Telogen E?uvium and Anagen E?uvium


Pathogenesis: Telogen effluvium can almost always be traced to a recent illness, surgery, iron deficiency, child bearing, or other major stressor in the patient’s life. Many medications have been reported to induce telogen effluvium, and the clinician should evaluate all medications taken. Dietary habits, especially crash dieting and anorexia nervosa, may lead to telogen effluvium. The hair follicles are not scarred and eventually grow back after the stressors have been resolved. Because the beginning of hair loss may be delayed after the stressful event, by 3 to 4 months on average, the patient may not realize the relationship.


Treatment: The treatment of telogen effluvium consists of determining the etiology and educating the patient. It is important to rule out an underlying disorder (e.g., iron deficiency, hypothyroidism) that may be triggering the hair loss. Once this has been accomplished, patients need to be educated and reassured that telogen effluvium almost always resolves within 6 to 8 months, and they may expect full regrowth. Supplemental vitamins and topical minoxidil have not been vigorously tested as therapies for telogen effluvium, and their use cannot be scientifically advocated. Referral to a psychological counselor may be appropriate in situations such as eating disorders.


Anagen effluvium is related to the use of chemotherapeutic agents to treat systemic cancer. The therapy should not be stopped because of this side effect. After therapy has been completed, most patients regrow their hair. Patients have reported many changes in the color, texture, and curling of their newly grown hair. These changes have not been fully explained. Topical minoxidil may shorten the duration of anagen effluvium, but its prophylactic use has not been helpful in preventing it. More studies are needed to confirm these findings. At this point, education and reassurance are the most important therapeutic considerations. Most patients will regrow their hair, and for the few that do not, other options exist. The use of hair pieces has been expanded for many medically related forms of alopecia.


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Aug 11, 2016 | Posted by in Dermatology | Comments Off on Telogen E?uvium and Anagen E?uvium

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