Telogen effluvium
Overview
Definition
- Diffuse, non-scarring hair loss due to synchronous shift from anagen to telogen phase with consecutive shedding 2–4 months after trigger.
- Latency Trigger → Effluvium: ~ 2–4 months (= telogen phase duration).
Trigger
- severe infection, additionally postpartum + stress and iron deficiency (+ crash diet, heparin, beta-blockers, retinoids).
Clinical Presentation
- Diffuse hair loss without visible bald areas, usually > 100 hairs/day.
- Pull test positive (more than 5 hairs pulled out during the bundle test, predominantly telogen hairs with root club).
- Trichogram: Telogen rate > 25% (normal 10–15%).
Diagnostics
- History: Triggers, medications, illnesses in the last 2–4 months before effluvium onset.
- Laboratory: Ferritin (target > 70 ng/ml), TSH, CBC, possibly vitamin D, zinc, estrogen status postpartum, syphilis serology if at risk.
- Trichoscopy: unremarkable (in contrast to AGA with caliber variation or AA with yellow dots).
Differential diagnoses
- Anagen effluvium
- Androgenetic Alopecia
- Alopecia areata
- Trichotillomania
- Psoriasis vulgaris (plaque psoriasis)
- Secondary syphilis (lues II)
Practise Telogen effluvium in the app
Flashcards with spaced repetition, exam questions and spot-the-diagnosis on this topic – in DermaFuchs, free of charge.
In the DermaFuchs app: 3 flashcards · 1 clinical images
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More diseases of the skin appendages
- Acne fulminans
- Hidradenitis suppurativa (acne inversa)
- Acne vulgaris
- Alopecia areata
- Androgenetic alopecia
- Folliculitis (infectious)
- Lichen planopilaris
- Milia (milium)
Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.