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This is a diffuse type of Alopecia.

It is the loss of telogen hair that occurs 2-4mths after an acute systemic stressful episode. The hair matrix is highly susceptible to a variety of endogenous insults. It reverts back to its inactive stage ie telogen.



  1. Hereditary
  2. Endocrine (Androgenetic alopecia in females)
  3. Auto-immune (AA)
  4. Iron Deficiency
  5. Febrile state (Malaria, Typhoid ,Tuberculosis->39degree C, recurrent)
  6. Severe liver/kidney dysfunction
  7. Stressful circumstances-
  8. Difficult labour
  9. Major accident
  10. Surgical trauma
  11. Haemorrhage
  12. Severe emotional stress
  13. Starvation
  14. Crash dieting
  15. Leukemia
  16. Lymphoma

Normal scalp has 13% of its follicles in telogen. In telogen effluvium, it rises to 20%.


T.E never results in total alopecia (baldness) and is always diffuse. After the radical physiological change comes to an end, the follicles resume their natural growth cycle and produce normal hair.

T.E can occur at any age, but is common between 30 & 50 yrs of age in women.


Some may require CBC & TFT’s in addition to clinical examination.

Classically TE is assessed using hair-pull test.


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