills
  • Strict diets, especially those without enough protein, and weight loss
  • Many medications

The good news: It’s temporary.

Hair loss from telogen effluvium stops when the stress is removed or the underlying medical condition is addressed. This sounds simple, but TE doesn’t happen immediately. It usually occurs about one to three months after a major stress to the body, so it may be difficult to pin down the stressor. 

If you suddenly lose a lot of hair, talk to your doctor for help figuring out what caused it. A blood test could also reveal underlying health problems that are contributing to the hair shedding. 

How to reverse hair loss from telogen effluvium

In most cases, no treatment is necessary. “Once the stress has passed, your hair will usually return to normal in a few months,” says Dr. Bailiff. 

Sometimes, medication may be needed — like when your doctor detects a thyroid disorder. Any treatment will depend on what caused the stress to your body. 

Some things you can do to help in the meantime:

  • Be gentle with your hair. Use mild hair care products, be careful when combing and styling your hair and don’t sport hairstyles that pull on the scalp (like high ponytails). Extend your good skin care practices to your scalp. A gentle scalp massage while shampooing and conditioning your hair may help stimulate hair growth.
  • Eat a healthy, balanced diet. Make sure you get plenty of protein, healthy fats and antioxidants.
  • If your doctor finds you have a nutritional deficiency and recommends supplements, be sure to start taking them as soon as possible. A healthy diet can supply vitamins and minerals your body needs, but sometimes a supplement is necessary to get your body back on track. 

What’s the difference between telogen effluvium and androgenetic alopecia?

Telogen effluvium involves rapid shedding of hair over a short period. It typically happens a couple of months after your body goes through a physical or emotional stress. It can also happen from sudden hormonal changes. Hair loss due to TE is usually temporary, but can last up to six months. Your hair often grows back without treatment once that stress is gone.

Androgenetic alopecia (male pattern baldness and female pattern baldness) is a type of hair loss that’s more gradual. “Without medications or treatment, hair loss due to androgenetic alopecia is permanent and progressive,” explains Dr. Bailiff.

Next steps:

Learn about androgenetic alopecia
9 effects of stress on your body
Meet Oksana Bailiff, MD

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