Source: Cleveland Clinic, DermNet, AAD

• What is telogen effluvium?
• Symptoms
• Causes and triggers
• Types: acute and chronic
• Diagnosis
• Treatment options
• Recovery time and outlook
• Complications
• Prevention and living with it
• When to see a doctor
• FAQ
• Sources

What is telogen effluvium?

Telogen effluvium is a temporary form of hair loss in which far more hairs than usual shed at the same time. It happens when a shock to the body, such as a high fever, childbirth, surgery, a crash diet or severe emotional stress, pushes many growing hair follicles into their resting phase all at once. A few months later those resting hairs fall out together, so the hair feels noticeably thinner across the whole scalp.

Source: Cleveland Clinic, DermNet

The hair growth cycle

Each scalp follicle repeats a three-phase cycle. In the growing phase (anagen), which lasts roughly two to five years, the hair lengthens. A short transition phase (catagen) of a few weeks follows. Then comes the resting phase (telogen), lasting about three to five months, at the end of which the old hair, called a club hair because of its rounded white root, is pushed out. Sources give slightly different figures for how much hair is growing at any time: a review on PMC cites about 90% growing and 10% resting, while DermNet cites about 85% and 15%.

Source: Cureus review (PMC), DermNet

In telogen effluvium, a trigger can shift as many as 70% of growing hairs into the resting phase early. Because the resting phase lasts a few months, the shedding is delayed and usually starts about two to three months after the event. That delay is why many people do not connect their hair loss with the illness or stress that caused it.

Source: Cleveland Clinic, DermNet, Cureus review (PMC)

Telogen effluvium is one of the most common causes of diffuse hair loss and of hair loss in women. It is not contagious, it does not cause scarring, and it does not harm physical health, although it can be very upsetting. In most people the follicles stay alive and hair grows back once the trigger has passed.

Source: Cleveland Clinic, Cureus review (PMC), DermNet

Symptoms

The main sign of telogen effluvium is a sudden increase in hair shedding. Typical features include:

• Much more hair than usual in the hairbrush, on the pillow, in the shower drain or in your hands after washing.
• Diffuse thinning spread over the whole scalp, often most noticeable on the top of the head, rather than one bald patch.
• Shed hairs that have a small white bulb at the root (club hairs).
• A scalp that usually looks healthy, without redness, scaling or scarring.
• A hairline that is generally preserved; complete baldness does not occur.
• In severe cases, thinning of the eyebrows or body hair.

Source: Cleveland Clinic, DermNet

Most people shed around 50 to 100 hairs a day without noticing. With telogen effluvium, Cleveland Clinic says losses can reach around 300 hairs a day. MedlinePlus gives a wider normal range of 50 to 200 hairs a day, so a single number is less useful than a clear change from your own usual pattern.

Source: NHS, AAD, Cleveland Clinic, MedlinePlus

Some people also notice scalp tenderness, burning, itching or a tingling discomfort, a symptom called trichodynia. As the episode settles, short new hairs often appear along the forehead and temples, which is a sign of regrowth. Horizontal grooves across the fingernails (Beau’s lines) sometimes appear after the same shock and can help date when it happened.

Source: Cureus review (PMC), DermNet

Telogen effluvium can look like pattern hair loss, but the pace is different. Telogen effluvium causes heavy, fairly rapid shedding, whereas pattern hair loss is a slow, gradual thinning over years.

Source: Cleveland Clinic

Causes and triggers

Telogen effluvium is a reaction to a change or stress in the body rather than a disease of the hair itself. Common triggers named by dermatology sources include:

• High fever or severe infection, including recovery from an illness that caused a fever.
• Childbirth: postpartum shedding often starts about two months after delivery and peaks around four months.
• Major surgery, an accident or blood loss.
• Severe psychological stress, such as bereavement, divorce, job loss or caring for a sick relative.
• Rapid weight loss or restrictive diets, especially diets low in protein; the AAD mentions losing 20 pounds or more.
• Nutritional deficiencies, such as low iron, zinc, protein or essential fatty acids.
• Thyroid disorders, both an underactive and an overactive thyroid.
• Stopping the contraceptive pill.
• Chronic illness or inflammatory scalp conditions such as psoriasis and seborrheic dermatitis.

Source: Cleveland Clinic, AAD, DermNet, Cureus review (PMC), MedlinePlus

Medicines

Several medicines can trigger telogen effluvium, usually around 12 weeks after starting them or after a dose change. Examples listed in sources include retinoids, beta-blockers, ACE inhibitors, calcium channel blockers, some antidepressants, anticonvulsants, anticoagulants such as heparin, androgens, oral contraceptives and NSAIDs. Too much vitamin A or selenium can also cause hair loss. Never stop a prescribed medicine on your own: speak to the prescriber first, because stopping suddenly can cause serious problems.

Source: Cureus review (PMC), Cleveland Clinic, AAD, AAD

COVID-19

According to the American Academy of Dermatology, about 20% of people who had COVID-19 in studies later developed temporary shedding, most often telogen effluvium. It usually starts about two to three months after infection, often linked to fever and the stress of illness, and typically resolves without treatment.

Source: AAD

Who gets it

Acute telogen effluvium can affect anyone, at any age and of either sex. It is reported more often in women, partly because women are more likely to seek help for shedding. Chronic telogen effluvium without a clear cause is most typical in otherwise healthy women aged roughly 30 to 60. In about a third of acute cases no trigger is ever identified.

Source: DermNet, Cleveland Clinic, Cureus review (PMC)

Types: acute and chronic

Feature	Acute telogen effluvium	Chronic telogen effluvium
Duration	Less than 6 months	More than 6 months, sometimes years, often fluctuating
Trigger	Usually a clear event 2 to 3 months earlier	Often no clear cause
Typical patient	Any age, either sex	Mostly women aged about 30 to 60
Outlook	Resolves in about 95% of cases	Does not cause total baldness; may unmask pattern hair loss

Source: Cleveland Clinic, DermNet, Cureus review (PMC)

A well-known form of acute telogen effluvium follows pregnancy and is sometimes called telogen gravidarum. Researchers have also described five functional patterns depending on which part of the hair cycle is disturbed, for example follicles leaving the growing phase too early, or a growing phase that is persistently too short, which is thought to underlie many chronic cases.

Source: Cureus review (PMC)

Telogen effluvium should not be confused with anagen effluvium, in which growing hairs are damaged directly, for example by chemotherapy, and fall out within days to weeks.

Source: DermNet, AAD

Diagnosis

A doctor or dermatologist can usually diagnose telogen effluvium from your history and a scalp examination. They will ask when the shedding started and about illnesses, fevers, surgery, pregnancy, diet, weight changes, stress and medicines in the months before. Because of the delay between trigger and shedding, it helps to think back about three months.

Source: Cleveland Clinic, MedlinePlus

Tests that may be used

• Hair pull test: the clinician gently pulls a group of about 40 to 60 hairs. Normally only 2 or 3 come out; in telogen effluvium, 4 to 6 or more come out, mostly with white club roots.
• Modified wash test: after five days without shampooing, the hair shed during one wash is collected and counted. More than 100 hairs with few fine (vellus) hairs points to telogen effluvium.
• Trichogram: hairs plucked from a defined area are examined under a microscope; more than 25% in the resting phase strongly suggests the condition.
• Trichoscopy, videodermoscopy or phototrichogram: magnified images of the scalp that can show many short regrowing hairs.
• Blood tests: may be ordered if another cause is suspected, for example to check thyroid function, iron stores, vitamin B12 or folate.
• Scalp biopsy: rarely needed, but sometimes used when shedding lasts more than six months or the diagnosis is unclear.

Source: Cleveland Clinic, Cureus review (PMC), DermNet, MedlinePlus

Conditions a doctor may need to rule out include female and male pattern hair loss, diffuse alopecia areata, anagen effluvium and hair shaft disorders. Telogen effluvium and pattern hair loss can also occur together.

Source: DermNet, Cureus review (PMC)

Treatment options

Telogen effluvium is usually self-limiting. The most important step is to identify and remove the trigger. Once that happens, the follicles return to their normal cycle and new hair grows, and many people need no specific treatment.

Source: Cleveland Clinic, DermNet, AAD

• Treat the underlying cause: correct thyroid problems, iron, vitamin B12 or folate deficiency, and treat scalp conditions such as psoriasis or seborrheic dermatitis.
• Review medicines: if a drug is a likely trigger, your doctor may switch or adjust it.
• Eat well: a balanced diet with enough protein, fruit and vegetables, and a stable body weight.
• Minoxidil: over-the-counter topical minoxidil is sometimes suggested. Possible side effects include scalp irritation, headache and unwanted hair growth, and it should be avoided in pregnancy and breastfeeding. A review notes that minoxidil and finasteride are not specifically designed to correct the hair-cycle disturbance in telogen effluvium.
• Supplements: iron or multivitamin supplements may help when a deficiency is present; check with a clinician before starting them.
• Corticosteroids: topical steroids, and in some chronic cases systemic steroids, are used by some dermatologists, particularly when scalp discomfort is present.
• Cosmetic help: hairstyles, wigs or hair pieces can disguise thinning while hair regrows.

Source: Cleveland Clinic, DermNet, Cureus review (PMC), MedlinePlus

Treatments such as PRP hair treatment and hair transplant surgery are aimed mainly at permanent forms of hair loss. With telogen effluvium the follicles normally recover by themselves, so surgery is not a treatment for the shedding itself. However, repeated or long-lasting episodes can reveal an underlying tendency to pattern hair loss. If thinning persists after a dermatologist has ruled out active causes, a specialised hair-transplant centre such as Hair Cultivate can assess whether restoration options are suitable. For background on surgery, see our guide to hair transplant in Turkey.

Source: DermNet, NHS

The NHS notes that no hair-loss treatment is 100% effective, that many are not available on the NHS, and advises seeing a GP before visiting a commercial hair clinic.

Source: NHS

Recovery time and outlook

The outlook for telogen effluvium is good. Sources give slightly different time frames, because recovery depends on how long the trigger lasts:

• Cleveland Clinic: shedding usually lasts 3 to 6 months, and most cases resolve within 6 to 8 months of addressing the cause.
• AAD: once the body readjusts, hair usually returns to its normal fullness within 6 to 9 months.
• DermNet: shedding peaks and then tapers over about 6 to 9 months; recovery may be incomplete in some people.
• MedlinePlus: shedding usually lessens over 6 to 8 months, but can sometimes become chronic.

Source: Cleveland Clinic, AAD, DermNet, MedlinePlus

New hairs take time to reach a length where the volume looks normal again. Seeing short new hairs along the hairline is a good sign. If the stressor continues, for example ongoing illness or constant stress, the shedding can carry on for much longer.

Source: Cureus review (PMC), AAD

Complications

Telogen effluvium does not damage physical health and does not cause scarring or permanent baldness. Its main burden is emotional: sudden shedding can cause significant anxiety, low mood and loss of confidence, and these feelings deserve attention as part of care. Anxiety about the hair loss can, in turn, add to the stress load.

Source: Cleveland Clinic, DermNet, Cureus review (PMC)

In some people, repeated acute episodes or chronic telogen effluvium can unmask or be followed by female pattern hair loss. Persistent shedding can also signal an untreated underlying problem, such as thyroid disease or iron deficiency, which is why a proper assessment matters.

Source: DermNet, Cureus review (PMC)

Prevention and living with it

Not every trigger can be avoided, but you can lower the risk and support recovery:

• Eat enough protein; Cleveland Clinic suggests about 40 to 60 grams a day, which is especially important on vegetarian or vegan diets.
• Avoid crash diets and rapid weight loss; combine a balanced diet with regular exercise if you want to lose weight.
• Get enough vitamins and minerals important for hair, such as iron, zinc and vitamin D, ideally from food; ask a professional before taking supplements.
• Manage stress and aim for 7 to 9 hours of sleep a night.
• Handle hair gently while it is shedding: avoid vigorous brushing and combing.
• Ask your doctor whether any new medicine can cause hair loss.

Source: Cleveland Clinic, DermNet, AAD

Knowing that telogen effluvium is usually temporary can itself ease worry. Keeping a simple diary of illnesses, stressful events and medicine changes can help you and your doctor link shedding to its cause.

Source: Cureus review (PMC), Cleveland Clinic

When to see a doctor

See a doctor or dermatologist if you are worried about how much hair you are losing or if it is affecting your wellbeing. An assessment can tell whether you have shedding, hair loss or both, find the cause and explain what to expect. Also seek advice if:

• The shedding lasts longer than about six months.
• You have bald patches, a hair loss pattern that looks unusual, or loss at a young age.
• Your scalp is painful, itchy, red or scaly, or looks infected.
• You also have symptoms such as tiredness, weight changes, feeling cold, muscle weakness, irregular periods, acne or new facial hair.
• You suspect a medicine is the cause (do not stop it without advice).

Source: NHS, AAD, MedlinePlus, AAD

These emergency signs relate to the underlying illness rather than to the hair loss itself, which is not an emergency.

Source: NHS, AAD

Related treatments

Related conditions

Further reading

Telogen effluvium: frequently asked questions

Sources

1. Cleveland Clinic — Telogen Effluvium: Symptoms, Causes, Treatment & Regrowth
2. DermNet — Telogen effluvium (hair shedding)
3. AAD — Do you have hair loss or hair shedding?
4. AAD — Hair loss: Who gets and causes
5. AAD — Can COVID-19 cause hair loss?
6. NHS — Hair loss
7. MedlinePlus — Hair loss (Medical Encyclopedia)
8. Cureus (PMC) — Telogen Effluvium: A Review of the Literature (Asghar et al., 2020)

This page is part of the Morepital medical reference. It is for general health education and does not replace a consultation with a qualified doctor. Last reviewed: October 2026.