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  • Aug 03, 2018

Excessive Hair Loss from the Scalp

(Medical Diagnosis: Telogen Effluvium)

Excessive hair loss from the scalp is an extremely common condition. We either experience it ourselves or hear about this condition someone who is close to us. This happens to be the case far more frequently than any other hair problem.

In this article, I am going to tell you about how to cope with “more than perceived to be normal” hair fall from the scalp.

Let me first tell you that instead of being a harbinger of doom (in most cases), it actually is a sign indicating that the trigger for the causative event has brushed past by you and that the recovery is about to set in. Why I say so is because this condition (TE) is witnessed several months after the original insult to the hairs. The recovery by itself is commoner than a progression in most cases. Taken care of appropriately, there are excellent chances of recovery rather than deterioration in any given case. So, rejoice! But please do not neglect the condition as every case is characterised by a number of variable that might alter the course of recovery. Some of the patients require investigations and suitable treatment over several months. Statistically, the improvement is the usual outcome but statistics are figures that apply to the pool of the studied population and are non specific for a particular individual.

Before broaching the subject, let us first clarify as to what the normal hair fall range is. Our hairs are like a field crop and show the same patterns of growth phase (sowing), resting phase (tending), and the final phase of decay or downfall (harvesting). However, there is one big difference here. This difference relates to the fact that all hairs are not in the same phase at any given time. A huge and predominant proportion of them, about 85% , can be categorised as growing (Anagen), while most of the rest, that is, a little under 15% are in resting (Telogen) phase with a very few being in the decaying phase (Catagen).

Now what does this imply when we attempt to understand TE? Simply put, if the ratio of resting hairs to growing hairs faces a reversal, then it would mean that the former would easily and quickly fall off. This exactly is what we observe in this condition. Medically, it is called Telogen Effluvium which indicates that Telogen or resting phase hairs are literally flowing out (pouring out). Please bear in mind that due to peculiar life cycle of scalp hairs, it is normal to experience a loss of about 100 strands of hairs per day, taken as an average over several days or weeks as any single day count might be misleading.

As one of the commonest conditions experienced in both the young and the middle age individuals of either sex, this indeed is one of the most talked about complaint in the social gatherings and propelling the sufferers to approach dermatologists or anyone known to offer a cure.

Let me share with you that this condition in most cases would not need any investigation or frequent visits to the physician. This does not mean that they are of no help and will not do anything to help you out or that it is of no use visiting doctor for that matter. A proper diagnosis and necessary investigations can only be advised by a healthcare provider, not to forget the regular supervision and assessment. My attempt here is to tell you that there is no need to panic and that there is so much that you can do yourself and which would make you a better informed person that would help your doctor to attend to your condition more effectively with minimum inconvenience and maximum yield.

The condition is easy to diagnose. As I said that most fallen hairs are in resting phase. An examination of such hairs reveals that telogen hairs carry a bulb or root at their base which may be of any colour: dark or white doesn’t make any difference. This appearance makes this condition distinct from others.

Certain factors in immediate past history will also help in making the recognition and probable outcome of this condition quite easily. These are physical ailments like anaemia, iron deficiency, childbirth, abortion, fever, prolonged medical conditions, thyroid disease, fracture, stress due to examination or otherwise, grief, poor diet, weight reduction, surgery, Vit B 12/ folic acid deficiency, hormonal imbalance or discontinuation of oral contraceptives, and use of antidepressants, etc.

If any of the above conditions has been operative, then most probably you will recover better once the offending cause has been removed and hairs are provided with a congenial environment to recover.

Recovery is slow but generally gratifying, and it can take up to a year or so in some cases. Another good thing about TE is that an individual never goes completely bald, just a thinning which may not be homogeneous in all cases.

While on treatment, it is imperative that an individual stays proactive in the restoration of healthy hairs. Hairs need to be handled gently while combing and bathing, protected from physical or chemical/ thermal trauma. There is a proven and research supported role for good diet, sufficient sleep, physical exercise, and stress busting activities while you are recovering

Armed with this information, I believe that you, as one of my dear readers, will be better equipped to handle such a common but disturbing hair loss condition. I have literally seen thousands of patients who were so crestfallen and restless having been afflicted by this condition. Their behaviour made me write about the condition for your benefit. May be you can pass along the information to someone who can benefit in turn.



You are permitted to share, distribute, print, or reproduce this article for private use with proper citation of the source. The article is a part of our service to fellow human beings as a means of health education and awareness enhancement to minimize dependence on healthcare


Dr Vinay Kumar

Senior Consultant Dermatologist



+91-93 199 299 00



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