Diffuse hair loss or ‘telogen effluvium’, as it is termed, can be divided into ‘temporary self-correcting diffuse hair loss’ and ‘permanent diffuse hair loss until the cause is corrected’. Here are the key differences between them.

Temporary Self-correcting Diffuse Hair Loss

The following are common causes of temporary diffuse hair loss:

  • After pregnancy (postpartum hair loss)
  • Operations
  • Fevers that give rise to a temperature exceeding 39.5°C (103°F)
  • Crash dieting or a change in diet
  • Medications
    • Sometimes it’s difficult to know whether it is the medication itself or the underlying medical problem that is causing the hair loss. When caused by medication, in most cases the hair recovers once the body has adjusted to the new drug. However, sometimes the hair loss continues for as long as the person is taking the medication. Drugs that are used for the treatment of cancer often interfere with hair growth. The hair loss or hair breakage that results will only stop when the drug is discontinued, at which time the hair usually recovers quite normally.
  • Stopping medication
    • The body experiences as much change when you cease medication as when you start taking it, so diffuse hair loss may result. Discontinuing birth control pills often results in temporary diffuse hair loss. The ‘day after’ pill can do the same, as can changing from one birth control pill to another
  • Extreme stress
    • The hair loss occurs two or three months after the triggering event. This is because the imbalance causes some growing ‘anagen’ hairs to pass prematurely to the resting ‘telogen’ phase of the hair cycle; the hairs stay in the telogen phase for about three months before they fall from the scalp.
    • No treatment is required for this type of hair loss. It will improve on its own after two or three months, and the hair will return to normal after about six months.
    • Remember that the hair is continually being replaced, but with this type of hair loss the rate of loss is greater than the rate of replacement. Diffuse hair loss never leads to baldness.

It’s important to recognize that the hair is very sensitive to any body imbalance due to its fast rate of growth, so hair loss can result from the slightest imbalance. Also, what causes diffuse hair loss in one person may not cause it in another. Temporary hair loss can also continue for more than three months if the patient has experienced two causes at different times. For example, they might have had a baby in January, followed by a high fever in April, which could lead to a total of six months of diffuse hair loss.

Case study: Temporary Self-correcting Hair Loss

One patient suffered diffuse hair loss three months after changing her birth control pill. She then changed back to the original pill because she assumed her hair loss was caused by the new pill. In actual fact, what caused her initial hair loss was the change from one pill to another. Normally the hair loss would have slowed after three months, but because she then changed the pill again, her hair loss continued for a further three months before correcting itself.

Permanent Diffuse Hair Loss Until Correction of The Cause

Numerous imbalances can cause permanent hair loss, such as iron deficiency, an underactive thyroid, other hormonal imbalances, some medications, continual stress, liver or kidney problems – in fact, any imbalance that reaches the hair through the blood can cause this type of hair loss.

The only way to treat this is to correct the underlying imbalance. Once addressed, the hair loss will slow after two or three months, before fully recovering.

Case study: Permanent Diffuse Hair Loss

A 27-year-old female patient had been taking the medication risperidone for behavioral disturbances for nine months, and noticed an increase in hair loss three months after starting the medication. Her weight had also increased and her skin and hair had become drier, suggesting hypothyroidism (underactive thyroid). What had happened was that the medication had increased her prolactin levels, which in turn caused a decrease in her thyroid hormone levels. These changes then led to diffuse hair loss. The patient stopped her medication and the hair loss slowed to normal about three months later. Eventually her hair fully recovered.

Hair loss is incredibly distressing to the sufferer and people experiencing it often fear the worst, so I am always as positive as I can be with patients. Ninety per cent of my job is reassurance, but I will never give false hope. Luckily, unless hair follicles have been destroyed (cicatricial alopecias), most hair loss problems are treatable.

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