Managing Telogen Effluvium: A Guide to Hair Restoration
By Dr. Reena Jogi, Village Dermatology
Telogen effluvium is a common cause of temporary hair shedding that often leaves patients feeling frustrated and anxious about their hair health. The condition, usually triggered by stress, illness, or underlying health issues, can disrupt the normal hair growth cycle, resulting in noticeable hair loss. Today, we’re discussing the case of a 34-year-old female patient who returned to our office to refill her prescription for oral minoxidil, which she has been using to manage her telogen effluvium.
Understanding Telogen Effluvium
Telogen effluvium is a form of hair shedding that occurs when a significant number of hair follicles shift prematurely from the growth phase (anagen) into the resting phase (telogen). This can result in diffuse hair shedding across the scalp and can be triggered by a variety of factors, including:
Stress: Physical or emotional stress can impact hair growth cycles.
Illness: Acute or chronic illnesses, especially those involving high fevers, can contribute to shedding.
Nutritional Deficiencies: Iron deficiency and low levels of essential nutrients are common contributors.
Thyroid Disease: Both hyperthyroidism and hypothyroidism can disrupt hair growth.
Medications: Certain medications are known to cause hair shedding as a side effect.
Telogen effluvium is typically a self-limiting condition, meaning it often resolves on its own within a few months once the underlying cause is addressed. However, in prolonged cases, additional treatment may be beneficial to encourage hair regrowth.
Treatment Overview and Patient’s Current Regimen
Our patient was initially prescribed off label Minoxidil 2.5 mg in tablet form, with instructions to take half a tablet daily. Minoxidil is a well-known hair regrowth treatment that works by extending the growth phase of hair follicles. While commonly used as a topical solution, oral minoxidil can be effective in cases like this where patients experience more extensive shedding.
The patient reported no significant side effects from the oral minoxidil but expressed concern about its effectiveness after a year of use. In response, we discussed additional treatment options, including the following:
Topical Minoxidil 5% Solution: For some patients, adding topical minoxidil alongside oral minoxidil can provide added benefit and address any areas of concern.
Hair Growth Supplements: Supplements such as Viviscal or Nutrafol contain nutrients that support hair health and growth, particularly for those with nutritional deficiencies.
Low-Level Laser Therapy: Devices like Theradome use low-level laser therapy to stimulate hair follicles, promoting healthier hair growth.
Platelet-Rich Plasma (PRP) Therapy: PRP therapy is a promising treatment that involves injecting concentrated platelets into the scalp to promote hair regrowth.
Medication Counseling: Risks and Considerations of Oral Minoxidil
We reviewed the potential risks of oral minoxidil with the patient to ensure she felt informed and comfortable continuing treatment. Possible side effects include:
Swelling of the Feet or Ankles: Minoxidil can sometimes cause fluid retention.
Dizziness and Lightheadedness: Minoxidil may occasionally lead to blood pressure changes.
Unwanted Hair Growth: Patients may experience hair growth in areas other than the scalp.
Allergic Reaction: Rarely, patients may experience an allergic reaction.
Cardiac Concerns: Although rare, there is an association with pericardial effusion and cardiac tamponade, so we monitor closely for any signs of heart-related side effects.
After discussing these risks, our patient understood the importance of monitoring for any symptoms and immediately reporting any adverse effects. At this time, she felt comfortable continuing oral minoxidil and opted not to add any new medications to her regimen.
Exploring Additional Treatment Options: Dutasteride
We also discussed the possibility of introducing Dutasteride to her regimen, a medication that reduces levels of dihydrotestosterone (DHT), which can contribute to hair loss. However, Dutasteride is not recommended for women who are actively family planning or may become pregnant, as it can affect fetal development. After learning about these considerations, the patient decided to continue with her current regimen and hold off on Dutasteride for now.
Recommendations for Ongoing Care
For optimal hair health and to support her recovery from telogen effluvium, we recommended the following:
Daily Self-Care: Avoiding hairstyles that put tension on the scalp and minimizing heat styling can prevent further damage.
Dietary Supplements: Incorporating supplements like Nutrafol to provide essential nutrients that support hair strength and growth.
Regular Monitoring: Monthly self-exams of the scalp can help the patient monitor hair regrowth progress.
Follow-Up Visits: Scheduling follow-ups every 3–6 months allows us to assess the effectiveness of the treatment and adjust as necessary.
Conclusion
Telogen effluvium can be distressing, but with the right treatments and supportive care, many patients experience a return to normal hair growth within months. At Village Dermatology in Katy, TX, we work closely with patients to create customized treatment plans, using a combination of proven medications, supplements, and lifestyle recommendations to address hair loss concerns.
If you’re dealing with hair shedding or other hair health concerns, schedule a consultation with our team. Our approach is centered around understanding each patient’s unique needs and providing effective, individualized care. For more information on telogen effluvium, visit our Telogen Effluvium Treatment page.