DermatologicalICD-10: L65.0Common; one of the most frequent causes of diffuse hair shedding, particularly in women after childbirth or illness

Telogen Effluvium

Also known as: Stress-related hair shedding, Diffuse hair shedding

Telogen effluvium is a common form of temporary hair loss in which an unusually large number of hairs shift at the same time from the growing phase into the resting (telogen) phase and then shed, typically two to three months after a physical or emotional shock to the body. Triggers include childbirth, high fever, serious illness, surgery, crash dieting, major stress, and starting or stopping certain medications. The shedding is diffuse rather than patchy, so the hair looks thinner all over, and people often notice alarming amounts of hair in the shower, on the pillow, or in the brush. Because the follicles are healthy, the hair regrows once the trigger has passed, usually over six to twelve months. A chronic form can persist for longer and is more often seen in women.

At a Glance

Common symptoms
Increased hair shedding noticed in the brush, shower, or on pillows, often several times the normal amount, Thinning that is spread evenly over the scalp rather than in patches, A visibly thinner ponytail or wider parting
Main treatments
Identifying and addressing the trigger; in many cases, shedding stops on its own once the body recovers, Correcting nutritional deficiencies such as iron or vitamin D with supplements under medical guidance, Treating thyroid disease or other underlying conditions
Category
Dermatological · Common; one of the most frequent causes of diffuse hair shedding, particularly in women after childbirth or illness
See a doctor if
Shedding that continues for more than six months or seems to be getting worse

Symptoms

Increased hair shedding noticed in the brush, shower, or on pillows, often several times the normal amount
Thinning that is spread evenly over the scalp rather than in patches
A visibly thinner ponytail or wider parting
Shedding that begins two to four months after a triggering event
Hairs that come away with a small white bulb at the root
Occasional scalp tenderness or tingling
No bald patches, scaling, or scarring

Causes

  • Childbirth, as pregnancy hormones that prolonged the growth phase fall away
  • Severe illness, high fever, major surgery, or significant blood loss
  • Emotional stress such as bereavement, divorce, or job loss
  • Rapid weight loss, crash dieting, or nutritional deficiencies such as low iron, zinc, or protein
  • Thyroid disorders and other hormonal changes, including stopping the contraceptive pill
  • Medications such as beta-blockers, retinoids, anticoagulants, some antidepressants, and chemotherapy-free cancer drugs

Risk Factors

  • Being female, partly because of pregnancy and hormonal changes
  • Recent severe illness, including COVID-19 and other infections with high fever
  • Low iron stores (ferritin), vitamin D deficiency, or restrictive diets
  • Thyroid disease
  • Periods of high stress or major life change
  • Starting a new medication in the preceding few months

Diagnosis

  • A detailed history looking for a trigger in the two to four months before shedding began
  • Examination of the scalp and a gentle hair pull test, which is positive across the whole scalp
  • Blood tests for iron (ferritin), thyroid function, vitamin D, zinc, and a full blood count
  • Dermatoscopy to distinguish from pattern hair loss and alopecia areata
  • Scalp biopsy rarely, if shedding is prolonged and the diagnosis is uncertain

Treatment

  • Identifying and addressing the trigger; in many cases, shedding stops on its own once the body recovers
  • Correcting nutritional deficiencies such as iron or vitamin D with supplements under medical guidance
  • Treating thyroid disease or other underlying conditions
  • Reviewing medications with your doctor to see whether one may be responsible (never stop a prescribed medicine on your own)
  • Topical minoxidil in chronic cases to shorten the shedding phase and support regrowth
  • Reassurance and patience, as regrowth typically takes six to twelve months
  • Supportive: a balanced, protein-rich diet, gentle hair care, stress management, and adequate sleep

Prevention

  • Avoid crash diets and ensure adequate protein, iron, and overall calories, especially when losing weight
  • Manage stress through regular exercise, sleep, and relaxation techniques
  • Treat illnesses and thyroid problems promptly
  • Discuss hair shedding risk when starting new long-term medications
  • Be gentle with hair: avoid tight styles, excessive heat, and harsh chemical treatments while recovering

When to See a Doctor

  • Shedding that continues for more than six months or seems to be getting worse
  • Hair loss in patches, with scalp redness, scaling, pain, or itching, which suggests another condition
  • Thinning accompanied by tiredness, weight changes, feeling cold, or other symptoms of thyroid or iron problems
  • Hair loss that is causing significant distress or affecting your wellbeing
  • No obvious trigger can be identified

Frequently Asked Questions

Related Conditions

Alopecia (Hair Loss)

Dermatological

Iron Deficiency Anemia

Metabolic

Hypothyroidism

Endocrine

Male Pattern Baldness

Dermatological

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