Hair loss is a common problem that can have a significant impact on an individual’s quality of life. Telogen effluvium (TE) and anagen effluvium (AE) are two types of hair loss that can occur due to various factors. It is important to note that neither TE nor AE are scarring types of hair loss. In both conditions, the hair loss is typically temporary and the hair follicles are not permanently damaged. However, in rare cases, if the underlying cause is not identified and addressed, the hair loss may become permanent. In this article, we will discuss the etiology, pathophysiology, clinical features, presentation, diagnosis, management, prognosis, and complications of TE and AE.

Etiology

The etiology of TE and AE differs. TE can be triggered by a range of physical and emotional stressors, such as pregnancy, surgery, illness, or medications. In contrast, AE is usually caused by exposure to certain toxins, medications, or radiation therapy.

Pathophysiology

The pathophysiology of TE and AE is distinct. In TE, the hair follicles are prematurely pushed into the resting phase of the hair growth cycle (telogen phase), resulting in an increase in the number of hairs shed from the scalp. AE involves damage to hair follicles during the growing phase of the hair growth cycle (anagen phase), leading to sudden and widespread hair loss.

Clinical Features

The clinical features of TE and AE vary depending on the underlying cause. In TE, the hair loss is gradual and diffuse, and there is usually no noticeable thinning of the hairline. In contrast, AE is characterized by sudden hair loss, which may be accompanied by redness or itching of the scalp.

Presentation

The presentation of TE and AE also differs. In TE, hair loss is typically gradual and may occur over several months. Patients may notice an increase in shedding when brushing or washing their hair. In contrast, AE is characterized by sudden hair loss, which may occur within a few days or weeks. Patients may notice clumps of hair falling out when they brush or wash their hair.

Diagnosis

The diagnosis of TE and AE is usually made based on the patient’s history and physical examination. Blood tests may be ordered to rule out underlying medical conditions that could be causing the hair loss. A scalp biopsy although is rarely needed, it may also be performed to confirm the diagnosis.

Management

The management of TE and AE depends on the underlying cause. In many cases, the hair loss will resolve on its own once the underlying cause is identified and addressed. However, if the hair loss is causing significant distress, there are treatments available to help promote hair regrowth. These may include topical medications, oral medications, or hair transplant surgery.

Prognosis

The prognosis for TE and AE is generally good, as the hair loss is usually temporary and will resolve once the underlying cause is addressed. However, in some cases, the hair loss may be permanent.

Complications

Complications of TE and AE are rare but can occur if the underlying cause is not identified and addressed. In some cases, the hair loss may be permanent, leading to significant distress and decreased quality of life. Additionally, if the hair loss is caused by an underlying medical condition, there may be other health complications that need to be addressed.

Written by

Deemah AlHuraish, medical student

Revised by

Maee Barakeh, medical student

References

UpToDate

DermNet