GW MFA Dermatologist Explains Spike in Stress-Related Hair Loss

January 7, 2022
Ilana DeLuca, MD, smiles at the camera.

As if COVID-19 and its many infection surges haven’t been challenging enough, rates of telogen effluvium, a kind of temporary hair loss, have also reportedly spiked, either as a result of pandemic stress or of the disease itself. While hair loss can be traumatic, the condition typically resolves after several months with little treatment. Here, Ilana DeLuca, MD, PhD, assistant professor of dermatology at the George Washington University (GW) Medical Faculty Associates, explains the causes behind the condition and the signs for which patients should keep an eye out.

What is telogen effluvium?

DeLuca: Telogen effluvium (TE) is a type of diffuse, non-scarring hair loss. The good news is that patients with TE do not lose all their hair, and the hair loss caused by TE is temporary. Still, TE can be very distressing because hair can become noticeably thin.

The hair cycle consists of three phases: anagen, catagen, and telogen. Most of the hair on our scalp is in the anagen or growth phase of the hair cycle. In TE, hairs are prematurely pushed into the telogen or resting phase, where they are shed. Normally, we can lose up to 100 hairs a day, but with TE, this number is increased. Patients usually experience increased hair shedding and often notice large clumps of hair in the shower drain or after brushing.

What causes this kind of hair loss?

DeLuca: TE happens when the body becomes acutely stressed. The most common causes of TE include childbirth, severe infections, severe chronic illness, major surgery or hospitalization, crash diets, and severe psychological stress. TE begins several months after the stressful event, so it is not noticed immediately; hair loss and increased shedding begin 2–3 months later.

How do dermatologists diagnose telogen effluvium?

DeLuca: TE is usually diagnosed based on history and physical exam. Sometimes, when the cause of TE is not readily identifiable, or if hair loss has persisted beyond six months, we may perform blood tests and a scalp biopsy to rule out other causes. There are no laboratory tests that can definitively diagnose TE.

What kind of treatments are available?

DeLuca: TE typically resolves on its own after six to 12 months, so treatment is generally not needed[, depending on the results of any blood tests or scalp biopsies].

As a dermatologist, have you seen the rate of telogen effluvium increase over the last year or so? Why are so many people experiencing this condition?

DeLuca: Yes, there has been an increased incidence of TE over the past year, which we can attribute to the COVID-19 pandemic. TE can certainly occur after COVID infection, but it can also occur after an emotional or psychological stressor, of which there are many during this unprecedented time.

How can GW care for patients with telogen effluvium?

DeLuca: Hair loss can be complex and is often multifactorial, so it’s important for patients experiencing hair loss to see a dermatologist for evaluation. 

To make an appointment with a dermatologist, visit GW Dermatology or call 202-741-2600.

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