HAIR LOSS TREATMENT
Telogen Effluvium commonly known as temporary hair loss is different from permanent hair loss condition called Alopecia Areata. It takes place due to stress, shock or as a consequence of a traumatic event. In cases of temporary hair fall, the top of the scalp is affected. Usually a large chunk of hair falls out, the hair fall stops after some time and the hair grows back. A patient is described as having chronic telogen effluvium if he/she is experiencing frequent hair shedding for more than 6 months.
CAUSES
- The interval between the precipitating event and the onset of shedding corresponds to the length of the telogen phase, usually 3 months [can be 1-6 months]
- Acute illness – febrile illness, severe infection, major surgery, severe trauma, etc.
- Chronic illness- malignancy [especially lymphoproliferative disorders], systemic lupus erythematosus, end-stage renal disease, liver disease, HIV
- Hormonal change- pregnancy and delivery [can affect both mother and child], hypothyroidism, and discontinuation of hormonal pills
- Change in diet like crash dieting, anorexia, low protein intake, and chronic iron deficiency
- Sudden weight loss
- Heavy metals such as selenium, arsenic, and thallium
- Medications-ACE-inhibitors, anticoagulants, beta-blockers, contraceptives, retinoids, immunization
- Allergic contact dermatitis of the scalp
CLINICAL PICTURE
- Thinning of hair which involves the entire scalp; sometimes in public and axillary regions
- Gentle hair pull may be positive for two or more hair shafts per pull-telogen hair
- INVESTIGATIONS: CBC, Ferritin, ESR, TIBC, TSH, T3 T4 etc. are done as per the cause.
TREATMENT
- Assess for etiology: Evaluate medication list, history, precipitating events, thyroid, anemia, etc. and correction of the same with oral medication.
- Topical minoxidil, stem cell, and peptide preparations are also helpful in the hair regrowth.
- Mesotherapy with special mesococktails is also used for regrowth of hair.
- Hair Growth Therapy has been tried for treatment with good results.
- Stem cell treatment gives satisfactory results in 4 to 6 sessions.
PEARLS AND PITFALLS
- A chronic form of telogen effluvium can rarely occur and is a diagnosis of exclusion
- Regrowth take smonths to years [in some cases]
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