Telogen effluvium

Question
QUESTION: Hi,

I have been losing alot of hair since the past 1.5 months, for no apparent reason. Apart from long hair that was falling out, I also noticed some of my shorter, new hair strands around my hair line, easily falling out. I was on iron medications for low ferritin levels (which rose from 9 to 40 in 3 months last year) and for the next 6 months, I could see tiny new hair growing along with reduced hair fall.



However, the sudden loss of hair recently has left me confused. I havent been under any stress, except for falling ill with very high fever for a week, in the beginning of November. My hair fall then started around mid December. Can the short illness in november be responsible for this? Or are my ferritin levels at 40 to blame for this?



In any case, I have started taking iron supplements again, to raise my ferritn levels to atleast 70. My Haemoglobin levels are 11.6 (I am a 20 year old female).



To avoid any sudden hair loss of this kind, what else must I do? Could you suggest some  nutritional supplements that would help or any other tests you think I should take to check for factors causing this diffused hair loss?

And thank you so much for your time.



ANSWER: You have described the typical case of Telogen Effluvium following a fever. The timing of the loss after the fever is classic and it may take a few more months to get over it. A serum ferritin of 40 is not the cause and I doubt it will slow the regrowth although it would be better if you could get your ferritin over 60 or 70. I do not think you need to check for any other factors causing the shed. You have the answer already all you need to do now is wait for them to grow back. Using Rogaine 5% once a day for then next four months will speed up the regrowth.





http://dermnetnz.org/hair-nails-sweat/telogen-effluvium.html



http://dermnetnz.org/hair-nails-sweat/telogen-effluvium.html



"Typically, abrupt diffuse hair loss is noticed several weeks to several months after the incident has initiated the biologic program for hair loss. While the most often noticed hair loss occurs on the scalp, some individuals may also notice hair loss elsewhere on the body. Significant hair shedding usually occurs when shampooing, combing, or even when gently manipulating the hair. Shedding usually slowly decreases over 6 to 8 months once the cause for the hair loss is no longer present. "



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QUESTION: Thank you so much for your prompt reply! I'd like another clarification though.



Hair loss is hereditary in my family (with my grandmom, mother and sister with bald patches now). My mother and sister also had low ferritins level like me. Ever since I moved out for college (3 years back), the change in environment, lack of nutritious food and stress caused a heavy bout of hair loss, which lasted around 3 months and reduced my hair volume by almost half. I also noticed the hair diameter of individual strands becoming smaller and my hair growing out finer. Is this hereditary? Or was the excessive stress that time a trigger for finer hair to grow out?



Also, how long would it be before I can feel the thickness returning to my hair? Would it be naive to assume all my hair can grow back, to how thick it was originally, in maybe 3 years time?



Lastly, who would be a suitable candidate for a hair transplant? What about its side effects? Roughly, how costly is it and would hair remain as thick life long after the procedures?


Answer
The loss you experienced is a Telogen Effluvium. Much of that hair may grow back. What does not grow back is due to AGA. The hairs you were going to lose over the next 5 to 10 years due to normal hereditary loss but were shocked into dying early are those hairs which will not grow back in the next six months. Each hair has a predetermined number of life cycles with each life cycle being about 5 years. When you stress out thousands of hairs into falling our some of those were not going to grow back because they were in their last life cycle. There is no way to bring those hairs back. What has not grown back after one year is not likely to grow back. You should see a doctor who specializes in hair transplants to determine the cost as it varies depending on the degree of loss and the amount of donor hair available as well as your locale. The hairs moved from the back of the head are usually less vulnerable to the aging process and when moved to a thin area on top or front of the scalp they remain thick for many years beyond the time the other hairs fall out. The cost can vary from $3,000 to $10,000 depending on many factors. More information on hair transplantation can be found at www.HairDoc.com