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.
