Introduction
Acute hair loss, known as acute telogen effluvium, is diffuse, sudden and often alarming shedding of hair that usually begins 2 to 3 months after a triggering event. It is a temporary disturbance of the hair cycle that does not destroy the follicle, which is why it is reversible in most cases.
Symptoms
- Diffuse hair loss over the whole scalp
- Heavy shedding when washing or brushing, or on the pillow
- Overall reduction in hair density without bald patches
- Hairs falling out with their bulb (telogen hairs)
- No scarring
- Scalp looks normal or is slightly tender
- Anxiety about the amount of hair lost is common
Causes
- Common causes
- Severe stress or emotional shock High fever, acute infection Surgery Childbirth (postpartum) Acute illness or hospital stay Restrictive diet or rapid weight loss Nutritional deficiencies Stopping or starting certain medicines
- Severe stress or emotional shock
- High fever, acute infection
- Surgery
- Childbirth (postpartum)
- Acute illness or hospital stay
- Restrictive diet or rapid weight loss
- Nutritional deficiencies
- Stopping or starting certain medicines
Diagnosis
- Diagnosis is based mainly on: A detailed history (triggering event 2–3 months earlier) Dermatological examination of the scalp Diffusely positive hair pull test Trichoscopy showing an increased proportion of telogen hairs
- A detailed history (triggering event 2–3 months earlier)
- Dermatological examination of the scalp
- Diffusely positive hair pull test
- Trichoscopy showing an increased proportion of telogen hairs
- Targeted blood tests if needed (iron, ferritin, thyroid, vitamins)
- The examination mainly aims to rule out associated androgenetic or scarring alopecia
Treatments
- Identifying and correcting the trigger
- Reassurance and information for the patient
- Correcting any deficiencies
- Adjusting medication if needed
- Short-term topical minoxidil in some cases
- Targeted nutritional supplements
- Gentle shampoos and non-aggressive hair care
- Medical LED therapy (gentle stimulation of the hair cycle)
- Light scalp microneedling (selected cases)
- Personalised hair support protocols
- cause-focused and reassuring
Management
Specialist dermatology consultation
Accurate diagnosis and exclusion of serious causes
Personalised treatment strategy
Medium-term follow-up until hair has fully recovered