Not all hair loss is caused by genetics. Telogen effluvium is a form of hair shedding triggered by physiological stress — illness, surgery, rapid weight loss, nutritional deficiency, or significant emotional stress. Understanding it is important because it is frequently mistaken for the early stages of permanent pattern baldness, and the management is entirely different.
Under normal circumstances, approximately 85 to 90% of scalp hairs are in the active growth phase (anagen) at any given time, with the remainder resting in telogen before shedding and being replaced. A significant physical or emotional stressor can prematurely shift a large proportion of hairs into the telogen phase simultaneously. The resulting shedding typically occurs two to four months after the triggering event, which is why patients often struggle to identify the cause.
Telogen effluvium presents as generalised shedding across the whole scalp rather than in a specific pattern. Patients often notice excessive hair on the shower floor, on their pillow, or when running their hands through their hair. The loss is diffuse rather than patterned.
The good news is that telogen effluvium is almost always self-limiting and reversible. Once the triggering stressor resolves, the hair cycle returns to normal and the shed hairs regrow — typically within six to nine months of the initial shedding. Nutritional support (iron, zinc, vitamin D, biotin) and stress management are the primary interventions.
If shedding persists beyond six months or is accompanied by pattern recession, investigation by a dermatologist or trichologist is advisable to rule out concurrent androgenetic alopecia or other underlying conditions.
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