Telogen effluvium: diffuse hair shedding triggered by stress or hormonal changes
Understanding telogen effluvium
Telogen effluvium is a common cause of diffuse hair shedding in both men and women. It occurs when a larger-than-normal number of hair follicles prematurely shift from the growth phase (anagen) into the resting phase (telogen).
As a result, increased hair shedding becomes noticeable, often weeks to months after a physical, emotional, or hormonal trigger. Because of this delayed response, the connection between cause and hair loss is not always immediately clear.
Importantly, telogen effluvium affects the hair growth cycle, not the hair follicle itself. In most cases, follicles remain healthy and capable of regrowth once balance is restored.
What is telogen effluvium?
Telogen effluvium is a form of diffuse hair shedding that occurs when an unusually large number of hair follicles prematurely enter the resting (telogen) phase of the hair growth cycle.
Under normal conditions, only a small percentage of hair follicles are in the telogen phase at any given time. In telogen effluvium, this balance is temporarily disrupted, leading to increased shedding across the entire scalp rather than in specific areas.
This type of hair loss affects both men and women and is one of the most common non-hereditary causes of noticeable hair shedding. Importantly, telogen effluvium reflects a disturbance in the hair cycle, not permanent follicle damage.
What telogen effluvium Is – and Is NOT
Telogen effluvium is:
- a biologically driven disruption of the hair growth cycle
- characterised by diffuse, widespread shedding
- usually triggered by a temporary internal stressor
- typically reversible over time
Telogen effluvium is NOT:
- a hereditary form of hair loss
- pattern-based thinning at the temples, crown or part line
- caused by poor hair care or shampoo use
- a condition involving permanent follicle damage
This distinction matters, as telogen effluvium is often confused with hereditary hair loss, despite having a very different cause, pattern and expected course.
Diffuse or sudden hair shedding can have multiple underlying causes, and different forms of hair loss may overlap, particularly in early stages. Understanding the pattern and timing of hair changes is therefore essential.
Not sure if this applies to you?
The TRIX Hair Check guides you through a short, structured assessment based on hair pattern, timing and personal factors to help clarify which type of hair loss is most likely.
How telogen effluvium is identified in practice
Telogen effluvium is not identified based on a single symptom or observation. In clinical practice, assessment is based on a combination of timing, pattern, and contextual factors, evaluated together rather than in isolation.
This structured approach helps distinguish telogen effluvium from chronic or pattern-based forms of hair loss and reduces the risk of misclassification.
No single sign is decisive
Hair shedding can occur for many reasons, and similar symptoms may reflect different underlying mechanisms. For this reason, clinicians do not rely on shedding alone, visible thinning alone, or a single triggering event to identify telogen effluvium.
Instead, diagnosis emerges from the overall clinical picture and its evolution over time.
Key elements clinicians consider
When assessing telogen effluvium, clinicians do not rely on a single symptom or observation. Instead, evaluation is based on a combination of clinical features considered together. No single element is decisive on its own; assessment is cumulative and focuses on patterns, timing, and contextual factors rather than isolated signs.
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Timing and onset
Whether hair shedding began weeks to months after a potential trigger, rather than developing gradually over years. A delayed onset following stress, illness, or hormonal change is characteristic.
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Pattern of hair loss
Whether shedding is diffuse and evenly distributed across the scalp, without preferential involvement of the temples, crown, or frontal hairline.
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Course over time
Whether shedding appears sudden or subacute and whether it stabilises or improves over time, rather than progressing steadily.
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Hair follicle integrity
The absence of signs suggesting follicular damage, scarring, or progressive miniaturisation. In telogen effluvium, follicles remain structurally intact.
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Contextual factors
Recent physical, hormonal, emotional, nutritional, or systemic changes that could plausibly disrupt the hair growth cycle.
Why differentiation can be challenging
Telogen effluvium may coexist with other forms of hair loss, particularly androgenetic alopecia. In such cases, increased shedding can make underlying pattern-based thinning more noticeable.
This overlap can blur the clinical picture, especially in early stages, which is why assessment focuses on patterns and timing rather than assumptions.
The normal hair growth cycle
Hair grows according to a repeating biological cycle that takes place independently in each hair follicle. This staggered rhythm is what allows the scalp to maintain overall density, even though individual hairs are continuously shed and replaced.
The cycle consists of three main phases:
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Anagen (growth phase)
The hair grows actively. In healthy hair follicles, this phase can last several years.
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Catagen (transition phase)
Hair growth slows as the follicle prepares to enter a resting period.
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Telogen (resting and shedding phase)
The hair is eventually shed and replaced by a new growing hair.
At any given time, most hair follicles are in the growth phase, while a smaller proportion are in the resting phase. Because follicles cycle independently, daily hair shedding is a normal and healthy process that usually goes unnoticed.
✓ In telogen effluvium, this normal balance is temporarily disrupted.
Understanding the normal hair growth cycle helps explain why telogen effluvium causes increased shedding without damaging the hair follicles.
How does telogen effluvium develop?
Telogen effluvium develops as a result of a temporary disruption of the normal hair growth cycle. Importantly, this involves a change in timing, not permanent damage to the hair follicles themselves.
In telogen effluvium, a triggering event causes a larger-than-normal proportion of hair follicles to shift into the resting (telogen) phase at roughly the same time. This shift does not occur immediately at the moment of the trigger, but rather initiates a delayed biological response within the follicles.
As a result, increased hair shedding typically becomes noticeable weeks to months after the triggering event, when the resting hairs are released from the scalp.
What happens at the level of the hair follicle?
Under normal conditions, hair follicles cycle independently through growth, transition and resting phases. This staggered process ensures that overall hair density remains relatively stable, even though individual hairs are continuously shed and replaced.
Specifically:
- the growth phase ends earlier than usual
- the follicle enters the resting phase prematurely
- the hair is shed once the telogen phase is complete
- the follicle does not shrink or permanently miniaturize
Because the follicle itself is not damaged, it retains the ability to re-enter the growth phase and produce new hair once normal cycling resumes.
Why shedding appears diffuse
Unlike hereditary hair loss, telogen effluvium does not affect specific androgen-sensitive regions of the scalp. Instead, follicles across the entire scalp are involved.
Because follicles across the scalp are affected at the same time, this results in:
- widespread, even shedding
- no clearly defined bald patches
- an overall reduction in perceived hair density
As a result, hair thinning is perceived evenly rather than in specific areas.
Hair may feel thinner, and increased shedding may be noticed during washing or brushing, but the hairline and scalp pattern usually remain unchanged.
Why the onset often feels sudden
Although telogen effluvium is triggered by a specific event, the visible hair shedding is delayed. This delay can make the onset feel sudden and unexpected.
By the time shedding becomes noticeable, the original trigger may already have passed, which is why the connection is not always immediately recognised.
This delayed timing is a defining diagnostic feature of telogen effluvium.
Why telogen effluvium is usually temporary
Because telogen effluvium involves a reversible shift in the hair growth cycle, recovery is generally possible once the underlying trigger is resolved or stabilised.
Over time:
- excessive shedding decreases
- follicles gradually return to their normal growth rhythm
- new hair growth becomes visible
The speed and completeness of recovery vary between individuals and depend on factors such as the duration of the trigger and overall health of the hair follicles.
What happens during recovery?
Once the underlying trigger of telogen effluvium is resolved or stabilised, the hair growth cycle can gradually return to its normal rhythm.
Recovery typically follows a predictable sequence, although the exact pace varies between individuals and depends on the underlying trigger and overall health.
Importantly, recovery is a biological process, not an immediate cosmetic change. Improvements occur step by step.
Excessive shedding decreases
The first sign of recovery is usually a gradual reduction in daily hair shedding. This does not happen immediately, as hairs that have already entered the resting (telogen) phase still need to complete their cycle and be released.
As a result, shedding may continue for some time even after the original trigger has passed, without indicating ongoing hair loss or follicle damage.
Follicles return to their normal growth rhythm
Over time, hair follicles re-enter the growth (anagen) phase and resume their independent cycling pattern. At this stage, shedding stabilises, even if overall hair density has not yet visibly improved.
This phase reflects biological recovery at the follicle level, even before cosmetic changes become apparent.
New hair growth becomes visible
Fine regrowth hairs may gradually appear, often along the hairline or parting. Because hair grows slowly, visible improvement in density lags behind the reduction in shedding.
It is normal for regrowth to feel subtle at first. Meaningful changes in volume take time and typically follow biological recovery, rather than occurring at the same time.
✓ In telogen effluvium, improvement in shedding usually occurs before visible regrowth.
Recovery timelines and regrowth expectations
Recovery from telogen effluvium follows a biological timeline that unfolds over months rather than weeks. Because the condition reflects a shift in the hair growth cycle, improvement is gradual and often feels slower than expected.
Understanding the typical sequence and timing can help set realistic expectations and prevent unnecessary concern.
From trigger to visible shedding
In most cases, telogen effluvium begins 6 to 12 weeks after a triggering event. This delay occurs because hair follicles require time to transition into the resting (telogen) phase before shedding becomes visible.
As a result, the event that caused the shedding may already have resolved by the time hair loss is noticed.
How long increased shedding usually lasts
Once shedding starts, it typically persists for 3 to 6 months. During this period, hairs that entered the resting phase are gradually released.
A steady or slowly declining level of shedding is common. Day-to-day fluctuations are normal and do not necessarily indicate worsening or improvement on their own.
Short-term fluctuations are common and usually reflect normal hair cycle variation rather than renewed hair loss.
When shedding begins to improve
For most individuals, a gradual reduction in daily shedding is the first sign of recovery. This improvement often occurs before any visible increase in hair density and may be subtle at first.
It is normal for shedding to continue at a lower level for some time as the hair cycle rebalances.
When regrowth starts
Biological regrowth begins once follicles re-enter the growth (anagen) phase, but new hairs are initially fine and short. Early regrowth may be noticed along the hairline or parting.
Because scalp hair grows slowly, visible regrowth typically lags behind shedding improvement by several months, even when biological recovery is already underway.
When cosmetic improvement becomes noticeable
An increase in perceived hair density usually becomes apparent several months after shedding has stabilised. Full cosmetic recovery can take longer and varies depending on factors such as:
- the duration and intensity of the original trigger
- overall scalp and follicle health
- whether telogen effluvium coexists with another form of hair loss
What is considered normal progress
- Shedding improves before density
- Regrowth feels subtle at first
- Progress is uneven rather than linear
- Temporary plateaus are common
Lack of immediate visible change does not mean recovery is not occurring.
When timelines may differ
Recovery may take longer if the triggering factor persists, if telogen effluvium becomes chronic, or if there is an underlying hair loss condition present. In such cases, reassessment can help clarify the situation.
✓ Telogen effluvium recovery is gradual. Patience and consistency are essential and improvement in shedding typically precedes visible regrowth.
Telogen effluvium in men and women
Telogen effluvium affects both men and women and is driven by the same underlying mechanism in all individuals: a temporary disruption of the hair growth cycle leading to diffuse hair shedding.
Telogen Effluvium in women
In women, telogen effluvium is particularly common and is often linked to hormonal or physiological changes.
Common contexts include:
- pregnancy and the postpartum period
- starting or stopping hormonal contraception
- menopause
- periods of significant emotional or physical stress
These factors do not cause hair loss directly but are commonly associated with temporary disruption of the hair growth cycle.
Hair shedding typically presents as:
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Diffuse thinning across the scalp
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Increased hair loss during washing or brushing
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A noticeably thinner ponytail or parting
Because shedding is widespread and the frontal hairline is usually preserved, telogen effluvium in women is sometimes mistaken for general hair thinning or early androgenetic alopecia.
Telogen Effluvium in men
In men, telogen effluvium occurs less frequently than hereditary hair loss but can still be a significant cause of sudden hair shedding. However, when it occurs, it follows the same diffuse and typically reversible pattern.
Common triggers include:
- acute or chronic stress
- illness, infection, or surgery
- rapid weight loss or nutritional imbalance
Hair shedding in men is usually:
- diffuse rather than pattern-based
- evenly distributed across the scalp
- noticeable as increased daily hair shedding
Because many men are already aware of hereditary hair loss, telogen effluvium is often confused with androgenetic alopecia, especially when both conditions coexist.
Why sex-specific context matters
Although the biological mechanism of telogen effluvium is the same in men and women, differences in hormonal background, life events, and baseline hair patterns influence how the condition presents and how quickly it is recognised.
Understanding these contextual differences helps:
- reduce misinterpretation
- set realistic expectations
- distinguish telogen effluvium from other forms of hair loss
In some individuals, telogen effluvium may occur alongside other types of hair loss, which further underscores the importance of structured assessment rather than assumptions based on appearance alone.
Triggers and risk factors in telogen effluvium
Telogen effluvium occurs when a significant number of hair follicles prematurely enter the resting (telogen) phase of the hair growth cycle. This shift is usually triggered by a systemic physiological or psychological stressor rather than permanent follicle damage.
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Physical stressors
Physical stress placed on the body is one of the most common triggers of telogen effluvium. These stressors signal the body to redirect energy toward essential functions, temporarily deprioritising hair growth.
Common physical triggers include:
- acute or chronic illness
- fever or infection
- surgery or medical procedures
- significant injury or trauma
Hair shedding typically becomes noticeable several weeks to months after the event, rather than immediately.
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Hormonal changes
Hormonal fluctuations can strongly influence the timing of the hair growth cycle, even when hormone levels remain within the normal range.
Common hormonal contexts associated with telogen effluvium include:
- pregnancy and the postpartum period
- starting or stopping hormonal contraception
- menopause or perimenopause
- thyroid-related changes
In these situations, hair follicles respond to changing signals by synchronising into the telogen phase, leading to diffuse shedding.
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Emotional and psychological stress
Periods of intense emotional or psychological stress can also act as a trigger. While stress alone does not cause hereditary hair loss, it can disrupt hair cycle regulation and lead to telogen effluvium.
Examples include:
- prolonged emotional strain
- major life events
- sustained anxiety or burnout
The effect is often delayed, making the connection between stress and hair shedding less immediately obvious.
Stress does not need to feel extreme to act as a trigger; cumulative or prolonged strain can be sufficient.
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Nutritional and metabolic factors
Adequate nutrition is essential for normal hair cycling. Sudden changes in dietary intake or metabolic balance can influence follicular behaviour.
Potential contributing factors include:
- rapid weight loss
- restrictive dieting
- nutritional deficiencies or prolonged caloric restriction
- metabolic stress
In these cases, telogen effluvium reflects a temporary adaptation rather than permanent hair follicle damage.
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Medications and systemic changes
Certain medications and systemic changes can alter hair cycle timing as a secondary effect.
Examples include:
- changes in long-term medication
- initiation or discontinuation of specific treatments
- systemic physiological adjustments
Not all individuals experience hair shedding in response to these factors, highlighting the role of individual susceptibility.
Why triggers affect individuals differently
Not everyone exposed to the same trigger develops telogen effluvium. The likelihood and severity depend on factors such as:
- baseline hair density and follicle reserve
- duration and intensity of the trigger
- baseline hair density and overall recovery capacity
In some individuals, multiple triggers may overlap, increasing the likelihood of noticeable shedding.
When telogen effluvium may coexist with other hair loss types
Telogen effluvium can occur alongside other forms of hair loss, such as androgenetic alopecia. In these cases, increased shedding may unmask underlying pattern-based thinning, making hair loss appear more sudden or severe.
This overlap is one reason why structured assessment is often necessary to clarify the dominant cause and guide appropriate next steps.
Can telogen effluvium coexist with other hair loss types?
Yes. Telogen effluvium can occur alongside other forms of hair loss, most commonly alopecia androgenetica. When this happens, increased shedding from telogen effluvium can make underlying thinning appear more noticeable, even if it was previously subtle.
This overlap does not mean that telogen effluvium causes other types of hair loss. Rather, it reflects the fact that multiple hair loss processes can affect the scalp at the same time.
Telogen effluvium may also coexist with less common conditions such as alopecia areata, where immune-related mechanisms play a role.
Telogen effluvium and androgenetic alopecia
Alopecia androgenetica is a genetically influenced, pattern-based form of hair loss that develops gradually over years. Telogen effluvium, by contrast, causes sudden, diffuse shedding due to a temporary disruption of the hair growth cycle.
When both conditions are present:
- overall hair shedding increase
- reduced density can reveal areas already prone to thinning
- pattern-based changes (such as at the temples, crown, or part line) may become more apparent
As telogen effluvium resolves, shedding often improves, but any underlying pattern thinning may persist.
Learn more about Alopecia Androgenetica and how it differs from telogen effluvium.
Why overlap can be confusing
In early stages, it can be difficult to distinguish between:
- diffuse shedding caused by telogen effluvium
- early hereditary thinning
- a combination of both
Because telogen effluvium has a delayed onset, the timing of hair loss may further obscure the original trigger, making self-assessment unreliable.
How coexistence is assessed in practice
Rather than relying on assumptions, assessment focuses on:
- the distribution and pattern of thinning
- the timing of onset and progression
- whether shedding improves over time
- whether density loss follows a recognisable pattern
This approach helps clarify whether telogen effluvium is the primary driver, whether another form of hair loss is present, or whether both are contributing.
Why clarification matters
Understanding whether telogen effluvium exists alone or alongside another hair loss type is important because:
- recovery expectations differ
- timelines vary
- management strategies are not the same
For this reason, structured assessment is often necessary to determine the dominant process and guide appropriate next steps.
Other common hair loss types
Hair loss can present in different patterns and may not always involve a single underlying process. If your symptoms do not fully match telogen effluvium, the guides below provide detailed information on other clinically recognised hair loss conditions.
Not sure which type applies to you?
Hair loss patterns can overlap. A structured assessment such as the TRIX Hair Check helps clarify the most likely cause based on timing, distribution, and personal factors.
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Alopecia androgenetica
Learn more about alopecia androgeneticaGradual, pattern-based hair thinning driven by genetic and hormonal sensitivity. Typically affects specific areas such as the temples, crown, or part line and progresses over time rather than appearing suddenly.
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Alopecia areata
Learn more about alopecia areataAn autoimmune condition characterised by patchy or focal hair loss. Unlike telogen effluvium, hair loss is often localised rather than diffuse and may occur without increased daily shedding.
Targeted nutritional support for telogen effluvium
In some cases, targeted nutritional support may be used as part of a broader, supportive approach to telogen effluvium. This does not replace time or recovery of the hair growth cycle, but may help support normal follicle function during periods of increased shedding.
TRIX Basic Beta is formulated specifically for individuals experiencing stress- or hormone-related diffuse hair shedding, such as telogen effluvium.
It is designed to:
- support normal hair cycle balance
- help strengthen new hair growth during recovery
- provide nutritional support during periods of physiological or emotional stress
Because telogen effluvium follows a delayed and gradual recovery pattern, any supportive approach requires consistent use over several months. Individual responses vary, and supplements should be viewed as adjunctive support, not a standalone solution.
Gaining clarity about your situation
Hair loss can feel uncertain, especially when shedding patterns change over time or follow a stressful period. Understanding whether hair loss is cycle-related, pattern-based, or a combination of factors is an important step toward setting realistic expectations and determining appropriate next steps.
Because telogen effluvium often overlaps with other forms of hair loss, relying on a single sign—such as increased shedding—can be misleading. A broader view that considers timing, distribution, and progression provides more meaningful insight than assumptions based on isolated symptoms.
The role of a structured assessment
A structured assessment helps bring together multiple elements that influence hair loss, including pattern, onset, recovery behaviour, and individual context. This approach reflects how hair loss is evaluated in clinical practice and reduces the risk of misinterpretation.
The TRIX Hair Check is designed to guide users through a short, structured assessment that considers these factors together. Rather than focusing on a single symptom, it helps clarify which type of hair loss is most likely and whether telogen effluvium, another condition, or a combination may be involved.
Supporting informed next steps
Gaining clarity about the underlying type of hair loss supports informed decision-making and realistic expectations. Whether hair shedding is temporary, progressive, or overlapping with another condition, understanding the pattern helps guide appropriate long-term support.
If you are unsure how the information on this page applies to your situation, a structured assessment can provide a clearer starting point.
Based on 20+ years of dermatological expertise
Frequently asked questions about telogen effluvium
What is telogen effluvium?
Telogen effluvium is a form of diffuse hair shedding caused by a temporary disruption of the normal hair growth cycle. A larger-than-normal number of hair follicles enter the resting (telogen) phase at the same time, leading to increased shedding across the scalp.
Is telogen effluvium permanent?
In most cases, telogen effluvium is not permanent. Because the hair follicles remain structurally intact, normal hair growth can resume once the underlying trigger has resolved. Recovery is gradual and varies between individuals.
How long does telogen effluvium last?
Shedding typically begins several weeks to months after the triggering event and may continue for a few months. Regrowth usually becomes noticeable later, as hair grows slowly. The total recovery timeline can range from several months to longer, depending on individual factors.
What triggers telogen effluvium?
Common triggers include physical illness, surgery, fever, hormonal changes, emotional stress, rapid weight loss, nutritional imbalance, and certain medications. Not everyone exposed to these factors develops telogen effluvium, as individual susceptibility varies.
Can stress alone cause telogen effluvium?
Severe or prolonged stress can contribute to telogen effluvium by disrupting hair cycle regulation. However, stress is not the only trigger, and hair shedding is often the result of multiple contributing factors rather than a single cause.
How is telogen effluvium different from alopecia androgenetica?
Telogen effluvium causes sudden, diffuse shedding and is usually temporary. Androgenetic alopecia develops gradually, follows recognisable patterns, and is driven by genetic sensitivity of hair follicles. The two conditions may coexist, which can complicate interpretation.
Can telogen effluvium occur together with other types of hair loss?
Yes. Telogen effluvium can overlap with other forms of hair loss, particularly androgenetic alopecia. In such cases, increased shedding may make underlying pattern-based thinning more noticeable.
How can I tell if I have telogen effluvium?
Because different types of hair loss can present with similar features, a structured assessment is often helpful. Evaluating pattern, onset, progression, and contextual factors together provides clearer insight than relying on shedding alone.
