Telogen Effluvium or misdiagnosis

[wotsthedeal]

I think my shedding be slowing down, around 9-10 months after it started. By shedding slowing down I mean instead of losing 200-300 per shower, I'm losing more like 50-75, roughly. Of course, ten months ago I wasn't noticeably losing hair EVER. Hopefully the reduced shedding means my Telogen Effluvium is almost over with.

 

[pleasegodno]

but what do you believe incited your hairloss and how long has it been since the cause has been removed?

 

[Mickey]

to the guys whose shedding has subsided: how long after the inciting stress/events (after they had subsided as well) did it take for you to notice a reduction in hair loss? thanks.

My stress started in january 2004 and my life got back to normal roughly july time.I started to shed in October/November time washing my hair everyday and loosing 50-80 hairs per wash and loosing hair just by putting my hand through it.I have lost a lot of the top roughly 40% in 3 months.The shedding went back to normal all by itself middle of January 10-20 hairs lost when i wash my hair which is still everyday.And no more stray hairs when i put my hand through it.And i havent had a increase since then.I notice now im getting regrowth sprouting up around the front and the hair margins.Plus i dont get no more of the burning scalp or itch.The vertex is the worse hit for me i can see its getting slightly darker in the area.Just a matter of time i hope before it fills in :?

 

[Mickey]

but what do you believe incited your hairloss and how long has it been since the cause has been removed?

Death of a parent and the stress and depression that followed it.

 

[wotsthedeal]

Stress may have been a small factor for me, but it was mostly nutritional/unhealthy lifestyle. Not enough iron and protein!

 

[Mickey]

Stress may have been a small factor for me, but it was mostly nutritional/unhealthy lifestyle. Not enough iron and protein!

I think that was the the same for me too along with everything else as i wasnt eating properly i just spent the time eating crap.I hardly ate a proper meal and if i did i would just pick at it.

 

[rapidfrontal]

to the guys whose shedding has subsided: how long after the inciting stress/events (after they had subsided as well) did it take for you to notice a reduction in hair loss? thanks.

I don't want to speak too soon, but I think/hope my hair losss is slowing. My inciting event happened on Sept 2, 2004 and about mid Dec 2004 I started to notice the shedding. My situation is a bit different from losing a parent. I really can't disclose exactly what happened but it wasn't just an event. The event went on for a few months and my life still is not back to normal, but hopefully by the end of 2005 it will be, however, the stress and anxiety that I am dealing with now, I can't imagine would be bad enough to cause Telogen Effluvium. That level of stress ended a while back, howver, if I have new growth, I can't tell, it still looks like things are going downhill. My Derm (also Father) told me that it could take a year to come back. Also, I need to note that I have had so much recession on my temples since this whole Telogen Effluvium started, if that's really what it is, that there is no way I am getting back to where I was with my temples.

 

[Mickey]

I thought it would be a good idea to post this so hopefully new people will know whats what with T.E and what causes it.


Telogen Effluvium Hair Loss


It is normal to lose up to about 100 hairs a day on one's comb, brush, in the sink or on the pillow. This is the result of the normal hair growth cycle. Hairs will grow for a few years, then rest for a few months, shed, and regrow. Telogen is the name for the resting stage of the hair growth cycle. A telogen effluvium is when some stress causes hair roots to be pushed prematurely into the resting state. Telogen effluvium can be acute or chronic.

If there is some "shock to the system", as many as 70% of the scalp hairs are then shed in large numbers about 2 months after the "shock". This sudden increase in hair loss, usually described as the hair coming out in handfuls, is acute telogen effluvium. This is a different problem than gradual genetic hair thinning. However, this can be seen in the less common chronic telogen effluvium, only after a significant amount of hair has already been lost.

A considerable number of different causes for telogen effluvium exist. Among the common causes are high fevers, childbirth, severe infections, severe chronic illness, severe psychological stress, major surgery or illnesses, over or under active thyroid gland, crash diets with inadequate protein, and a variety of medications. Most hair loss from medications is this type and causes include retinoids, beta blockers, calcium channel blockers, antidepressants, and NSAIDS (including ibuprofen).

Typically, abrupt diffuse hair loss is noticed several weeks to several months after the incident has initiated the biologic program for hair loss. While the most often noticed hair loss occurs on the scalp, some individuals may also notice hair loss elsewhere on the body. Significant hair shedding usually occurs when shampooing, combing, or even when gently manipulating the hair. Shedding usually slowly decreases over 6 to 8 months once the cause for the hair loss is no longer present. As some of the causes represent ongoing problems, it is important to determine the likely cause when possible and take appropriate measures to prevent continued hair loss.

These shed or loose hairs all have club-shaped "roots" typical of resting, telogen hairs and may be easily identified under the microscope. After shampooing, the bulk of existing loose hair has often been shed and loose hair may not again appear until additional hairs enter this resting phase. When there is any doubt about the presence of this condition, a small piece of skin may be taken from the scalp as a biopsy to be examined under the microscope. In this way, the condition of the hair follicles, the tissues that produce the hair, may be determined.

No treatment is needed for most cases of telogen effluvium. Remember that the hairs fall out when a new hair growing beneath it pushes it out. Thus with this type of hair loss, hair falling out is a sign of hair regrowth. As the new hair first comes up through the scalp and pushes out the dead hair a fine fringe of new hair is often evident along the forehead hairline.

The most important issue in telogen effluvium is to determine if an underlying cause for the problem is present. Blood tests may need to be done if the cause is not obvious, such as mild iron deficiency. If the telogen effluvium is caused by a medication, the medication needs to be stopped. When the cause of the hair loss is something like giving birth, a transient illness, or other self-limited problem the induced telogen effluvium is also usually self-limited and requires no treatment.

Chronic telogen effluvium is recently recognized and not uncommon. It often occurs in women who previously had very thick hair in their teens and twenties and still have an apparently normal head of hair to a casual observer. It affects the entire scalp with no obvious cause apparent. It usually affects women of 30 to 60 years of age, starts suddenly and has a tendency to fluctuate for a period of years. The degree of shedding is usually severe in the early stages and the hair may come out in handfuls. It does not cause complete baldness and does appear to be self-limiting in the long run.

 

[JayB]

hey guys, i too was diagnosed with Telogen Effluvium last May. My shedding rate was terrible and scary. I had severe severe panic disorder and anxiety disorder which developed after I got into a car accident and shed alot of hair about a year before that.

While the shedding definately subsided after a month or two on nizoral and fluorinide or something , the constant debilitating anxiety continued. I have been plagued with such stress that there have been times i really feeel like i am losing control of my mind. It is horrible.

Well, come january my anxiety suddenly became debilitating again. It is horrible again to the point where i feel like i am going to vomit whenever i get on a bus to work because i get so scared of having a panic attack. Low and behold now march, that tickling feeling has come back on my scalp and i am shedding constantly when i rub my hands through my head. My hair, which i could not notice getting better at the time it must have been, feels like soft dead sh*t again and i realize just how much it had thickened up, but is now back to crap.

This is a vicious cycle for people with such intense stress in their lives that their hair falls out which causes even more anxiety and panic attacks.
I pray that my hair can survive this. Its looks like i still have alot of hair but there are definately parts where my scalp easily shows throw now. I cannot believe how incredibly fast my hair changed since i developed an anxiety disorder.

What makes it worse for people like myself, is that I can understand where all balding men are coming from, but it hurts me even harder knowing that i caused this upon myself. I can never forgive myself for not being able to control my own brain and the stress that i have caused.If this was part of a natural process, in a way it wouldnt hurt as much.

 

[rapidfrontal]

JayB, does it not help at all that whether it is acute or chronic Telogen Effluvium it is not supposed to cause total baldness and that it is all supposed to come back within a year after you shake your anxiety, because eventually you will shake your anxiety? My stress has been debilitating for over 6 months now and my shedding continues now for at least 3 months. Just yesterday, I thought, and actually wrote here on HairLossTalk.com, that my shedding had slowed, but I spoke too soon. It would do me a great deal of good to get a confirmed diagnosis that I have Telogen Effluvium, but unfortunately, I'll just have to wait and see what happens over the next year. One thing I know for sure is that my hairline is fucked and getting noticeably worse almost daily. Most people on HairLossTalk.com, it seems lose it over years if not decades, but, at this rate, I'll be completely screwed in 6 months. As for you, if you are really certain that it is Telogen Effluvium, then hang on, because you'll get through all this and be stronger in the end for having endured. Right now I am feeling better, but still totally depressed. My inciting event was in Sept. of 2004 and I can't imagine that I'll be back to normal before the end of 2005, especially if my hair goes away in the meantime, then I may never be back to normal. But if I do get back to normal, then I will have gained so much. I never thought that I would have a period in my life like this, I have always felt so strong emotionally, but when or if I get my life back on track I know I'll have gained a remarkable amount of confidence and I think the same thing about you. We just have to hang on and let time do what it does best - heal. Good luck.

 

[JayB]

JayB, does it not help at all that whether it is acute or chronic Telogen Effluvium it is not supposed to cause total baldness and that it is all supposed to come back within a year after you shake your anxiety, because eventually you will shake your anxiety? My stress has been debilitating for over 6 months now and my shedding continues now for at least 3 months. Just yesterday, I thought, and actually wrote here on HairLossTalk.com, that my shedding had slowed, but I spoke too soon. It would do me a great deal of good to get a confirmed diagnosis that I have Telogen Effluvium, but unfortunately, I'll just have to wait and see what happens over the next year. One thing I know for sure is that my hairline is fucked and getting noticeably worse almost daily. Most people on HairLossTalk.com, it seems lose it over years if not decades, but, at this rate, I'll be completely screwed in 6 months. As for you, if you are really certain that it is Telogen Effluvium, then hang on, because you'll get through all this and be stronger in the end for having endured. Right now I am feeling better, but still totally depressed. My inciting event was in Sept. of 2004 and I can't imagine that I'll be back to normal before the end of 2005, especially if my hair goes away in the meantime, then I may never be back to normal. But if I do get back to normal, then I will have gained so much. I never thought that I would have a period in my life like this, I have always felt so strong emotionally, but when or if I get my life back on track I know I'll have gained a remarkable amount of confidence and I think the same thing about you. We just have to hang on and let time do what it does best - heal. Good luck.

Thank you rapidfrontal. I too have never been emotional before i developed an anxiety disorder. The pain is so much sometimes i cry at 23!!!! I havent shed a tear since I was 11! and now i seem to only want to cry because i feel so lost. Sometimes i think about how incredibly liberating it will feel to get through this and conquer it, but then when it strikes during hard times, i realize how can one live the rest of their life stress-free when they have a disorder.
i know it can take very long even longer than a year for your hair to get back to the way it was, but my hair has taken a beating. Just when it was getting thick again, this hellish nightmare has returned 2 months after my extreme anxiety returned and is still very bad to this day. I cannot understand how i still have coverage on my scalp..its insane when i rub my hands through my hair to see how sparser the hairs are and yet cosmetically i am still acceptable and not bald. Rapid, where do you live? I wished you lived near me, sometimes only people going through this sh*t can understand the pain of knowing you inflicted it upon yourself and it wasnt part of Gd's plan and can keep the motivation high when u hit the low.

 

[pleasegodno]

i really reiterate your guys' sentiments. that f*****g vicious cycle. jayb, so you get that annoying limp/dead *feeling* hair at times too? and the tingling? have you ever experienced any burning or tenderness? if so, where? and where is your loss concentrated, if anywhere at all? i've lost 50-75% of the density all along the hairline in the past 6 months. and a signifcant amount of density from the crown when i was experiencing the burning there. do you get anxiety-induced stomach aches/tightening, shortness of breath?

 

[JayB]

i really reiterate your guys' sentiments. that f*****g vicious cycle. jayb, so you get that annoying limp/dead *feeling* hair at times too? and the tingling? have you ever experienced any burning or tenderness? if so, where? and where is your loss concentrated, if anywhere at all? i've lost 50-75% of the density all along the hairline in the past 6 months. and a signifcant amount of density from the crown when i was experiencing the burning there. do you get anxiety-induced stomach aches/tightening, shortness of breath?

Of course my hair is limp, lifeless, dull , and soft as sh*t. It wwas getting thick again all around the crown..hairline still fuked until my most recent outburst of anxiety.

I get it all. I get racing pounding heart, hot flashes, faintness, shaking and trembling, fear of losing my mind. I have seen the depths of hell and i truly mean it. My loss is concentrated all over to be honest. THe hair is dull and lifeless all over, but worse in the middle of my head. When it dries and naturally parts in the middle, it tends to feel thicker exception being the middle. I also lost hairs behind my ears. Crown is the worst though. I have a long part that hasnt cleared up yet, and it surely wont for a long time now that i am shedding again. My hair is a shell of its former texture. It as if i woke up one morning and someone implanted a different persons hair on my scalp.

and yes i also get the tingling and itchyness for the past 2 weeks since ive started my shed again. the specialist who saw me last week said my scalp is starting to get a little red as well, inflamed from the anxiety i have lost so many battles too. :cry:

 

[rapidfrontal]

Thank you rapidfrontal. I too have never been emotional before i developed an anxiety disorder. The pain is so much sometimes i cry at 23!!!! I havent shed a tear since I was 11! and now i seem to only want to cry because i feel so lost. Sometimes i think about how incredibly liberating it will feel to get through this and conquer it, but then when it strikes during hard times, i realize how can one live the rest of their life stress-free when they have a disorder.
i know it can take very long even longer than a year for your hair to get back to the way it was, but my hair has taken a beating. Just when it was getting thick again, this hellish nightmare has returned 2 months after my extreme anxiety returned and is still very bad to this day. I cannot understand how i still have coverage on my scalp..its insane when i rub my hands through my hair to see how sparser the hairs are and yet cosmetically i am still acceptable and not bald. Rapid, where do you live? I wished you lived near me, sometimes only people going through this sh*t can understand the pain of knowing you inflicted it upon yourself and it wasnt part of Gd's plan and can keep the motivation high when u hit the low.[/quote]

I am with you, JayB. I am 34 and have never been through sh*t like this before. My inciting event devastated my entire life on Sept 2, 2004 at 8pm. I'll never forget that date and time and where I was. It was the single worst night of my entire life, hopefully never to be outdone. The stress was so debilitating that I have barely been able to work since. I am self employed so nobody really cares if I don't work, so I find myself unable to focus. When I am at the office and I know I need to be working and I am not, I get even more depressed, making it even harder to get out of the depression. It is the vicious cycle. My depression is several fold. First and foremost is the inciting event, Sept. 2, 2004, which continues now. I also lost a very close friend to pancreatic cancer on Dec 2, 2004 and watched him die for all of 2004. On Dec. 10, 2004 I also quit my job with intentions of opening my own office, normally hugely stressful, but with everything that had happened, really not that big of a deal. Then there was also some marital stress, but again, in light of everything not a huge deal. Unfortunately, about Dec. 15, 2004 I noticed my shedding and completely freaked about that. You might find this strange, but of all of this I felt I could get through it in time, except the hairloss. I felt and feel that if I lose my hair, I lose my identity, and I'll never be attractive to women again. I know this is small minded, but it is difficult to help. I am so regrettful about letting my stress continue so much so long, but I can't seem to do much about it. Relieving this level of stress is very difficult for me and a slow process, but I know I can put it behind me in time. It would just be a LOT easier with my hair.

I know I am not that much older than you, but I must tell you that I am very regrettful about the past 10 years of my life. Don't get me wrong, I have always been a relatively happy person and very social and outgoing and I have had a good life so far, but I didn't work hard enough at obtaining the life I wanted for myself and now, for some of it, it is too late. The past 6+ months of my life have made me realize that I should have been living in the moment and not always looking into the future and planning everything out. I heard a quote the other day that really made me think. "Announcing your plans is a good way to hear God laugh." 6 months ago I wouldn't have paid attention to that, but that's what I did. I time-framed my entire life, practically and in the process failed to enjoy life as I could have. Only now do I realize that I just should have been working harder at school and work and living in the moment, because you never know what the future holds. The goal in life, I believe, is to minimize regret. I only hope that I am able to get out of my depression so that I can apply what I have learned to the rest of my life.

Don't mean to be so wordy, but I figured I'd tell you more of my story in hopes that it could have a positive impact on you. People have disorders of all types and most have the common thread that they can be overcome, and you'll overcome yours too. I know that lost feeling you describe all too well, but it can be overcome. We both need to hang on and get this sh*t under control so that we can enjoy the brighter days ahead. By the way, I live in St. Louis, thanks for your remarks, JayB.

 

[rapidfrontal]

i really reiterate your guys' sentiments. that f*****g vicious cycle. jayb, so you get that annoying limp/dead *feeling* hair at times too? and the tingling? have you ever experienced any burning or tenderness? if so, where? and where is your loss concentrated, if anywhere at all? i've lost 50-75% of the density all along the hairline in the past 6 months. and a signifcant amount of density from the crown when i was experiencing the burning there. do you get anxiety-induced stomach aches/tightening, shortness of breath?

I get those symptoms also. I don't have the burning itching scalp deal, but I do use a dandruff shampoo every day, for what its worth. My loss is concentrated on the top/crown of my head and while I do have full coverage still for the most part, it is a bit wispy, and I can easily see my scalp in the mirror. The biggest problem I am facing at the moment anyway is the hairline, hence the name Rapid Frontal. My sh*t is changing daily for the worse along the hairline. I have always had the peninsula in front if you know what I mean, but it appears that its turning into an island rapidly, which is especially bad for me as I have a HUGE scar from a high school party injury dead center on my forehead that is becoming more and more visible. If I lose that area I will probably be nicknamed Frankenstein or freak show. Also, those anxiety symptoms you guys talk of are all too common. In fact, my heart was beating so hard that I went to my cardiologist last month for a stress test. Those heavy, uncontrollable, irregular beats are called premature ventricular contractions and are very common. I have been experiencing them non stop since Sept 2, 2004, but my cardiologist is not concerned. He says and he is right that they will go away when I remove my extreme stress from my life, Ha Ha. Sounds like what a Derm will tell you about temporary hair loss. The vicious cycle all over again.

 

[JayB]

I am with you, JayB. I am 34 and have never been through sh*t like this before. My inciting event devastated my entire life on Sept 2, 2004 at 8pm. I'll never forget that date and time and where I was. It was the single worst night of my entire life, hopefully never to be outdone. The stress was so debilitating that I have barely been able to work since. I am self employed so nobody really cares if I don't work, so I find myself unable to focus. When I am at the office and I know I need to be working and I am not, I get even more depressed, making it even harder to get out of the depression. It is the vicious cycle. My depression is several fold. First and foremost is the inciting event, Sept. 2, 2004, which continues now. I also lost a very close friend to pancreatic cancer on Dec 2, 2004 and watched him die for all of 2004. On Dec. 10, 2004 I also quit my job with intentions of opening my own office, normally hugely stressful, but with everything that had happened, really not that big of a deal. Then there was also some marital stress, but again, in light of everything not a huge deal. Unfortunately, about Dec. 15, 2004 I noticed my shedding and completely freaked about that. You might find this strange, but of all of this I felt I could get through it in time, except the hairloss. I felt and feel that if I lose my hair, I lose my identity, and I'll never be attractive to women again. I know this is small minded, but it is difficult to help. I am so regrettful about letting my stress continue so much so long, but I can't seem to do much about it. Relieving this level of stress is very difficult for me and a slow process, but I know I can put it behind me in time. It would just be a LOT easier with my hair.

I know I am not that much older than you, but I must tell you that I am very regrettful about the past 10 years of my life. Don't get me wrong, I have always been a relatively happy person and very social and outgoing and I have had a good life so far, but I didn't work hard enough at obtaining the life I wanted for myself and now, for some of it, it is too late. The past 6+ months of my life have made me realize that I should have been living in the moment and not always looking into the future and planning everything out. I heard a quote the other day that really made me think. "Announcing your plans is a good way to hear God laugh." 6 months ago I wouldn't have paid attention to that, but that's what I did. I time-framed my entire life, practically and in the process failed to enjoy life as I could have. Only now do I realize that I just should have been working harder at school and work and living in the moment, because you never know what the future holds. The goal in life, I believe, is to minimize regret. I only hope that I am able to get out of my depression so that I can apply what I have learned to the rest of my life.

Don't mean to be so wordy, but I figured I'd tell you more of my story in hopes that it could have a positive impact on you. People have disorders of all types and most have the common thread that they can be overcome, and you'll overcome yours too. I know that lost feeling you describe all too well, but it can be overcome. We both need to hang on and get this sh*t under control so that we can enjoy the brighter days ahead. By the way, I live in St. Louis, thanks for your remarks, JayB.

"You might find this strange, but of all of this I felt I could get through it in time, except the hairloss. I felt and feel that if I lose my hair, I lose my identity, and I'll never be attractive to women again. "
Amazing how similiar we are. Therapists ive seen to try to help me are amazed that even when my hair was perfect, which i never took for granted and was happy every day to have it, I would lay in bed on nights and think about a roommate of mine who was losing his hair. I told myself, i can get through anything but if that were to happen to me, i think i would lose the control i have over my mind. It sounds so strange to some, but i was always able to keep anxiety at bay, eventhough i didnt have it back in college there were always certain signs like some nights having "bad thoughts to worry over" come into my mind at night . I told myself I can handle everything cause at least i will never lose my hair.
its so hard to live for the moment when i never feel like myself. All i do is look to my uncertain future with dread over how bad my hair might get. Its very hard to look on the bright side.

 

[rapidfrontal]

I told myself I can handle everything cause at least i will never lose my hair.
its so hard to live for the moment when i never feel like myself. All i do is look to my uncertain future with dread over how bad my hair might get. Its very hard to look on the bright side.

[/quote]

I can relate. Although, I did take my hair for granted before these problems. It's crazy, but I always thought I'd have great hair. You do have Telogen Effluvium, don't you? If you do you won't lose everything and what you have lost you'll get back. You just need time. I feel the same about my uncertain future. I shudder to think of what my hair will look like in 3 monts, because it has changed so much in the past 3 months. I've been told I have Telogen Effluvium, but I no longer believe it. Hang in there.

 

[JayB]

I can relate. Although, I did take my hair for granted before these problems. It's crazy, but I always thought I'd have great hair. You do have Telogen Effluvium, don't you? If you do you won't lose everything and what you have lost you'll get back. You just need time. I feel the same about my uncertain future. I shudder to think of what my hair will look like in 3 monts, because it has changed so much in the past 3 months. I've been told I have Telogen Effluvium, but I no longer believe it. Hang in there.

I was diagnosed by two hair specialists as having extreme stress related telogen effluvium last May. The stress has not left but in fact has magnified 10 fold within the past 2-3 months and what do ya know, im shedding again, hair itching, scalp hurting, red.... So im really beginning to believe the doctors and how bad stress can affect the hair. hair loss is a tricky thing though. It scares me because its been so long since i can remember last touching the hair i remember having all my life. On one hand your told good news that it will grow back when you are able to defeat the anxiety and stress, but on the other hand your a sitting duck wondering if you should go on propecia just in case.

 

[Mickey]

My shedding has still remained more or less back to normal still 6 weeks after i stoped shedding rapidly.The burning itchiness has gone.On my Vertex which took the most hammering im more or less bald in that area i now feel stubble there and it looks to be getting slightly darker.The crown thats a mess diffused everywhere but still got coverage just thin and pathetic looking.The front new regrowth is sprouting up everywhere.I know its going to take a long time before it recovers from this.But now i keep getting red spots on my scalp they dont hurt only when touched.I get them in my thinnest areas they normally hang around for a week or so then go. :?

 

[JayB]

My shedding has still remained more or less back to normal still 6 weeks after i stoped shedding rapidly.The burning itchiness has gone.On my Vertex which took the most hammering im more or less bald in that area i now feel stubble there and it looks to be getting slightly darker.The crown thats a mess diffused everywhere but still got coverage just thin and pathetic looking.The front new regrowth is sprouting up everywhere.I know its going to take a long time before it recovers from this.But now i keep getting red spots on my scalp they dont hurt only when touched.I get them in my thinnest areas they normally hang around for a week or so then go. :?

dont worry man, i feel your pain...this sh*t has ravaged my body..even my eyebrows are falling out like crazy and just recently hair on my chest has been falling out alot. Whatever. Its in the past, for the first time since talking with you guys, i know that we are not the only ones to suffer from Telogen Effluvium. and ive decided to put my stress and anxiety in the past to the best i can, and be more optimistic and give my body time to heal itself.

I read a post from another forum, i forget which, from a guy who had Telogen Effluvium and after 2 years of nonstop anxiety over it, he decided to let the chips fall where they may and stop counting hairs, and shortly after that he felt much better and his hair actually grew back in totally. Its inspirational.