Hair normally grows in cycles consisting of:

• Anagen (growth phase) – when hair is actively growing.

• Catagen (transition phase) – a short period when hair growth slows.

• Telogen (resting phase) – when the hair eventually sheds and is replaced by a new hair.

In telogen effluvium, a larger than normal number of hairs enter the resting (telogen) phase at the same time. Around 2–3 months later, these hairs are shed, resulting in noticeable hair loss.

This delay often makes it difficult to recognise the original trigger.

Telogen effluvium usually develops 2–3 months after a significant physical or emotional stress.

Common triggers include:

• Viral illnesses (including COVID-19)

• High fever

• Major surgery

• Childbirth (postpartum hair loss)

• Significant emotional stress

• Rapid weight loss

• Restrictive dieting

• Iron deficiency

• Thyroid disorders

• Certain medications

• Hospitalisation

• Severe infections

• Chronic illness

Sometimes no obvious trigger is identified.

People with telogen effluvium commonly notice:

• ·Sudden increase in hair shedding

• Hair falling out when washing or brushing

• Hair covering the pillow or shower drain

• Hair shedding throughout the scalp

• Reduced hair volume

• Thinner ponytail

• Increased scalp visibility in severe cases

Unlike alopecia areata, telogen effluvium does not usually cause completely bald patches.

The scalp generally appears healthy and is not inflamed.

Telogen effluvium can affect:

• Women

• Men

• Children

It is particularly common:

• After pregnancy

• Following major illness

• After significant emotional stress

• Following rapid weight loss

• After severe viral infections

Women tend to notice it more because longer hair makes shedding more obvious.

Your Specialist Dermatologist will perform a comprehensive assessment, including:

• Medical history

• Recent illnesses or surgery

• Medication review

• Dietary history

• Family history of hair loss

• Examination of the scalp

• Trichoscopy (dermoscopy of the scalp)

A gentle hair pull test may be performed to assess active shedding.

Blood tests may be recommended to identify treatable causes such as:

• Iron deficiency

• Low ferritin

• Thyroid disease

• Vitamin deficiencies

• Other medical conditions where appropriate

Occasionally, a scalp biopsy may be recommended if the diagnosis remains uncertain.

The most important step is identifying and treating the underlying cause whenever possible.

Treatment may include:

• Correcting iron deficiency or other nutritional deficiencies

• Treating thyroid disease or other medical conditions

• Reviewing medications that may contribute to hair shedding

• Nutritional advice

• Reassurance and monitoring

• Topical or oral minoxidil in selected patients

Many patients simply require reassurance that the condition is temporary and that hair regrowth is expected.

Hair shedding usually continues for 3–6 months, although some people experience shedding for longer.

Once the trigger has resolved, new hairs gradually begin to grow.

Because hair grows slowly, noticeable improvement often takes 6–12 months, and full recovery may take longer in people with long hair.

Most cases resolve within six months.

If hair shedding continues for more than six months, it is known as chronic telogen effluvium.

Further assessment may be required to exclude:

• Female pattern hair loss

• Male pattern hair loss

• Iron deficiency

• Thyroid disease

• Chronic illness

• Other causes of diffuse hair loss

Many patients with chronic telogen effluvium still experience eventual improvement once contributing factors are addressed.

Yes.

Hair shedding is a recognised complication following COVID-19 infection and is usually caused by telogen effluvium.

Most patients begin shedding hair 2–3 months after infection, with gradual recovery occurring over the following several months.

Although the amount of shedding can be alarming, permanent hair loss is uncommon.

While waiting for hair regrowth:

• Eat a balanced diet rich in protein.

• Avoid restrictive diets unless medically supervised.

• Treat any iron deficiency if present.

• Be gentle when brushing and styling your hair.

• Avoid unnecessary heat and chemical treatments.

• Continue normal hair washing, as washing does not increase hair loss.

Our Specialist Dermatologists have extensive experience diagnosing all causes of hair loss.

• We provide:

• Comprehensive scalp examination

• Trichoscopy (dermoscopic scalp assessment)

• Investigation for underlying medical causes

• Blood tests where appropriate

• Individualised treatment plans

• Long-term monitoring

• Assessment for other causes of hair loss if recovery is delayed

Our goal is to identify the cause of your hair shedding, provide reassurance where appropriate, and support healthy hair regrowth.