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Telogen Effluvium St. Louis

A woman looking at her hairbrush containing clumps of hair.

At Mid-County Dermatology in St. Louis, our dermatologists specialize in diagnosing and treating hair loss conditions like telogen effluvium. Unlike male pattern baldness which occurs gradually, telogen effluvium leads to rapid, excessive hair shedding often due to stress or underlying medical conditions.

Understanding the causes and symptoms of telogen effluvium is key to effectively managing and treating this distressing yet temporary form of hair loss. Stay tuned as the dermatology experts at Mid-County Dermatology delve into what triggers telogen effluvium hair loss, its warning signs, and solutions to help you combat this issue.

Understanding Hair Loss Basics

Hair Growth Cycle

Hair growth occurs in cycles, comprising three main phases: anagen, catagen, and telogen. During anagen, hair actively grows from the follicles. This phase can last 2-6 years. In catagen, growth slows down, preparing for shedding. Telogen is the resting phase before new hair emerges.  Hair follicles in telogen are usually miniaturized and shed easily. This phase lasts 3-6 months.

Normal Shedding vs. Excessive Hair Loss

Normal shedding involves losing 50-100 hairs daily, with new hair replacing them continuously. However, telogen effluvium causes excessive shedding due to stressors like illness or hormonal changes. It disrupts the natural cycle. Normally, around 90% of hair follicles are in the anagen phase and around 5-10% are in the telogen phase. With telogen effluvium, the ratio shifts dramatically with up to 40-50% of hair follicles entering the telogen phase. 

Contributing Factors to Hair Loss

Various factors can contribute to hair loss, including poor nutrition, stress, genetics, and medical conditions like thyroid disorders, low iron stores, or autoimmune diseases. Certain medications and treatments can also lead to temporary or permanent hair loss.

What is Telogen Effluvium?

Telogen effluvium is a form of hair loss characterized by excessive shedding of hair strands. It occurs when there is a disruption in the normal hair growth cycle, causing more hairs than usual to prematurely enter the telogen or "shedding" phase.

During the telogen phase, hairs are meant to naturally fall out to allow new anagen (growth) hairs to replace them. However, with telogen effluvium, this shedding becomes excessive, often diffusely spread across the entire scalp rather than concentrated areas.

Telogen effluvium is considered a reactive or temporary type of hair loss, commonly triggered by major life stressors like:

  • Significant weight loss or nutrient deficiencies

  • Childbirth and postpartum hormonal changes

  • Major surgery or serious illness

  • High fever

  • Severe psychological stress

  • Abrupt hormonal shifts or medication changes

While distressing, the condition is usually self-limiting as long as the underlying trigger is identified and addressed. Regrowth typically begins 3-6 months after active shedding subsides.

Identifying Telogen Effluvium Symptoms

Common Symptoms

Telogen effluvium symptoms often include increased hair shedding, noticeable when brushing or washing hair. Individuals may also experience thinning of the hair and a decrease in hair volume.

Timeline of Symptoms

Symptoms of telogen effluvium typically appear two to six months after the triggering event. This delay occurs because hair follicles go through a resting phase before shedding begins.

Diagnosing Telogen Effluvium in St. Louis

To accurately diagnose telogen effluvium, Dr. Feigenbaum utilizes a comprehensive evaluation process. This typically involves:

  • Patient History - A detailed medical history covers any recent stressors, medications, illnesses, or hormonal changes that could trigger excessive hair shedding.

  • Physical Examination - Dr. Feigenbaum will carefully inspect the scalp and hair, looking for patterns of shedding, thinning, and potentially pulling some hairs to examine the roots.

  • Trichoscopy - This non-invasive technique uses a specialized handheld dermatoscope or camera to magnify the scalp and inspect the hair follicles up close.

  • Pull Test - A standardized pull test may be performed by gently pulling on groups of hair to quantify the amount of active shedding.

  • Biopsy - In some cases, a small punch biopsy of the scalp skin may be taken to examine the hair follicles microscopically and rule out other conditions.

By combining these diagnostic approaches, the experienced dermatologists at Mid-County Dermatology can differentiate telogen effluvium from other causes of hair loss in St. Louis patients. An accurate diagnosis guides the formulation of an effective, customized treatment plan to reduce shedding and regrow thicker, fuller hair.

Distinguishing Types of Hair Loss in St. Louis

Alopecia Areata vs Telogen Effluvium 

Alopecia areata is a hair loss condition frequently evaluated by St. Louis dermatologists and hair specialists. In contrast to telogen effluvium, which causes overall thinning hair, alopecia areata leads to sudden, patchy hair loss in distinct round areas on the scalp.

As an autoimmune disorder, alopecia areata occurs when the body's immune system mistakenly attacks hair follicles, resulting in these well-defined bald spots. Meanwhile, telogen effluvium involves excessive shedding from a disruption in the hair growth cycle, often triggered by stress, illness, hormonal changes, or medications.

While telogen effluvium is typically temporary and diffuse, alopecia areata can be more unpredictable. This autoimmune form of alopecia can occur at any age and affects both men and women.

Telogen Effluvium vs. Androgenetic Alopecia 

While androgenetic alopecia is a progressive, patterned hair loss, telogen effluvium tends to be a temporary, generalized thinning. Telogen effluvium is caused by an interruption in the hair growth cycle by triggers like stress, illness, or hormonal changes. St. Louis hair specialists frequently see this excessive shedding condition in both men and women. In contrast, androgenetic alopecia is a chronic, hormone-driven process that follows more defined patterns.

Common Causes of Telogen Effluvium for St. Louis Residents

Various factors can trigger Telogen effluvium, disrupting the normal hair growth cycle and leading to excessive shedding. At Mid-County Dermatology, our dermatologists in St. Louis are well-versed in identifying and addressing the underlying causes of this distressing hair loss condition.

Hormonal Imbalances and Life Events

Hormonal changes, such as those experienced after pregnancy, during menopause, or due to thyroid disorders, are a common culprit behind telogen effluvium in patients. These hormonal fluctuations can disrupt the hair's natural growth and resting phases, leading to excessive shedding.

Nutritional Deficiencies Impacting Hair Health

Inadequate levels of essential nutrients like iron, zinc, protein, and vitamins (particularly biotin) can contribute to the development of telogen effluvium hair loss. Our hair specialists may recommend dietary adjustments or supplements to correct deficiencies and support healthy hair growth.

Medications and Medical Treatments

Certain prescription medications, including antidepressants, new weight loss injections like Mounajro and Ozempic, blood thinners, birth control pills, and chemotherapeutic agents, have been linked to telogen effluvium as a potential side effect. Patients undergoing medical treatments like surgery or experiencing chronic illnesses may also experience heightened hair shedding.

Physical and Emotional Stress

Significant physical or emotional stress can serve as a trigger for telogen effluvium hair loss. Events like major surgery, severe injuries, dramatic weight loss, or traumatic life events can disrupt the hair growth cycle, leading to excessive shedding a few months later.

Autoimmune Disorders and Skin Conditions

In some cases, telogen effluvium may result from underlying autoimmune disorders like lupus or thyroid diseases, as well as certain skin conditions like psoriasis or alopecia areata. Our dermatologists carefully evaluate patients to identify these potential causes.

Hair Treatments and Styling Products

Exposure to harsh hair treatments like chemical straighteners or permanent waves, as well as the excessive use of heated styling tools or harsh hair products, can potentially trigger telogen effluvium hair loss.


Environmental Factors

Certain environmental factors, such as high fever, severe infection, or exposure to toxins, may also contribute to the development of telogen effluvium in some individuals.

Identifying Underlying Causes with our St. Louis Hair Specialists

Recognizing and addressing the specific underlying cause(s) of telogen effluvium is essential for effective management and treatment. At Mid-County Dermatology, our dermatology team in St. Louis works closely with patients to determine the specific trigger(s) and develop a personalized treatment plan to address their unique needs and promote healthy hair regrowth.

Treating Telogen Effluvium in St. Louis

Common Treatment Approaches

Our hair doctors take a multi-pronged approach when treating telogen effluvium. Common treatments include:

  • Medicated Shampoos: Ketoconazole, zinc pyrithione, selenium sulfide to improve scalp health and reduce shedding

  • Topical Solutions:

    • Minoxidil to stimulate hair follicles

    • Bimatoprost solution to promote growth

    • Personalized topical compound foams and solutions

  • Oral Medications:

    • Anti-androgens like spironolactone, finasteride, dutasteride

    • Oral minoxidil

    • Low-dose oral anti-inflammatory medications

  • Light Therapy: Low-level laser (LLLT), photobiomodulation

  • Hair Vitamins: Multivitamins with biotin, iron, vitamin D, zinc

  • Injectable Therapy:

    • Platelet-rich plasma (PRP)

    • Intramuscular steroids

  • Lifestyle Changes: Making certain lifestyle adjustments is crucial when managing telogen effluvium:

    • A balanced diet rich in protein, iron, vitamins, antioxidants

    • Stress management via meditation, yoga, exercise

    • Adequate sleep (7-9 hours per night)

    • Quitting smoking

    • Treating any underlying medical conditions

An individualized, multi-therapy treatment plan overseen by our experienced St. Louis hair specialist, Dr. Feigenbaum, is essential for effectively managing telogen effluvium over the long term. Early intervention and consistent treatment are key. Schedule your appointment now.

PRP Therapy for Telogen Effluvium in St. Louis

What is PRP Hair Therapy?

PRP (platelet-rich plasma) therapy is an innovative regenerative treatment offered by our hair restoration specialists. It utilizes the patient's blood to promote new hair growth when experiencing telogen effluvium or other forms of hair loss.

During a PRP treatment for telogen effluvium, a small amount of the patient's blood is drawn and processed to extract the platelet-rich plasma, which contains concentrated growth factors. This PRP is then injected into the scalp at the areas of thinning hair or excessive shedding.

How PRP Combats Telogen Effluvium

PRP therapy for telogen effluvium works by increasing blood supply and delivering growth factors directly to the hair follicles. The enriched plasma helps:

  • Stimulate dormant follicles (telogen hairs) to enter the growth cycle (anagen phase)

  • Support follicle cell proliferation and cycles

  • Promote healing of any follicle micro-damage

  • Enhance thickness and density of active hair growth

The rejuvenating effects of PRP can help reverse the excessive shedding and hair thinning seen with telogen effluvium.

We offer PRP as an effective, minimally-invasive treatment for telogen effluvium and other hair loss conditions. A series of treatments (typically 3 treatments spaced 4-6 weeks apart) is often recommended for optimal results in restoring fuller, thicker hair.

Possible Side Effects and Limitations of PRP

While PRP therapy is generally considered safe and minimally invasive, some individuals may experience mild side effects such as redness at the injection site or minimal discomfort during the procedure. These side effects typically subside within a few days post-treatment.

One of the limitations of PRP therapy for hair restoration is that it may require multiple sessions to achieve optimal results and therefore can be costly (a typical treatment costs $650). Not all individuals may respond equally to the treatment, with some experiencing more significant hair growth improvements than others.

Emotional Impact of Telogen Effluvium

The emotional impact of alopecia can be profound, affecting one's self-esteem and confidence. Individuals experiencing alopecia areata may feel self-conscious about their appearance due to the visible patches of hair loss. On the other hand, telogen effluvium, although reversible, can still cause distress as it alters one's physical appearance temporarily.

Final Remarks: Taking Control of Telogen Effluvium at Mid-County Dermatology


Dr. Feigenbaum and the experts at Mid-County Dermatology in St. Louis offer a range of solutions tailored to telogen effluvium. From medicated shampoos and topical compounds to oral medications, light therapy, PRP injections, and personalized foams compounded for women, there are many potential paths to reducing shedding and promoting regrowth.

As a board-certified dermatologist and hair transplant surgeon, Dr. Feigenbaum provides comprehensive hair loss evaluation and customized treatment plans. Schedule your hair consultation with him now to obtain your customized treatment program to protect and regrow your hair.

Frequently Asked Questions

What are the common symptoms of Telogen Effluvium?

Telogen Effluvium symptoms include increased hair shedding, thinning of hair all over the scalp, noticeable hair loss when brushing or washing, and a decrease in hair density.

How can Telogen Effluvium be identified?

Telogen Effluvium is typically diagnosed by a healthcare provider through a physical examination, medical history review, and sometimes blood tests to rule out other potential causes of hair loss.

What are the main causes behind Telogen Effluvium?

Common causes of Telogen Effluvium include significant stress or trauma, hormonal changes (such as after pregnancy), certain medications, nutritional deficiencies, and underlying health conditions like thyroid disorders.

What treatment options are available for Telogen Effluvium?

Treatment options for Telogen Effluvium may include addressing the underlying cause (if identified), improving nutrition, managing stress levels, using minoxidil to promote hair growth, and in some cases, Platelet-Rich Plasma (PRP) therapy for hair restoration.

How can Telogen Effluvium be managed effectively?

Effective management of Telogen Effluvium involves identifying and addressing the root cause (if possible), adopting a healthy lifestyle with balanced nutrition, managing stress levels through relaxation techniques or therapy, and consulting with healthcare professionals for guidance on suitable treatments.

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