Diffuse hair loss: Its triggers and management
SHANNON HARRISON, WILMA BERGFELD, MD
Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195

exerpt (edited)

The most important aspect in the management of telogen effluvium is educating the patient about the natural history of the condition. The normal hair cycle should be explained, as well as the relationship between triggers and the timing of hair loss. For example, in telogen effluvium, shedding usually is noted 2 to 3 months after a trigger, although it can rarely begin as soon as 2 weeks after a trigger.

To help identify triggers, a health diary or calendar can be useful. The patient should be instructed to record any stresses, hospital admissions, surgical procedures, new medications, dosage changes, or other potential triggers of hair loss.

The patient should understand that, once the trigger (for hair loss) is identified and removed or treated, the shedding settles but can continue for up to 6 months.1 Regrowth can be noted 3 to 6 months after the trigger has been removed, but cosmetically significant hair regrowth can take 12 to 18 months.

In acute telogen effluvium, if the trigger can be identified and removed, the shedding is short-lived and no further treatment is required.1,4 Patients can be reassured that they are unlikely to go bald.