- Wilma Bergfeld, MD
Wilma Bergfeld, MD
- Professor of Dermatology and Pathology
- Cleveland Clinic
- Clinical Associate Professor of Dermatology
- Lerner Medical School and Case Western Reserve Medical School
Telogen effluvium is a form of diffuse, nonscarring hair loss that presents as a transient or chronic loss of hair. Hair loss in telogen effluvium occurs as a result of an abnormal shift in follicular cycling that leads to the premature shedding of hair.
A wide variety of endogenous and exogenous factors have been linked to the induction of telogen effluvium. Examples include major surgery, serious illness, childbirth, protein or caloric malnutrition, drugs, and severe emotional distress. In some cases, the inciting cause is unclear.
The clinical features, diagnosis, and management of telogen effluvium will be reviewed here. An overview of the evaluation of patients with scalp hair loss is provided separately. (See "Evaluation and diagnosis of hair loss".)
Data on the epidemiology of telogen effluvium are limited. The disorder is one of the most common forms of nonscarring hair loss for which patients present for clinical evaluation . Telogen effluvium does not appear to have a predilection for particular racial or ethnic groups.
Most experts divide telogen effluvium into acute and chronic variants. Acute telogen effluvium may occur at any age, including infants and children [2,3]. For unclear reasons, women are more likely to present for evaluation of acute telogen effluvium than men . Chronic telogen effluvium is much less common than the acute variant, and is most frequently diagnosed in women between the ages of 30 and 60 years [5,6]. Chronic telogen effluvium can further be subdivided into chronic and chronic-repetitive clinical presentations. (See 'Clinical features' below.)
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- Inciting factors
- CLINICAL FEATURES
- Patient history
- Physical examination
- - Hair pull test
- - Dermoscopy
- - Wood's light examination
- - Scalp biopsy
- - Trichograms and phototrichograms
- - Hair collection
- Laboratory tests
- DIFFERENTIAL DIAGNOSIS
- First-line interventions
- - Removal or treatment of underlying cause
- - Cosmetic measures
- - Psychological support
- Other interventions
- - Topical minoxidil
- - Supplements
- SUMMARY AND RECOMMENDATIONS