Telogen Effluvium

Telogen Effluvium

This is most common diagnosis in women in everyday hair clinic
TE is characterized by sudden shedding of hair on the entire scalp as a result of an early, synchronous entry of hair follicles (more than 20%) in to the telogen phase.
TE is more common in women than men.

Mechanism of action- Immunosuppression is main mechanism of action.
Intralesional Corticosteriods
Intralesional corticosteriods injection is first line therapy for adult patient with less than 50 % scalp involvement.
Causes of TE
1) Thyroid influences- hypo or hyperthyroidism.
2) Iron deficiency( In about 72% of women patients)
3) Fever
4) Postpartum
5) Major intervention and prolonged anesthesia
6) Malignant disease and malabsorption
7) Crash dieting /hypoproteinemia (rapid weight loss with less than 1000 calories/day intake can often causes immediate arrest of anagen followed by TE)
8) Vitamin D deficiency
9) Vitamin A overdose (more than 50,000 IE daily)
10) Zinc deficiency
11) Copper deficiency
12) Selenium deficiency
13) Essential fatty acids ( Vitamin F) deficiency
14) Psychological stress ,Acute anxiety and depressions
15) Medications like chemotherapy, Radiotherapy

Clinical Features

1) Predominately occurs in female 2) Abrupt onset of shedding of hairs 3) Reduction in density and their pony tail diameter 4) Hair thinning, especially on the temples. Diagnosis
History
Clinical examination
Pull test
Biopsy
Laboratory testing like haemogram ,serum ferratin,protiens etc.
Thyroid function test
Serum vitamins levels.

Management

Removal of cause
1) Iron supplementation
2) Correction thyroid functions
3) Psychotherapy-assurance
4) Medication- Topical minoxidil