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Telogen Effluvium: Symptoms, Causes, and Treatments

Knox Beasley, MD

Reviewed by Knox Beasley, MD

Written by Sian Ferguson

Published 07/10/2021

Updated 04/14/2024

If you’ve noticed your  hair shedding a few months after having surgery, falling ill or starting a new medication, you might be experiencing telogen effluvium, a common form of hair loss.

The good news? It’s usually temporary.

Telogen effluvium happens when a stressor — say, a traumatic event or a major hormonal change — disrupts your hair growth cycle.

As a result, you may find a concerning number of hairs on your pillow or stuck in your shower drain. You might also have noticeable thinning hair all over your head.

While telogen effluvium usually goes away on its own, it’s not something you should ignore.

For one, it can be a symptom of a medical issue. Hair loss can be your body’s “check engine” light — a warning sign that you need to make an appointment with a healthcare professional. It may also be a sign you need tor pay better attention to your diet.

Let’s take a look at the symptoms, common causes and treatment options for telogen effluvium.

Telogen effluvium is a type of hair loss caused by stress or a shock to the system. It’s technically a scalp disorder that leads to  excessive hair shedding.

Before we get into the weeds, let’s take a very quick class on the stages of hair growth.

The hair goes through three main stages during the hair cycle:

  • Anagen phase. This is the active stage of growth where the hair stretches to its full length. At any given time, around 90 percent of all scalp hair is in this phase.

  • Catagen phase. Here, the hair transitions from growing to a resting stage.

  • Telogen phase. This is a dormant stage where the hair remains in place without growth.

After these growth phases happen, the hair will shed. This is called the exogen phase.

So, back to telogen effluvium. This condition is triggered when some form of stress causes hairs still in the process of growing (anagen stage), to zoom past and enter the resting or telogen phase of hair growth.

Those telogen hairs stop growing for about one to six months — although it often takes an average of three months.

While this is happening, the person experiencing this change is usually clueless.

That is, until the hairs re-enter the growth phase, bumping the telogen hairs away from the hair follicle.

When this happens, a lot of telogen hairs are shed — sometimes up to 50 percent — making for a noticeable missing portion of hair.

For this reason, most cases of telogen effluvium are only noticed months after you experience the stressor. This might make it hard to identify the causes of your hair loss. We’ll get into possible triggers for telogen effluvium later in this guide.

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If you’ve been noticing a worrying amount of hair littering your pillows, floor, clothing or hair brush, you may be experiencing telogen effluvium symptoms.

But how do you know whether you’re experiencing telogen effluvium or another type of hair loss?

Here’s what to look out for:

  • A considerable loss in hair. Telogen effluvium causes a very noticeable reduction in hair volume. While it’s normal to lose around 50 to 100 strands of hair daily, this number could be much higher with this condition.

  • Tender scalp. In addition to losing hair, this disorder could also cause some pain, which you may notice when touching the skin of your scalp or your hair. This is caused by a condition called trichodynia.

  • Diffuse hair loss. One of the main differences between telogen effluvium vs male pattern baldness is that pattern hair loss happens in a specific place — say, thinning on the crown or a receding hairline — while telogen effluvium causes hair fall all over your scalp.

In general, telogen effluvium does not cause total baldness.

How long does telogen effluvium last? Acute telogen effluvium becomes noticeable around two months after the body has been exposed to a shock or trigger. It lasts a few months — usually less than three months.

Should you experience these symptoms for more than six months, you may be diagnosed with chronic telogen effluvium.  Sometimes, chronic telogen effluvium occurs without a particular trigger.

A healthcare professional can diagnose telogen effluvium by physically examining your scalp for signs of hair loss.

They might also conduct a “hair pull test”. During a pull test, they’ll gently pull about 40 to 60 hairs between their fingers and count how many hair shafts they manage to dislodge from the root. Normally, two or three hairs would come out, but if you have telogen effluvium, more will dislodge.  o identify the cause of your telogen effluvium, your healthcare provider might ask about:

  • Your diet

  • Medical history

  • Current medications

  • Recent traumas and emotional stress

They might also run blood tests if they suspect a medical issue — for example, hypothyroidism — could be to blame for your hair loss.

It usually takes a lot for noticeable hair loss to occur — we’re talking serious stressors, not just a week of poor eating or a stressful day at work.

Let’s look at the common causes of telogen effluvium.

Medications

Many medications can trigger the hair into a premature telogen phase.

These medications can include:

  • ACE inhibitors, which are used for managing blood pressure and heart failure

  • Androgens

  • Anticoagulants (also called blood thinners)

  • Anticonvulsants, which are used to treat seizure disorders and bipolar disorder

  • Antidepressants

  • Beta blockers

  • Oral retinoids, which are used to treat acne and other skin conditions

Some experts categorize all medication-related hair loss as anagen effluvium, while others only use the term anagen effluvium to refer to certain types of drug-induced hair loss (such as hair loss from chemotherapy).

Before you clear out your medicine cabinet, we’d encourage you to speak with a healthcare professional.

It’s important that you don’t stop taking your meds suddenly without expert guidance. Withdrawals and unmedicated health conditions can be even more stressful for your body and mind.

We’ll also add that, because of the length of the hair growth cycle, you’ll typically only notice hair loss after about 12 weeks of using these drugs.

Physical Stress

When your body goes through a particularly traumatizing experience, this can increase your chances of developing telogen effluvium.

Examples of physical stress can include:

  • Hemorrhages (significant blood loss)

  • High fevers

  • Hormonal changes

  • Pregnancy and childbirth

  • Severe illnesses or infections

  • Major surgery

By the time you notice hair loss, you might’ve already recovered from the physical stressor. In time, your hair density can recover, too.

Nutrient Deficiencies

Crash dieting can take a toll on your scalp.

Your body needs to be nourished in order to carry out all of its functions, including functions relating to hair growth. That’s why an inadequate diet can cause hair loss.

It’s also why weight loss and hair loss sometimes go hand-in-hand.

Common nutrient deficiencies that cause hair loss include:

  • Vitamins A, B, C, D, and E

  • Zinc

  • Iron

  • Selenium

  • Fatty acids

You might lose out on these nutrients if you’re restricting your food intake because of dieting, anorexia nervosa or a medical condition that affects appetite.

Or, you might be eating a decent amount but still not getting enough of the right vitamins.

Medical Disorders

In some cases, medical conditions can cause your hair to fall out.

These conditions include:

  • Inflammatory bowel disease

  • Kidney disease

  • Liver failure

  • Diabetes

  • Thyroid diseases (both hyperthyroidism and hypothyroidism)

As mentioned, your body needs adequate nutrients to produce hair cells.

That’s why diseases that affect your body’s ability to absorb nutrients — including conditions of the bowel, kidneys and liver — can also affect your hair.

Severe Emotional Stress

Although the connection between psychological stress and hair loss isn’t fully understood, it does seem that significant traumatic events and chronic stress can lead to telogen effluvium.

These stressful situations can include losing a loved one or experiencing near-death situations. Constant stress — from experiences including abuse, family difficulties or work-related demands — can also contribute to hair loss.

Fortunately, it’s possible to regain hair loss after stress.

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The good news about telogen effluvium is that this condition usually goes away on its own.

In fact, as high as 95 percent of all cases of acute telogen effluvium go into remission. When the underlying cause of hair loss resolves — for example, when you recover from stress or illness — your hair should begin growing again.

But that doesn’t mean you should ignore it. It’s a good idea to speak with a healthcare professional and get personalized medical advice.

It’s also smart to take a few steps to encourage telogen effluvium recovery. You can start with these treatment options.

A Balanced Diet

If you suspect a nutrient deficiency is to blame for the amount of hair you’ve been shedding, a balanced diet is a great place to start.

Make sure you’re getting enough of all the necessary vitamins and minerals by eating a variety of vegetables, proteins and healthy fats.

You can also use vitamin supplements to restore your mane to its former glory. For example, if you have an iron deficiency, you might need iron supplements to get your hair looking good.

Need a little extra support? Our biotin gummies contain a variety of vitamins that promote hair growth.

Minoxidil

This topical treatment is approved by the Food and Drug Administration (FDA) to address hair loss.

Minoxidil helps to counter hair loss by moving hairs from the telogen phase to the anagen phase of the growth cycle. In other words, the hair shifts from a resting phase to a growth phase.

You might experience mild, temporary hair shedding before the new hair shaft begins to grow. This side effect doesn’t last forever, but it may take a few months before minoxidil starts working.

You’ll need to apply minoxidil foam or minoxidil solution to your scalp regularly — usually every day. he effort tends to pay off and you’ll likely notice telogen effluvium regrowth within a few months.

Finasteride

Finasteride is another trusted FDA-approved treatment for managing hair loss. It’s typically used to treat androgenic or androgenetic alopecia, also known as male pattern hair loss.

This medication gets the job done by blocking dihydrotestosterone (DHT), a hormone that affects the hair follicle and causes pattern baldness.

While finasteride isn’t usually used to treat telogen effluvium, it can be worth looking into if you think you’re experiencing male pattern hair loss as well as telogen effluvium.

Finasteride is a prescription-only medication. You can take it orally or use a topical finasteride & minoxidil spray.

Hair Care Products

While you’re waiting for new hairs to grow, keep your current hair (and scalp) as healthy as possible.

A number of quality hair care products can address hair thinning and reduce the appearance of hair shedding.

For example:

While we’re on the topic of hair care, be sure to avoid harsh chemicals or styling techniques that put too much strain on your scalp. Restrictive ponytails and tight cornrows, for example, can damage your hair follicles to the point where new hair won’t be able to grow.

Corticosteroids

In cases where telogen effluvium is the result of inflammation in the body, corticosteroids can help.

They also offer a convenient way to reduce the pain that can sometimes accompany telogen effluvium.

Prevention is better than cure — and that’s especially true for hair loss.

Although you can’t always prevent telogen effluvium, there are a few things you can do to reduce your risk.

For example:

  • Eat a balanced diet and avoid crash dieting

  • Take supplements to address any nutritional deficiencies

  • Use healthy stress-relief techniques

  • Manage your medical conditions, like thyroid disorders

  • Treat illnesses and infections as soon as you notice symptoms

A healthcare professional can give you more personalized advice on managing your particular health needs in a holistic way.

Losing clumps of hair can be frustrating — but fortunately, this particular type of hair loss is temporary. Telogen effluvium recovery is possible, especially if the underlying trigger goes away.

Usually, acute telogen effluvium lasts less than three months and resolves on its own.

But if you’re experiencing diffuse alopecia (hair loss) for six months or longer, you may have chronic telogen effluvium. In this case, it’s extra important to seek medical advice. A GP or dermatologist can be a good first port-of-call.

Hair loss treatments, delivered

Hair loss is never fun. This is especially true with a condition like telogen effluvium, where you're left witnessing a significant portion of your hair fall out over a short period of time.

  • Telogen effluvium has a range of triggers. Extreme stress, major surgery and severe infections can all disrupt hair growth and cause excessive shedding.

  • It often resolves on its own. Telogen effluvium regrowth usually happens on its own. But to encourage healthy hair growth, you can use hair loss treatments, take supplements and eat a balanced diet.

  • Hair loss can be a warning sign. Because hair loss can be triggered by underlying health conditions, it’s a good idea to seek medical advice if you’ve noticed significant hair thinning or shedding.

If you want to know more about keeping your scalp and hair healthy, check out our guide to Preventing Hair Loss and our article on Hair Care Tips for Men.

Concerned about hair loss? No matter the potential cause, it’s always wise to get expert medical advice. We can help you speak with a healthcare professional online so that you can access the treatment you need.

9 Sources

  1. Asghar, F., Shamim, N., Farooque, U., Sheikh, H., & Aqeel, R. (2020). Telogen Effluvium: A Review of the Literature. Cureus, 12(5), e8320. Retrieved from: ncbi.nlm.nih.gov/pmc/articles/PMC7320655/
  2. Oh, J. W., Kloepper, J., Langan, E. A., Kim, Y., Yeo, J., Kim, M. J., Hsi, T. C., Rose, C., Yoon, G. S., Lee, S. J., Seykora, J., Kim, J. C., Sung, Y. K., Kim, M., Paus, R., & Plikus, M. V. (2016). A Guide to Studying Human Hair Follicle Cycling In Vivo. The Journal of investigative dermatology, 136(1), 34–44. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4785090/
  3. Hughes EC, Saleh D. Telogen Effluvium. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Available from: ncbi.nlm.nih.gov/pmc/articles/PMC7320655/
  4. Aad.org (n.d) Do you have hair loss or hair shedding. Retrieved from: https://www.aad.org/public/diseases/hair-loss/insider/shedding
  5. Badri T, Nessel TA, Kumar D D. Minoxidil. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK482378/
  6. Zito PM, Bistas KG, Syed K. Finasteride. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK513329/
  7. Hodgens A, Sharman T. Corticosteroids. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK554612/
  8. Hughes EC, Saleh D. Telogen Effluvium. [Updated 2020 Jun 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK430848/
  9. Willimann B, Trüeb RM. Hair pain (trichodynia): frequency and relationship to hair loss and patient gender. Dermatology. 2002;205(4):374-7. Available from: https://pubmed.ncbi.nlm.nih.gov/12444334/
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Knox Beasley, MD

Dr. Knox Beasley is a board certified dermatologist specializing in hair loss. He completed his undergraduate studies at the United States Military Academy at West Point, NY, and subsequently attended medical school at Tulane University School of Medicine in New Orleans, LA. 

Dr. Beasley first began doing telemedicine during his dermatology residency in 2013 with the military, helping to diagnose dermatologic conditions in soldiers all over the world. 

Dr. Beasley is board certified by the American Board of Dermatology, and is a Fellow of the American Academy of Dermatology.

Originally from Nashville, TN, Dr. Beasley currently lives in North Carolina and enjoys spending time outdoors (with sunscreen of course) with his wife and two children in his spare time. 

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