What is Telogen Effluvium & How to Treat It

What is Telogen Effluvium & How to Treat It

We answer your burning questions on causes of common hair loss and how to treat this.

Hair loss can be a distressing experience, and understanding the underlying causes is crucial for effective treatment. One common form of hair loss is telogen effluvium (TE), sometimes called ‘stress hair loss.’  It’s a condition that causes excessive shedding of hair. In this article, we’ll delve into what telogen effluvium is, its causes, and who it can affect.  We’ll also discuss how telogen effluvium is diagnosed, how long it lasts, and what the best treatment options are for it.  Finally, we’ll highlight some ways that you can support hair growth and discuss how anti-stress products designed to combat stress-induced hair loss can be helpful.


What is Telogen Effluvium?

Telogen effluvium is a type of hair loss that occurs when a significant number of hair follicles enter the telogen (resting) phase prematurely. Normally, hair growth cycles through three stages: anagen (growth), catagen (transitional), and telogen (resting). In telogen effluvium, a sudden shift from the anagen phase to the telogen phase results in increased shedding.


Characteristics of Telogen Effluvium

Telogen effluvium is marked by:

  • Diffuse thinning: Hair loss is spread evenly across the scalp, as opposed to being concentrated in patches.
  • Rapid onset: Hair shedding typically starts a few months after the triggering event, such as a significant stressor or health change.
  • Temporary: The condition is often reversible once the underlying cause is addressed, and the hair follicles return to the normal growth cycle.


Types of Telogen Effluvium

  • Acute telogen effluvium: This is a short-term condition, usually triggered by a specific event or change, and typically resolves within six months once the trigger is removed.
  • Chronic Telogen Effluvium: Lasts longer than six months and can persist for years. Chronic TE requires ongoing management and a deeper investigation into underlying chronic conditions or persistent stressors.



What Causes Telogen Effluvium?

Various things can cause telogen effluvium, leading to a disruption in the normal cycle of hair growth. These causes can fall into three main categories: Physical, Psychological, and Environmental.


Physical Causes

  • Hormonal changes: Significant hormonal shifts, such as those occurring during pregnancy, childbirth, menopause, and thyroid disorders, can trigger TE. The postpartum period is particularly known for causing TE and is often referred to as "postpartum hair loss."


  • Nutritional deficiencies: Inadequate intake of essential nutrients, particularly iron, zinc, and vitamin D, can lead to TE. Iron deficiency anemia is also a well-known cause of hair shedding.


  • Medical conditions: Chronic illnesses, infections, and surgical procedures can stress the body and disrupt the hair growth cycle. Conditions like lupus, diabetes, and severe infections can lead to TE.


  • Medications: Certain drugs can have side effects that include hair loss. Medications for blood pressure, depression, chemotherapy, and some birth control pills can cause TE.


Psychological Causes

  • Stress: High levels of psychological stress can significantly impact the hair growth cycle. Stressful events such as the death of a loved one, divorce, or job loss can push more hairs into the telogen phase, leading to increased shedding.


Environmental Causes

  • Toxic exposure: Contact with harmful chemicals or pollutants can lead to TE. This includes exposure to heavy metals, radiation, and other environmental toxins.


  • Extreme dieting: Rapid weight loss and restrictive diets can lead to nutritional deficiencies that cause TE. Crash diets and eating disorders like anorexia and bulimia are also common triggers.



Who Does Telogen Effluvium Affect?

Telogen Effluvium can affect individuals of all ages and genders, although some groups may be more susceptible due to specific risk factors.



  • Women: Women are more likely to experience TE due to hormonal fluctuations, particularly during pregnancy and menopause. Women are also more prone to experiencing chronic TE due to conditions like polycystic ovary syndrome (PCOS) and thyroid imbalances.


  • Older adults: Age-related hormonal changes and health issues increase susceptibility. As people age, hair growth naturally slows down, making it easier for external factors to cause TE.


  • Individuals under high stress: Those experiencing significant life changes or chronic stress are more prone to TE. Stress can be physical (illness, surgery) or emotional (anxiety, depression).


Risk Factors

  • Genetic predisposition: Family history of hair loss or TE may increase the likelihood of developing the condition.


  • Underlying health conditions: Autoimmune diseases, chronic illnesses, and endocrine disorders can predispose individuals to TE.


  • Lifestyle factors: Poor diet, lack of sleep, and high stress levels can exacerbate the risk of TE. Unhealthy lifestyle habits, such as smoking and excessive alcohol consumption, can also contribute to hair loss.


Lady suffering from Telogen Effluvium hair loss as a result of stress


How Do I Know If I Have Telogen Effluvium vs. Normal Hair Loss?

Distinguishing telogen effluvium from other types of hair loss can be challenging, but certain signs and diagnostic methods can help.


Signs of Telogen Effluvium

  • Increased shedding: One of the hallmark signs of TE is a noticeable increase in hair shedding. This is often seen during washing, brushing, or simply running your hands through your hair. You may find more hair on your pillow, in the shower drain, or on your hairbrush.


  • Diffuse thinning: In TE, hair loss is often spread evenly across the scalp rather than being concentrated in patches. This uniform thinning can make the scalp more visible but does not typically result in complete baldness. That being said, thinning hair around the temples may commonly be seen in TE.


  • Recent trigger: TE often follows a known stressor or event that occurred 2-3 months before the onset of shedding. For instance, TE often occurs a few months after childbirth, or after a major surgery. Identifying this trigger can help you tell the difference between TE and other types of hair loss.


Diagnostic Methods

  • Clinical examination: Dermatologists can assess hair density and scalp condition through a visual and physical examination. They may use a specialized instrument called a dermatoscope to get a closer look at the scalp and hair follicles.


  • Pull test: This is a simple test where the doctor gently pulls on a small section of hair to see how many strands come out. In TE, a higher number of hairs (more than 10-15% of the pulled hairs) may be shed.


  • Scalp biopsy: A common test that involves taking a small scalp tissue sample to examine under a microscope. This can help distinguish TE from other types of hair loss like alopecia areata or scarring alopecia.


  • Blood tests: Checking for nutritional deficiencies, hormonal imbalances, and underlying medical conditions. Tests might include complete blood count (CBC), thyroid function tests, iron levels, and vitamin D levels.



How Long Will Telogen Effluvium Last?

The duration of telogen effluvium can vary depending on the underlying cause and an individual’s particular response to treatment.


Phases of Telogen Effluvium

  1. Acute TE: Typically lasts less than six months and often resolves once the trigger is removed. Recovery is usually quicker when the underlying cause is identified and addressed promptly.


  1. Chronic TE: Persists for more than six months and can last for years if the underlying cause is not addressed. Chronic TE may require a more in-depth treatment plan and ongoing management.


Recovery Timeline

  • Initial shedding: Begins 2-3 months after the trigger. This phase can be alarming, but it is a natural response to hair growth cycle disruption.


  • Regrowth phase: New hair starts to grow within 3-6 months after the shedding phase ends. Patience is key during this phase, as new hair growth can be slow and may initially appear finer and thinner.


  • Full recovery: Can take up to 12-18 months for hair density to normalize. Continuous support through proper hair care, nutrition, and stress management is essential during this period.




What is the Best Treatment for Telogen Effluvium?

Addressing the underlying cause of telogen effluvium is crucial for effective treatment. Several approaches might help manage hair loss.


Medical Treatments

  • Medications: Minoxidil (Rogaine) is an over-the-counter treatment that can stimulate hair growth and prolong the anagen phase. It is sometimes used ‘off-label’ for telogen effluvium. It is applied topically to the scalp and can be used for both men and women.


  • Hormone therapy: For those with hormonal imbalances such as thyroid disorders or PCOS, hormone therapy can help regulate the levels and reduce hair shedding. Thyroid hormone replacement, for example, can be crucial for those with hypothyroidism.


  • Nutritional supplements: Iron supplements can be prescribed for those with iron deficiency anemia. Other supplements like zinc, biotin, and vitamin D can also boost hair health when they are lacking.


Lifestyle Modifications

  • Stress management: Techniques such as meditation, yoga, and counseling can help reduce stress levels. Regular exercise, mindfulness practices, and engaging in hobbies can also promote relaxation and well-being. Adaptogenic supplements can also be useful for helping to manage the body’s stress response.


  • Balanced diet: Ensuring adequate intake of essential nutrients through a balanced diet is critical. Foods rich in iron, zinc, and vitamins A, C, D, and E should be included. Protein is also vital for hair health, so including sources like lean meats, fish, eggs, and legumes is beneficial.


  • Hair care practices: Gentle handling of your hair, avoiding excessive heat and harsh chemicals, and using mild shampoos and conditioners can help maintain hair health. It's also important to avoid tight hairstyles that can cause traction alopecia and further hair loss.



What Else Can I Do to Help with Hair Regrowth?

In addition to medical treatments, several supportive measures can promote hair regrowth and overall scalp health.


Scalp Care

  • Regular massage: Scalp massage offers numerous benefits for hair health. It helps improve blood circulation to the scalp, delivering essential nutrients and oxygen to hair follicles. Additionally, scalp massage can reduce stress and tension, which may contribute to hair loss. Using a scalp serum with ingredients such as rosemary or peppermint can enhance the benefits of scalp massage. To perform a scalp massage, use your fingertips to gently apply pressure in circular motions across the scalp. You can incorporate natural oils like avocado oil or jojoba oil to enhance the massage's benefits. These oils provide hydration and nourishment to the scalp, helping to maintain its health and balance.


  • Mild shampoos: Choosing the right shampoo is crucial for scalp health. Harsh chemicals found in many commercial shampoos can strip the scalp of its natural oils, leading to dryness, irritation, and even inflammation. Opt for mild, sulfate-free shampoos that cleanse the scalp without causing damage or imbalance. Use shampoos that are free from harsh chemicals like sulfates and parabens. Look for shampoos containing natural ingredients like aloe vera, tea tree oil, or lavender, known for their soothing and antimicrobial properties. These ingredients help maintain scalp health while gently cleansing away dirt and excess oil.


  • Hair tea rinses: Hair tea rinses are an effective and natural way to support scalp and hair health. Using tea and herbal botanical ingredients in your hair care routine can offer a variety of benefits. Green tea, a key component in hair tea rinses aimed at growth, is rich in antioxidants to support hair growth. It also can help reduce shedding.  Other ingredients in hair tea rinses like chamomile, rosemary, and hibiscus aid in soothing and calming the scalp, promoting blood circulation, and reducing hair fall. To make a hair tea rinse, steep your chosen blend in hot water, allow the tea to cool to a comfortable temperature, and then pour it over your scalp and hair after shampooing, gently massaging the tea into your scalp and allowing it to sit before rinsing. Regular use of hair tea rinses can enhance scalp health, improve hair texture, and support overall hair growth.


  • Avoid tight hairstyles: Hairstyles that pull on the hair shaft, like tight ponytails, braids, or buns, can cause traction alopecia and exacerbate hair loss. Wearing hair in loose styles can help reduce this risk.


woman using green tea hair tea rinse for hair loss


Diet and Nutrition

A balanced diet is essential for hair health. Here are some dietary recommendations to support hair regrowth:


  • Protein-rich foods: Hair is primarily made of keratin, a protein. Including high-quality protein sources like eggs, nuts, seeds, fish, and lean meats in your diet can support hair strength and growth.


  • Antioxidant-rich foods: Fruits and vegetables high in antioxidants, such as berries, spinach, and bell peppers, can help combat oxidative stress and support overall health.


  • Omega-3 fatty acids: Found in fish oil, flaxseed, and walnuts, omega-3 fatty acids can help reduce inflammation and promote scalp health.


healthy diet



If dietary intake is insufficient, supplements can help ensure you receive the necessary nutrients for hair growth:


  • Biotin: Known for its role in maintaining healthy hair, skin, and nails. Biotin deficiency can lead to hair thinning.


  • Iron: Particularly important for women, iron supports the production of hemoglobin, which carries vital oxygen to hair follicles.


  • Vitamin D: Low levels of vitamin D have been linked to hair loss. Your physician can do a blood test to see if your levels are adequate.


  • Adaptogens: Taking adaptogen supplements with ingredients like holy basil or ashwagandha can help with hair health by helping the body manage stress and balance stress hormone levels, thereby supporting the hair growth cycle and reducing stress-induced hair loss.


Stress Reduction Techniques

Managing stress effectively can help reduce the impact of telogen effluvium:

  • Mindfulness practices: Activities like meditation, deep breathing exercises, and yoga can help reduce stress and promote relaxation.


  • Physical activity: Regular exercise, especially done outdoors, can help manage stress levels, improve mood, and support overall health. Activities like walking, swimming, or cycling can be beneficial.


  • Sleep hygiene: Get your beauty sleep! Getting adequate and quality sleep is essential for managing stress and promoting overall health. Aim for 7-9 hours of sleep per night.



    How Do I Know If My Hair is Regrowing?

    Monitoring hair regrowth can be a gradual process, but several indicators can help you track progress.

    Signs of Regrowth

    • Short, fine hairs: New hairs that are finer and shorter than existing ones are a sign of regrowth. These may appear along the hairline or throughout the scalp.


    • Increased volume: Over time, as new hair grows, you may notice an increase in hair thickness and overall volume.


    • Decreased shedding: A reduction in the number of hairs falling out daily is a positive sign that the hair growth cycle is normalizing. Less hair in the shower drain is a sign of improvement!


    Monitoring Your Progress

    • Photographs: Hair grows slowly, so it can be hard to tell if you are improving. Taking regular photos of your hair and scalp can help you visually track changes and improvements in hair density over time.


    • Dermatologist visits: Regular check-ups with a dermatologist can help assess your progress, address any ongoing issues, and adjust your treatment plan as necessary.


    Expertly Formulated Anti-Stress Products for Hair Regrowth

    Managing stress is a crucial aspect of combating telogen effluvium. Our range of scientifically formulated anti-stress products are designed to support hair regrowth through a blend of adaptogens, teas and bioactive botanical ingredients.


    1. Gro-Well+Stress-Less Hair Tea

    -Key Ingredients: Ashwagandha, Raspberry leaf, Green tea

    -Benefits: Balances stress levels, supports hair follicle health, and enhances overall stress resilience. Ashwagandha is known for its adaptogenic properties, helping the body manage stress more effectively. Green Tea provides follicle support and antioxidant benefits.


    2. Revita+Fol Antioxidant Scalp Serum

    -Key Ingredients: Billberry, Tulsi (Holy Basil), Rosemary.

    -Benefits: Antioxidant shield against pollution and stress hair loss.  Enhances resilience to stress and supports growth.  Tulsi is revered for its ability to balance stress hormones, and rosemary is known for its hair growth promoting properties. 


    3. Tricho+Gro AOx Green Tea Hair Rinse

    -Key Ingredients: Green tea, rose flower, olive leaf.

    -Benefits: Green tea contains hair growth boosting caffeine and powerful antioxidant polyphenols.  Rose flowers and olive leaves support healthy hair growth and reduce shedding. 



    Frequently Asked Questions (FAQ)

    What is telogen effluvium?

    Telogen Effluvium is a form of temporary hair loss caused by a significant number of hair follicles entering the telogen phase prematurely.


    What causes telogen effluvium?

    Triggers include hormonal changes, nutritional deficiencies, stress, medical conditions, and certain medications.


    Who is at risk of developing telogen effluvium?

    Women, older adults, and individuals under high stress are more susceptible.


    How is telogen effluvium diagnosed?

    Diagnosis can involve a clinical examination, hair pull test, scalp biopsy, and blood tests.


    How long does telogen effluvium last?

    It can last from a few months to over a year, depending on the cause and treatment.


    What are effective treatments for telogen effluvium?

    Treatments include addressing the underlying cause, medical treatments, stress reduction, and lifestyle changes.


    How can I promote hair regrowth?

    Supporting hair regrowth involves scalp care, medical treatments, a balanced diet, supplements, and stress reduction techniques.


    How can I tell if my hair is regrowing?

    Signs of regrowing hair can include short, fine hairs, increased volume, and decreased shedding.



    In conclusion, telogen effluvium can be a challenging condition to manage, but with the right approach and supportive measures, hair regrowth is achievable. Medical evaluation, stress management, and supplements can further enhance your efforts to combat stress-induced hair loss and promote a healthy scalp environment.



    Malkud, S. Telogen Effluvium: A Review 

    Harrison S, Bergfeld, W. Diffuse hair loss: its triggers and management