What is Telogen Effluvium?

Hair loss and how to fix it

If you’re noticing more hair shedding than usual, it could be telogen effluvium; a temporary condition triggered by stress, illness or hormonal changes. Understanding the causes and steps to recovery will help your hair bounce back.

Telogen effluvium is a type of hair loss that can happen after a stressful event, illness or major changes in the body - like pregnancy, surgery or nutritional deficiencies. Although it can undoubtedly be an unsettling time, the good news is telogen effluvium is usually temporary. With the right approach, your hair can recover and grow back stronger than ever. 

In this article, we’ll explore what causes telogen effluvium, how to recognise it, and the steps you can take to support hair regrowth and restore your scalp’s health.

What is telogen effluvium?

Telogen effluvium is a temporary condition where hair sheds more than usual. It’s often triggered by physical or emotional stress. This could be anything from sudden weight loss to a breakup, surgery, pregnancy and postpartum or menopause. Telogen effluvium happens because stress disrupts the natural hair growth cycle, pushing more hairs into the telogen (resting) phase, where they eventually fall out.

To understand this better, it helps to know how hair grows:

• Growth (anagen phase): This lasts roughly 2 to 7 years, depending on genetics. Around 85–90% of your hair is in this phase, growing about 1 cm per month
• Transition (catagen phase): A short phase lasting about 2–3 weeks. Hair stops growing and detaches from the blood supply, preparing to shed. Less than 5% of your hair is in this phase
• Resting (telogen phase): Hair stays in place for around 2–4 months before eventually shedding. Normally 10–15% of your hair is in this phase, but in telogen effluvium, this increases significantly

This is why shedding from telogen effluvium usually happens 2–3 months after a trigger, because that’s how long it takes for hairs to reach the shedding stage. 

What is chronic telogen effluvium?

For the vast majority of people, telogen effluvium is a short-term issue. Hair loss usually lasts a few months before things return to normal. But if hair shedding doesn’t stop after six months, this could be chronic telogen effluvium (CTE).

CTE can last several years. It’s often intermittent, with periods that are better or worse than others - linked to stressful life events or health conditions. 

Unlike pattern baldness, which leads to a receding hairline or bald patches, chronic telogen effluvium causes overall thinning of hair rather than concentrated areas of hair loss. So if your hair has been thinning for a while and doesn’t seem to be improving, a visit to a doctor or trichologist (a specialist in hair and scalp health) can help identify the root cause.

How do I know if my hair loss is telogen effluvium?

Since hair loss happens for many reasons, it’s tricky knowing whether you’re dealing with telogen effluvium or something else. But telogen effluvium hair loss is quite specific, once you know what to look for.

Signs of telogen effluvium include:

• Diffuse shedding: Hair falls out evenly across the scalp rather than in specific patches
• Increased shedding when brushing or washing: You might notice more hair than usual in the shower, on your pillow or in your hairbrush
• A triggering event two to three months before: Telogen effluvium is usually set off by a period of stress, illness, surgery or dietary changes. So think about your work and personal life, as well as health and well-being. Can you identify any triggers?
• No visible scalp changes: Unlike other types of hair loss, your hairline remains intact, and you won’t see specific bald spots or skin problems (such as dry, itchy skin with psoriasis hair loss)
  

What do telogen effluvium hairs look like?

When hair falls out due to telogen effluvium, it often has a small white bulb at the root. This is a sign the hair has completed its natural cycle (i.e. finishing the resting “telogen” phase) before shedding.

Unlike pattern baldness, which primarily affects mature hairs, telogen effluvium can cause the loss of both long and short hairs. This is why some people notice their regrowth looks uneven at first. New hairs may start sprouting, but older ones might still fall out.

Will I lose all my hair with telogen effluvium?

It’s fortunately very unlikely you’ll lose all your hair with telogen effluvium. The condition usually results in diffuse thinning across the scalp, rather than total hair loss. So your hair might look thinner, but it won’t completely fall out. 

If you’re currently experiencing telogen effluvium, know your follicles are still alive and capable of growing new hair. So your hair can and will thicken-up again. Once you’ve dealt with the underlying causes, you can focus on regrowth and recovery.

What triggers telogen effluvium?

The most common cause of telogen effluvium is stress - either physical or emotional. When the body experiences a significant shock, it prioritises essential functions like healing and survival. So it stands to reason that non-essential tasks like hair growth take a backseat. As we’ve seen, this causes more hairs to enter the telogen (resting) phase, leading to increased shedding.

Here are some common triggers:

• Physical stress: Things like surgery, injury, illness, fever, childbirth or recovering from COVID-19 can disrupt hair growth
• Emotional stress: Anxiety, depression or significant life events (like a breakup, grief or job loss) can push more hairs into the shedding phase
• Nutritional deficiencies: A lack of essential nutrients can put the body under stress, weakening hair and preventing growth
• Hormonal changes: Pregnancy, menopause and thyroid imbalances can all affect hair
• Extreme weight loss or crash diets: Sudden calorie restriction (either through illness or crash dieting) can deprive hair follicles of the energy and nutrients needed to function
• Medication side effects: Certain drugs, including antidepressants and blood pressure medications, may trigger telogen effluvium.
  

What vitamin deficiency causes telogen effluvium?

While many causes of telogen effluvium - like illness, stress or hormonal changes - are out of our control, nutrition is one area we can take action. A well-balanced diet helps support healthy hair growth, as certain nutrient deficiencies make shedding worse. 

If you suspect a nutrient deficiency is contributing to your hair loss, a blood test can confirm it. Your doctor may check ferritin, vitamin D, B12 and zinc levels to see if they’re in a healthy range.

Here are some of the most common deficiencies linked to telogen effluvium:

Iron deficiency

Iron is essential for producing haemoglobin, which carries oxygen to hair follicles. Low ferritin (a protein that stores iron) can disrupt the growth cycle. To boost iron levels, focus on red meat, poultry, leafy greens (spinach, kale), legumes (lentils, chickpeas) and iron-fortified cereals.

Vitamin D deficiency

Vitamin D supports the development of new hair and helps regulate the growth cycle. Low levels can lead to more follicles entering the resting phase. Focus on fatty fish (salmon, mackerel, sardines), egg yolks, fortified dairy and plant-based milk. Spending time outdoors also helps vitamin D production.

B vitamin deficiencies

B vitamins are crucial for energy production and supporting hair follicles. Biotin (B7) is linked to stronger hair, while B12 is essential for red blood cell production. Opt for biotin-rich foods like eggs, nuts (almonds, walnuts), sweet potatoes and seeds. For B12, eat meat, fish (tuna, salmon), dairy and fortified plant-based milks

Zinc deficiency

Zinc plays a significant role in tissue repair and regulating hair follicle function. Deficiency can weaken hair and cause increased shedding. You’ll find zinc in shellfish (such as oysters and prawns), meat (beef, pork), pumpkin seeds, chickpeas, lentils and dairy products.

Protein deficiency

Since hair is made of keratin (a protein), getting enough protein in your diet is crucial for healthy hair growth. Good sources of protein include lean meats (like chicken), fish (salmon, cod, tuna), dairy (Greek yoghurt, eggs, cheese) and plant-based options (tofu, beans, lentils, quinoa).

While it’s important to address any deficiencies, be cautious about over-supplementing. For instance, too much iron or vitamin A can worsen hair loss. It’s a good idea to check with your doctor before adding new supplements or drastically changing your diet.

How do you fix telogen effluvium?

Telogen effluvium is usually temporary. So, once the underlying cause is addressed, your hair will grow back. While you can’t speed up the hair growth cycle, you can support recovery by giving your scalp and follicles the best conditions to thrive. As well as focusing on a nutrient-rich diet, following a gentle hair-care routine and incorporating scalp massage, try to minimise stress and avoid harsh treatments.

Here’s what to focus on.

1. Identify and address triggers

Since telogen effluvium is often triggered by stress, illness, hormonal changes or dietary deficiencies, figuring out the root cause is key. Focus on reducing stress with relaxation techniques (like mindfulness or yoga), improving sleep quality and addressing any health issues or life changes (as far as possible).

2. Be gentle with your hair

While your hair is recovering, treat it with care. Avoid excessive heat styling, harsh chemical treatments like bleaching or tight hairstyles that put unnecessary stress on the scalp. Instead, opt for gentle heat-free hairstyles (like low, loose buns tied with non-snagging satin scrunchies) as well as mild, sulfate-free shampoo and a nourishing conditioner.

3. Scalp massage

Gentle scalp massage can increase blood flow to hair follicles, which is key for healthy regrowth. You can massage your scalp with your fingertips for a few minutes daily. Oils like rosemary oil or peppermint oil can also help nourish your hair and scalp, encouraging regrowth.

4. Minimise inflammation

Chronic inflammation can affect your scalp health and worsen hair loss. To help, focus on anti-inflammatory foods like berries, fatty fish (salmon, mackerel), nuts and leafy greens (as part of a balanced, nutritious diet). Staying hydrated and cutting back on processed foods and sugar can also support a healthier scalp.

5. Track your progress

Hair regrowth happens gradually, making it hard to notice improvements. So take monthly photos to track changes. Comparing pictures over time can help you see progress, even when things feel slow. However, if excess shedding continues beyond a year, it may be time to consult a specialist.

Should I wash my hair less with telogen effluvium?

It’s a common myth that washing your hair causes it to fall out faster. But this isn’t true. The hairs you see in the shower were already in the shedding (telogen) phase - they just come loose when you wash. Avoiding hair washing won’t stop shedding. In fact, it can lead to buildup on the scalp, which may irritate hair follicles and make things worse.

Washing your hair regularly can actually support regrowth, as it keeps the scalp clean and healthy. Just make sure to use gentle techniques such as soft microfibre towelling and avoid harsher products like clarifying shampoos while helping your hair recover.

Final thoughts: coping with telogen effluvium

Experiencing hair loss is always tough. But remember, telogen effluvium is usually a temporary condition. With the right care, your hair can recover and grow back stronger. If you’re feeling uncertain or shedding doesn’t seem to stop, consulting a doctor can offer peace of mind. Know you’re not in this alone - your hair is on its way back!

Patience is key when it comes to regrowth. While shedding tends to slow within 3-6 months, full recovery can take anywhere from 6 to 12 months. In this time, stick with a gentle hair care routine and focus on nourishing yourself physically and mentally.

For a confidence boost while waiting for your hair to recover, consider Phoenix Crown luxury hair extensions, made from pure Virgin human hair. Our barely-there flexi-wefts offer a discreet and elegant solution, so you can feel great while supporting your hair’s regrowth journey.