Telogen effluvium


Shieva Ghofrany: [00:00:00] Tuesday morning people I put on lipstick. I never wear lipstick. Um, but I found it when I was cleaning out my car yesterday, and lo and behold, I decided to put it on. So we're gonna talk about telogen effluvium, which really is telogen effluvium, which means flood of hair loss in Latin. A bunch of people actually wrote about this, and it's a common thing for you mamas who have had. 

So you might know that three to six months after you've had a baby, you can have a true like flood of hair loss for three to six months. I remember when I had my first, and I was like, HAA, three months. I get to my hair lady and I'm like, trim my hair. Look at me. I didn't lose it. I'm so lucky. And she was like, girlfriend, don't you know that you're gonna lose it? 

And I thought, young doctor, I was a year out of residency. I didn't know about this stuff that much. Because you learn, but you also learn by by what you've gone. And she said it starts three to six months after the delivery. You're just at three months. You never [00:01:00] know it's probably gonna happen. I swear to God, within that week, I manifested and I lost my hair for three straight months and it's distressing. 

So here's what it means. When you are pregnant, your hair actually arrests in the same phase. So all your follicles, which are typically going through different phases, like you're losing hair, you're keeping your hair. Part of it is falling out, but part of it is staying, right? So it's not all doing the same thing. 

Each follicles in a different phase, but during pregnancy, they arrest in the same phase. So patients will say things like, these prenatal vitamins are making my hair amazing. And the answer is, Nope, it's not the prenatals. It's the pregnancy in the hormones, which are causing you to not lose your hair in that cycle. 

So, whereas you would normally every day have a couple of hairs. In fact, studies have shown that on average we lose a hundred strands a day during pregnancy, you lose very few. So now imagine instead of losing and then growing and losing and growing, you have all the hair. None of it's lost. You think it's thick and luxurious. 

You think it's your vitamin. You have your pregnancy and then all of [00:02:00] a sudden, three to six months later, maybe you've stopped your vitamins because maybe you're not nursing, or maybe you've switched to a regular vitamin because you somehow think that you should, which PS you could take your prenatal vitamins for the rest of your life. 

They're not gonna make you pregnant. They're just theoretically, the nutrients you need in pregnancy. And again, it might be a little bit of marketing, so you suddenly are in distress because you think it's the lack of your vitamins or something else. When in fact, almost. It is telegen effluvium, which in Latin means flood of hair loss. 

And it will stop, I promise, three to six months out. It'll start and it'll last three to six months. You'll get those little baby fuzzy hairs and it'll grow back. Promise. Promise. If you're distressed. And sometimes patients come to me distressed about it, I will certainly, um, in an effort, as you know, to decrease the anxiety of our mindset. 

I will absolutely check your thyroid because in theory, that could be a reason for hair loss, though usually it's more brittle hair than hair. Um, I'll check a blood count to make sure you're not anemic. That includes your iron and ferritin levels, which is not a standard [00:03:00] part of the blood count, um, because some of us have normal iron but very low iron stores, which is ferritin and that would not show up on a regular CBC complete blood count. 

So I'll do that to kind of help prove to patients they're okay and occasionally. Lo and behold, they do have low iron or iron stores and depleting that makes them feel better. In many ways, though, it will not help their hair. Patients ask about biotin. You can certainly try it, but it's unlikely to help because the mechanism for the hair loss doesn't have to do with the quality of hair. 

Again, it has to do with the phase the hair was in. So it all stopped falling out and then all of a sudden it all fell out at the same time because they, instead of having, again, those cycles, so once you go through a couple of cycles, it'll be, it'll kind of grow at the same time, meaning each follicle will grow differently the way it did before you were pregnant. 

It's the same thing that happens with eyelashes after chemo again, another thing I learned on my own, so I lost all my eyelashes during chemo. , I don't know. A couple weeks after chemo [00:04:00] finished, my lashes started growing back. Yay. I'm so glad. And then maybe six to eight weeks later, I started to notice they fell out again. 

And at first I was distressed because this is not something the medical community actually talked to me about at least. And I did the Dr. Google thing, and guess what? I found out that many women have reported that, that because again, your lashes all fell out together and then they all grew at the same time. 

They all grew in the same phase. So it just meant that that normal cycle of growth and loss and growth and loss. Occurs at different times for different lashes was happening all at the same time. So they grew, they fell out, they grew, they fell out. So it took now in three and a half years out, it's happens much less frequently because now I have a bunch of lashes in different phases. 

Okay. I hope that helps. It's very distressing. It's very annoying, but it is not a bad or dangerous thing. You're not broken. Your hair will grow back. This is the time where many women will choose to cut their hair short, um, or donate their hair to things like Locks of Love, I think might not be doing it, but one of those companies where they take your long hair and donate it, because certainly if it's [00:05:00] shorter and you wash it less frequently, it's less likely to get pulled out. 

It doesn't mean you won't lose your hair, but you won't notice it as much. All right. Happy.