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Therapeutic Approach

Telogen effluvium (TE) is a form of nonscarring hair loss and is the most common cause of diffuse hair loss in both women and men. TE may be acute and transient, or may be chronic in nature. It is most often triggered by an inciting event including acute or chronic illness, autoimmune disease, metabolic or endocrine disorders, surgery, pregnancy, malnutrition, drugs, or severe emotional distress. It may preceed other forms of hair loss such as androgenetic alopecia and may be concomitant with scalp disorders such seborrheic dermatitis.

In the author’s experience, the mainstay of therapy is identifying and removing or treating any inciting triggers. If a triggering event is isolated and transient, hair loss is likely to resolve spontaneously with time. If the insult persists, the underlying cause should be eliminated or treated when possible. This may include treating any associated scalp disorders such as seborrheic dermatitis, promoting overall skin health, correcting any nutritional deficiencies, treating any illnesses, and discontinuing any drugs that may have triggered hair loss. In addition to addressing triggers for telogen effluvium, psychologic support and reassurance should be provided that complete hair loss is not expected and regrowth is likely to become noticeable within 6-12 months of the inciting trigger being addressed. Cosmetic techniques such as hair styling and coloring may be helpful to camouflage the hair loss until regrowth occurs. Additional therapeutic options may be considered as outlined below. See Table 78-1.

Table 78-1Telogen Effluvium Treatment Table

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