Telogen effluvium is a temporary form of excessive hair shedding that can follow illness, stress, childbirth or another major change to the body. Find out what it looks like, what can trigger it and how long recovery usually takes.
🕒 7 min read
Finding more hair than usual on your pillow, in the shower drain or wrapped around your hairbrush can be unsettling, particularly when you can't work out why it has started.
One possible cause is telogen effluvium, a temporary form of excessive hair shedding that can happen after a physical or emotional stressor or another significant change to the body. The shedding often begins months after the original trigger, which can make the connection difficult to spot.
What is telogen effluvium?
Telogen effluvium is a type of diffuse hair shedding caused by disruption to the normal hair growth cycle. Rather than hair disappearing from one particular area, increased shedding tends to occur across the scalp.
According to the British Association of Dermatologists, around 85% of scalp follicles are normally in the active growth phase, known as anagen, while around 15% are resting and preparing to shed in the telogen phase.1
When a follicle moves into the telogen phase, the hair stops growing and rests for around two to four months before shedding. In telogen effluvium, a larger proportion of follicles enter this phase at around the same time, leading to a noticeable increase in hair loss.1
How much hair shedding is normal?
Everybody loses hair as part of the normal growth cycle. The British Association of Dermatologists states that most people naturally shed around 30 to 150 scalp hairs each day.1
Trying to count individual hairs is rarely practical. What tends to draw attention to telogen effluvium is a clear increase from what is normal for you: significantly more hair in the shower, on your brush, on your pillow or around the home.
If you're experiencing hair loss but aren't sure whether it fits this pattern, our guide to the most common causes of hair loss explains some of the other possibilities.
What are the symptoms of telogen effluvium?
The main symptom of telogen effluvium is a noticeable increase in shedding from across the scalp. Rather than forming a distinct bald patch, the hair may simply begin to feel less dense or lose volume.
You may notice:
- More hair than usual coming away when washing or brushing.
- Extra hair on your pillow or clothing.
- An overall reduction in hair volume.
- A ponytail that feels thinner than it used to.
- More scalp becoming visible if the shedding is particularly noticeable.
The scalp itself usually looks healthy. However, some people can experience tenderness or altered sensations of the scalp, sometimes referred to as trichodynia.1
How is telogen effluvium different from pattern hair loss?
The two conditions can both make hair look thinner, but they usually behave differently.
Telogen effluvium tends to involve relatively sudden, increased shedding across the scalp following a trigger. Male or female pattern hair loss, also known as androgenetic alopecia, generally develops more gradually and produces a more recognisable pattern of thinning.
In men, pattern hair loss commonly involves a receding hairline or thinning crown. In women, it may appear as progressive thinning around the top of the scalp or a widening parting.
Telogen effluvium itself is not considered hereditary. The British Association of Dermatologists states that it can affect people of all ages and both sexes and does not have a genetic cause.1
Can telogen effluvium and pattern hair loss happen together?
Yes. Telogen effluvium and androgenetic alopecia can occur at the same time. In some cases, an episode of heavy shedding makes previously subtle pattern hair loss more noticeable.
The British Association of Dermatologists notes that telogen effluvium can sometimes lead to an earlier diagnosis of androgenetic alopecia.1
If your shedding settles but your hair remains noticeably thinner, or thinning continues to progress in a recognisable pattern, speak to your GP or a dermatologist rather than assuming it is simply taking longer to recover.
What triggers telogen effluvium?
Telogen effluvium can follow a wide range of physical or emotional stresses on the body. Common triggers include:1
- Childbirth.
- Severe illness, trauma or a high fever.
- Major stressful life events.
- Surgery.
- Marked weight loss or extreme dieting.
- Severe scalp conditions.
- Starting certain medicines.
- Stopping hormonal treatment, such as the contraceptive pill.
Thyroid conditions and iron deficiency are among the other possible causes a healthcare professional may consider when investigating diffuse hair shedding.1
If your shedding began after pregnancy, our guide to postpartum hair loss explains the hormonal changes and typical recovery timeline in more detail.
Why can shedding start months after the trigger?
This delay is one of the most confusing features of telogen effluvium. Hair does not usually fall out immediately after the triggering event.
Affected follicles first enter the resting phase. Hair can remain in this phase for around two to four months before shedding, which is why increased hair loss may only become obvious several months after an illness, stressful event or other trigger.1
How long does telogen effluvium last?
Acute telogen effluvium is usually temporary. The shedding phase typically lasts around three to six months. New hair then begins to grow, although it can take considerably longer for your previous volume and thickness to become visible again.1
Telogen effluvium that continues for longer than six months is generally described as chronic telogen effluvium.2
What should you expect during telogen effluvium recovery?
Recovery follows the pace of the natural hair cycle, so visible changes can take time even after shedding starts to reduce.
Acute telogen effluvium usually improves once the trigger has passed or an underlying cause has been addressed. If a contributing factor remains unresolved, such as an identified iron deficiency, shedding may continue or return.1
Reduced shedding and restored hair volume do not happen at the same time. New hairs need time to grow long enough to contribute noticeably to overall thickness, so your hair may still feel thinner for a while after the excessive shedding has stopped.
How is telogen effluvium diagnosed?
A doctor will usually start by examining your scalp and asking about your medical history, diet and any illnesses, stressors or significant changes that occurred in the months before the shedding began.
Diagnosis is commonly based on the appearance of the scalp and medical history. A clinician may also perform a hair-pull test to assess active shedding.1
Depending on your symptoms and history, blood tests may be used to look for other possible causes, including thyroid conditions or iron deficiency. In less straightforward cases, hairs may be examined under a microscope and, rarely, a scalp biopsy may be considered.1
Because several different conditions can cause diffuse thinning, these assessments can be particularly useful when the cause is not obvious or the shedding is not improving.
When should you see a doctor?
Telogen effluvium is often temporary, but speak to your GP if you're concerned about your hair loss, particularly if:
- Excessive shedding is continuing without improvement.
- You notice clearly defined bald patches rather than general thinning.
- Your scalp is painful, itchy, inflamed or visibly changed.
- Your hair continues to become progressively thinner.
- You have other unexplained symptoms such as persistent fatigue or weight changes.
- You think a medicine or medical condition may be contributing.
Getting the cause right matters because not all excessive hair shedding is telogen effluvium, and different forms of hair loss may need different approaches.
What can help while telogen effluvium resolves?
The most important step is identifying and, where possible, addressing the underlying trigger. Telogen effluvium normally resolves naturally, and medication does not generally speed up the hair-regrowth process.1
While you're waiting for the normal hair cycle to recover, sensible hair-care and nutrition habits include:
- Eating a varied, balanced diet with adequate protein and iron-rich foods.
- Avoiding crash diets or unnecessary dietary restriction.
- Handling shedding hair gently rather than brushing or combing it harshly.
- Limiting excessive use of heated styling tools.
- Avoiding very tight hairstyles that repeatedly pull on the hair.
- Seeking medical advice before treating a suspected nutritional deficiency yourself.
A volumising shampoo may also help give thinning hair the appearance of greater thickness while shedding settles.1
Frequently asked questions
Does telogen effluvium grow back?
In most cases, yes. Acute telogen effluvium is usually temporary and new hair begins to grow as the normal hair cycle recovers. It may still take several months for your hair to return towards its previous volume and thickness.
How long does telogen effluvium last?
The excessive shedding phase usually lasts around three to six months. If telogen effluvium continues for longer than six months, it is generally described as chronic telogen effluvium.
Can telogen effluvium cause bald patches?
Telogen effluvium usually causes diffuse shedding and reduced hair volume across the scalp rather than clearly defined bald patches. If you're developing distinct patches of hair loss, speak to a GP or dermatologist because another form of hair loss may be responsible.
Can stress cause telogen effluvium?
Significant physical or emotional stress can disrupt the hair cycle and trigger telogen effluvium. Because affected hairs usually shed later, the increase in hair loss may not become noticeable until a few months after the stressful event.
How do you stop telogen effluvium?
There is usually no treatment that immediately stops telogen effluvium. The priority is identifying and addressing the trigger where possible. In acute cases, shedding usually settles naturally as the hair cycle recovers.
Supporting your hair through telogen effluvium
Telogen effluvium can be unsettling, but acute cases usually improve with time. Addressing the underlying cause, eating a balanced diet and treating your hair gently are more important than trying to force the hair cycle to recover faster.
Hair Vitality with Keranat® provides targeted nutritional support with Keranat® alongside biotin, zinc and selenium. Biotin, zinc and selenium contribute to the maintenance of normal hair.
A food supplement cannot treat every cause of excessive hair shedding. If you have unexplained or persistent hair loss, an underlying medical condition or a suspected nutrient deficiency, seek advice from a healthcare professional.
Food supplements should not be used as a substitute for a varied, balanced diet and healthy lifestyle.
Browse the full hair, skin and nails range to explore Healthspan's nutritional and topical hair-care options.
