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I’ve Lost So Much Hair Due to Telogen Effluvium (TE), You Can See My Scalp – Tips and Advice to Help

Yesterday, I received an email from a woman who was extremely upset. She told me that she’d had telogen effluvium (TE) or hair shedding for about 4 months and that the hair loss was so severe that you could now see straight through to her scalp.  She wanted help for a few things.  First, she wanted advice on how to make the shedding stop.  Second, she wanted ways to make her hair look somewhat better and thicker (as though there were more of it.)  And finally, she wanted advice on how to cope.  I’ll try to answer all three concerns in the following article.

Is This Really TE?:  First, I wanted to know if her loss was really run of the mill telogen effluvium.  Because while this type of shedding can present with severe loss, it’s pretty rare to see it be so extreme that you begin to see the scalp four months later.  And, after only a month, at least some regrowth should’ve started to kick in to help the situation and begin to cover the scalp.  The reader swore that she could see no regrowth even when I had her spray white dry shampoo at the hair line in the search for tiny sprouts.

The reader was too embarrassed to send a picture so it was difficult for me to gage the severity, but she assured me that this was not just a widening part line.  I asked her to take a good look at her scalp for signs of pinkness, irritation, bumps, crust, flakes or anything which could indicate inflammation or infections that could be perpetuating the problem.  She did say that her scalp was red, inflamed, itchy and somewhat painful and tight, but she didn’t know if this was possibly psychological.  To me, this is a tip off that there were  possible inflammation or androgens that followed the shed and lengthened the cycle.

Also, the reader insisted that she had no medical issues and no known thyroid or adrenal problems. She assured me that all recent blood work was normal and that her doctor has assured her that this was probably seasonal shedding or lessening hormones.  This may well be the case, but any shedding that goes on for more than three months now becomes a chronic condition and cycle called CTE (chronic telogen effluvium.)  These cases become a bit more dire because it sometimes becomes a cycle that feeds upon itself, but it can be difficult to stop the trigger and end this. 

Because of her scalp issues and her lack of decent regrowth, there were a few potential issues that came to my mind.  The first was AGA or androgenic alopecia (AGA.)  Even though she had no medical history, genetic thinning for women is extremely common.  And, very often, this loss results in inadequate regrowth that results in the scalp peeking through. 

The second possibility was CTE in which she wasn’t finding the trigger or she was experimenting with hormones or other things that were kicking off new sheds with each attempt.  This cycle could’ve also kicked off a serious round of inflammation in her scalp which seriously compromised her regrowth. This almost had to be the case as the regrowth wasn’t at all visible.

The other possibility is that she has scalp issues which were the initial cause (or at least the result) of the severe loss in the first place.  Possibilities are yeast over growth, bacterial infections, or severe inflammation caused by autoimmune issues or other body changes. At the very least, CTE can cause pretty nasty inflammation.

Some Treatments For Severe Shedding:  In response to her question about the best way to treat the shedding and bump up the regrowth, I really want to see her try topicals first.  The reason for this is that if you limit yourself to topicals, you’ll at least know that your treatment isn’t causing internal havoc that causing new sheds. 

Adding in hormones is, to me, a last resort.  And there are many topicals that do a fantastic job of both lessening the inflammation and stimulating the scalp to regrow hair.  It’s always a good idea to include some anti androgen topicals in case  DHT or androgens are at play.  Zinc, tea tree oil, horsetail, emu oil, lavender, rosemary, and boysenberry are all possibilities.  It’s important though to chose the right combination and rotations so that you’re not further clogging any follicles. The best case scenario is often stopping or lessening what’s causing the hair loss (DHT, inflammation, etc.) and then stimulating and soothing the scalp to spur on healthy regrowth.

Cosmetic Options To Cover The Scalp With Severe Shedding: Regrowth can start to show up in about a month, even with good, aggressive treatment.  So, she was going to need something to tide her over until that happened.  Some good options are toppik which is a sort of powder that you can get in your same hair color. You sprinkle it into your hair and it blends in, camouflaging the white of your scalp.  It looks extremely natural, but it doesn’t manufacture hair.  If the loss is extremely severe and you need to go this far, there are human hair toppers that fit just on top of your head and blend in with your regular hair.  It’s important to chose one with a realistic part line (yaffa makes a good one.)

In her case, I am hoping that aggressively trying to get to her trigger and stimulating regrowth will mean that she won’t need to go the topper or wig growth. Toppik should hold her off for a few months and hopefully by then healthy and thick regrowth will start coming in.

As far as coping, you really have to tell yourself that your hair doesn’t amount to who you are. She was aggressively seeking treatment and this allowed me to reassure her that we would find an answer and that the good news about hair is that with the right treatment, it can most definitely grow back.

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