Telogen Effluvium commonly known as temporary hair loss is different from permanent hair loss condition called Alopecia Areata. It takes place due to stress, shock or as a consequence of a traumatic event. In cases of temporary hair fall, the top of the scalp is affected. Usually a large chunk of hair falls out, the hair fall stops after some time and the hair grows back. A patient is described as having chronic telogen effluvium if he/she is experiencing frequent hair shedding for more than 6 months.
CAUSES
1. The interval between the precipitating event and the onset of shedding corresponds to the length of the telogen phase, usually 3 months [can be 1-6 months]
2. Acute illness – febrile illness, severe infection, major surgery, severe trauma, etc.
3. Chronic illness- malignancy [especially lymphoproliferative disorders], systemic lupus erythematosus, end-stage renal disease, liver disease, HIV
4. Hormonal change- pregnancy and delivery [can affect both mother and child], hypothyroidism, and discontinuation of hormonal pills
5. Change in diet like crash dieting, anorexia, low protein intake, and chronic iron deficiency
6. Sudden weight loss
7. Heavy metals such as selenium, arsenic, and thallium
8. Medications-ACE-inhibitors, anticoagulants, beta-blockers, contraceptives, retinoids, immunization
9. Allergic contact dermatitis of the scalp
CLINICAL PICTURE
Investigations: CBC, Ferritin, ESR, TIBC, TSH, T3 T4 etc. are done as per the cause.
TREATMENT
PEARLS AND PITFALLS
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