rapid, like i said our situations seem very similar, I had an extreme continuing episode of stress/depression and months later noticed extreme shedding (lose 300+ hairs when i shampoo) which I still exper. My hairline has also been ravaged during this time. The difference is I began finasteride almost imed. after i noticed the shed, 5 months ago. According to Dr.Lee finasteride can in rare instances can induce a tel.effluvium, so i don't know to what extent if any finasteride has contributed to my situation, so this further complicates things for me.
As i was re reading my emails to dr.lee i realized much of them revolved around finasteride use, so i didn't think that would be helpful to you. So i only submitted a short excerpt from the email. But i included some quotes from articles that i've seen and some links to articles htat might interest you. I recently wrote email that posed some ques. relevant to what your exper. If i receive a reply w/ any helpful info i will repost it on this thread.
"There are no specific numbers that we can put on the numbers or percentages of hair shed in a telogen effluvium. The amount and degree of hair loss is dependent on the severity of the telogen effluvium. Rarely, will the amount of hair loss exceed 50%. The shedding is generally diffuse (global) and can affect areas of the scalp not usually affected by male pattern baldness. So, it would be common to note shedding from the sides and back of the head in addition to the crown, vertex and frontal areas. The shedding tends to be fairly symmetrical, but will be more noticeable in the areas affected by male pattern baldness, because there is a higher ratio of hairs in the telogen phase than in the other areas of the scalp. The shedding lasts about 6 weeks. It usually takes 4 months to a year for the hair to grow back."
"If the telogen effluvium is not coupled with accelerated pattern loss, then all of the hair should grow back within a year, beginning as early as 4 months after the effluvium"
"Many hair loss sufferers with traditional male or female pattern baldness want to believe they have Telogen Effluvium (Telogen Effluvium), because it provides a glimmer of hope that the whole ordeal is just temporary. Unfortunately, Telogen Effluvium by definition is a condition that occurs in response to serious traumatic shock to the system as a whole. It is not a something that will happen without any abnormalities going on in your life. Things like sudden shock, chronic debilitating stress, extreme malnutrition, certain medications, and chronic serious illness are the most common causes. There is no way to know for sure how long shedding will last with telogen effluvium. Increased shedding occurs in response to a trigger factor. If exposure to the trigger is brief and there are no other contributing factors then the shedding may last for around 3 months and then recover so that 6 months later the hair is pretty much back to normal. However, if the trigger factor hangs around, like chronic stress or illness, then the shedding may persist. The hair follicles can get into a habit of short, truncated growth cycles, producing short hair that falls out after a few months. This results in a high shed rate ? although the hair loss on the scalp need not progress much. "
"Since it would be normal to have 10 to 15% of all the hairs on the scalp in the telogen phase, we can expect that 50-100 of those hairs are at the end of the phase and will readily shed. The anagen phase is in proportion to the size of the follicle and can vary from months to years. Vellus hairs have an anagen period of a few months. However, regardless of the length of the growing period or of the size of the hair follicle, the length of the telogen phase remains fairly stable, i.e. approximately 100 days. As a consequence, the anagen/telogen ratio in an area affected by male pattern baldness is higher than in areas unaffected or less affected by male pattern baldness (male pattern baldness), so in any given time period, there will be more shedding of hair from the areas affected by male pattern baldness than there will be in the remainder of the scalp."
"Often the cause of a telogen effluvium are obscure, but has been related to high fevers, stress, trauma, medications, etc.
The shedding is generally diffuse (global) and can affect areas of the scalp not usually affected by male pattern baldness. So, it would be common to note shedding from the sides and back of the head in addition to the crown, vertex and frontal areas. The shedding tends to be fairly symmetrical, but will be more noticeable in the areas affected by male pattern baldness, because there is a higher ratio of hairs in the telogen phase than in the other areas of the scalp.
The duration of a telogen effluvium is variable, but rarely lasts more than a few months and there is invariably complete restitution unless another pathologic process also occurs. "
"The alopecia in male pattern baldness is caused by progressive miniaturization, rather than destruction of involved hair follicles. In affected follicles, the percentage of hairs in telogen is increased and the duration of anagen is decreased. As a consequence, there is relatively more shedding in areas affected by male pattern baldness. Since vellus and intermediate hairs have a short anagen phase, they will shed frequently. There can be permanent hair loss because the replacement hair shaft is finer in texture and lacks the same volume.
The age of onset and the rate of progression of male pattern baldness are genetically controlled and cannot be predicted. There are times of remission and, alternately, times of acceleration. When there is a period of acceleration, it is often proceeded by a telogen effluvium. male pattern baldness can proceed with alarming speed and everyone is familiar with stories of men who went bald ‘overnight’. Unfortunately (and understandably) the patient will blame whatever event or treatment coincided with the accelerated hair loss. It is the philosophical fallacy of post hoc, ergo propter hoc, i.e. "after this, therefore, because of this". Since the dramatic miniaturization of the follicle occurs within one single hair growth cycle, these patients are poorly responsive to treatment and reversing the male pattern baldness is improbable. "
"Stress:
Stress can cause a type of hair loss called telogen effluvium. This condition is not caused by the general accumulated stress of ordinary interactions with people at home and at work, but rather by sudden severe emotional or physiological incidents. Severe stressful events can cause some or most actively growing hair follicles to prematurely shift into the regression phase, and then the resting phase, during which the hairs fall out easily.
There is usually a delay of a few weeks to a few months before the shedding is noticeable, but after this delay the shedding seems to occur quite suddenly. Because the shedding is delayed, this type of hair loss is often a mystery to the person suffering the condition. The stressful event that triggered it is frequently forgotten, and it is rarely thought to be connected with the "new problem."
Examples of sudden severe emotionally stressful events include the death or terminal illness of a family member or close friend, marriage, divorce, and unexpected job loss. Severe physiological stressful events shock the body, and some examples are heart attacks, major surgery, and illnesses with prolonged high fever such as malaria, viral pneumonia, and severe cases of the flu.
In most cases of telogen effluvium, the hair follicles recover and soon shift back to the regular growth cycle.
However, repeated instances of telogen effluvium can result in premature hair loss in people predisposed to lose their hair late in life. The average growth cycle of a hair follicle takes about 5 years, but each follicle is "genetically programmed" for only a limited number of growth cycles. For example, if a particular hair follicle were "genetically programmed" for only 10 growth cycles, after about 50 years that follicle would stop producing new hairs. When all the follicles at the hairline or crown of the head are "genetically programmed" this way, a receding hairline or bald spot appears after all the growth cycles for the follicles in those areas have been cycled through.
Each incidence of telogen effluvium uses up one "life" of the affected hair follicles. So instead of having a receding hairline or bald spot at age 50, the hair loss may occur a few years earlier. This is not a significant issue if telogen effluvium occurs once or twice in a lifetime; however accelerated hair loss can result from repeated severe stressful events, if each instance triggers a new round of telogen effluvium.
I had a patient who was totally bald when I met him at age 70, and he had lost all his hair by age 22. He had worked on the Panama Canal 50 years earlier, and for two straight years starting when he was 20 he suffered repeated bouts of severe fever from episodes of malaria. Each time he suffered from malaria-induced fever he experienced telogen effluvium, lost what hair he had, and his hair follicles lost another "life." After 10 or 15 malaria stress-cycles, at the age of 22 he had the hair he would have had at age 70. Which unfortunately for him was no hair at all!"
http://www.hairlosstalk.com/discussions ... depression
http://www.hairlosstalk.com/discussions ... n&start=10
http://www.hairlosstalk.com/newsletter/article222.htm
http://www.hairdoc.com/book/chapter4.html
http://www.hairdoc.com/book/chapter14.html
http://forhair.com/stressAndHair.htm
http://forhair.com/stressAndHair2.htm
http://forhair.com/stressAndHair3.htm
http://forhair.com/stressAndHair4.htm
