Telogen Effluvium: Why Hair Sheds, and How It Recovers
Last reviewed on 25 July 2026. We review our treatment guides every six months to keep them accurate.
Telogen effluvium is a common, and usually temporary, form of hair loss in which more hairs than normal are shed from across the whole scalp at the same time. It happens when something disturbs the natural hair growth cycle and pushes a larger than usual number of follicles early into the resting, or telogen, phase, which is when hairs are shed. The result is diffuse thinning all over the scalp rather than bald patches, and in most people the hair grows back once the underlying trigger has passed. It is one of the most common causes of hair loss. This guide is general information and not a substitute for medical advice, so please speak to your GP or a dermatologist about your own hair loss.
For concise, regularly updated overviews, the NHS guide to hair loss, the British Association of Dermatologists leaflet on telogen effluvium and DermNet's page on telogen effluvium are reliable starting points, and they stay current between our own reviews.
What is telogen effluvium?
Telogen effluvium is a condition in which more hair than usual falls from the scalp because illness, stress or another major change in the body has disturbed the normal hair cycle. Dermatologists sometimes describe the trigger as a shock to the system. It affects all age groups and both sexes, and it does not run in families or damage the hair follicles, which is why the hair almost always grows back.
The hair growth cycle
Understanding telogen effluvium starts with the hair growth cycle. Each follicle moves through three phases: a long growing phase (anagen), a short transition phase (catagen), and a resting and shedding phase (telogen). On a healthy scalp, around 85% of follicles are growing at any one time and about 15% are resting. A follicle grows a hair for several years, then rests for a few months while a new hair forms underneath and pushes the old one out.
Because of this constant turnover, it is completely normal to lose up to around 100 hairs a day on your brush, in the shower or on your pillow. Losing some hair every day is part of a healthy cycle, not a sign of a problem.
What happens in telogen effluvium
In telogen effluvium, a trigger pushes many more follicles than usual out of the growing phase and into the resting phase all at once. According to DermNet, as many as 70% of the growing hairs can be tipped early into telogen, and the British Association of Dermatologists notes that the proportion of resting hairs can rise from the usual 15% to 30% or more.
A key feature is the delay. The extra shedding does not usually appear until about 2 to 4 months after the trigger, often around 3 months later, which is why the cause can be easy to miss by the time the hair starts to fall. Paradoxically, the shedding itself is a sign of recovery: the hairs come out because new hairs growing underneath are pushing them free, and a fine fringe of new hair can often be seen along the forehead hairline.
Causes of telogen effluvium
The causes of telogen effluvium hair loss are physical or emotional strains that disturb the hair cycle. Common triggers include:
- Major physical or emotional stress, such as bereavement, a relationship breakdown or a stressful life event.
- A high fever or serious illness, including some viral infections.
- Childbirth. Shedding a few months after having a baby is a very common form of telogen effluvium; our guide on postpartum hair loss covers it in detail.
- Surgery or a general anaesthetic.
- Crash dieting or rapid, marked weight loss.
- Iron deficiency and other nutritional shortfalls.
- Thyroid disease and other hormonal or endocrine changes.
- Starting or stopping certain medications, including coming off the contraceptive pill.
Not every case has an obvious cause. The British Association of Dermatologists notes that in roughly 1 in 3 people diagnosed with telogen effluvium, no clear trigger is found.
Acute telogen effluvium
Most cases are acute telogen effluvium, meaning they are short lived and self-limiting. The heavy shedding phase usually lasts about 3 to 6 months and then settles, with the scalp gradually thickening back up over roughly 6 to 9 months once the trigger has passed.
Chronic telogen effluvium
Telogen effluvium is described as chronic telogen effluvium when the increased shedding continues for longer than 6 months. Chronic telogen effluvium tends to affect otherwise healthy women between about 30 and 60 years of age, often has no single identifiable cause, and can fluctuate over months or years. It is uncomfortable and distressing, but it still does not cause complete baldness.
Symptoms: what telogen effluvium looks like
The main symptom is a noticeable increase in shedding, most obvious when washing or brushing, with more hair than usual collecting in the shower drain, on the hairbrush or on the pillow. The onset is often sudden. Over time this leads to diffuse thinning and a loss of overall volume spread across the whole scalp, rather than distinct bald patches. Some people notice the thinning most around the temples and hairline, where the new fringe of regrowth can also appear. Occasionally telogen effluvium is accompanied by scalp tenderness or altered sensation, known as trichodynia.
How telogen effluvium differs from other hair loss
Because telogen effluvium is diffuse and temporary, it is worth distinguishing from other causes of hair loss:
- Male and female pattern hair loss (androgenetic alopecia) is gradual and follows a pattern, such as a receding hairline or a widening parting, rather than sudden shedding all over. Sometimes telogen effluvium unmasks an underlying tendency to pattern loss.
- Alopecia areata causes distinct, often round, bald patches and is driven by the immune system, whereas telogen effluvium thins the whole scalp without creating bald areas.
- Anagen effluvium is a separate condition and a common point of confusion. As DermNet explains, anagen effluvium is shedding during the active growth (anagen) phase, caused by an acute insult to the follicle such as chemotherapy, certain toxins or radiation. It comes on within weeks, can cause up to about 90% hair loss and can leave the scalp bald, which is very different from the milder, diffuse thinning of telogen effluvium.
Diagnosing telogen effluvium
A doctor or dermatologist usually diagnoses telogen effluvium from the appearance of the scalp and a careful medical history, looking for a trigger in the previous few months. A gentle hair pull test may be used to see whether more hairs than normal come away, and blood tests are often arranged to check for treatable contributors such as thyroid problems and iron deficiency. A scalp biopsy is only rarely needed. The British Association of Dermatologists notes that if the hair has been washed within 48 hours before a pull test, the result can be falsely reassuring.
Treatment and recovery
The most important point about treatment is that telogen effluvium is usually self-correcting, so the aim is to address the underlying cause and then allow time for recovery. The British Association of Dermatologists is clear that no medication speeds up regrowth, and that in most cases the hair will start to come back on its own once the trigger has resolved.
Sensible steps include:
- Treating any underlying issue, for example correcting iron deficiency, a thyroid problem or a low vitamin B12 or folate level, and managing ongoing stress.
- Eating a balanced diet with enough protein, fruit and vegetables, and being cautious about crash diets.
- Handling the hair gently, avoiding harsh brushing, tight styles and unnecessary heat or chemical treatments.
Minoxidil is sometimes discussed for hair shedding, but the evidence that it helps telogen effluvium specifically is limited, and whether it is worthwhile is a decision for a doctor rather than something to start on your own.
Outlook
Telogen effluvium is usually reversible. Because it does not damage the follicles, regrowth typically begins within a few months of the trigger settling, and the hair gradually returns towards its normal thickness, although it can take many months to feel fully back to normal. Chronic cases may fluctuate for longer. Reassurance matters, because the condition can be distressing even though the outlook is good.
When to see a doctor
The NHS advises seeing a GP if you are worried about hair loss, if it is sudden, patchy or accompanied by other symptoms, or if it is affecting your wellbeing. It is sensible to get an idea of what is causing your hair loss from a GP before considering a commercial hair clinic, since the right approach depends on the diagnosis.
Where hair transplant surgery fits
A hair transplant is a treatment for permanent hair loss, most often pattern baldness, where follicles have been lost for good. Telogen effluvium is temporary and the follicles remain healthy, so surgery is not a treatment for it, and a good clinic would not offer one while active shedding is going on. Because heavy shedding can sometimes reveal an underlying pattern loss, anyone considering surgery in the future should have a proper assessment by a clinician once the shedding has settled.
Frequently asked questions
What causes telogen effluvium?
Telogen effluvium is triggered by a physical or emotional strain that disturbs the hair cycle. Common causes include major physical or emotional stress, a high fever or serious illness, childbirth, surgery or a general anaesthetic, crash dieting, iron deficiency and other nutritional shortfalls, thyroid disease and other hormonal changes, and starting or stopping certain medications. In roughly 1 in 3 people no clear trigger is found.
How long does telogen effluvium last, and can it last for years?
Acute telogen effluvium usually sheds heavily for about 3 to 6 months, then settles, with the scalp thickening back up over roughly 6 to 9 months. If increased shedding carries on beyond 6 months it is called chronic telogen effluvium, which can fluctuate over months or years but still tends to recover.
What is chronic telogen effluvium?
Chronic telogen effluvium is when the increased shedding continues for longer than 6 months. It tends to affect otherwise healthy women between about 30 and 60 years of age, often has no single identifiable cause, and can fluctuate over months or years. It is distressing, but it still does not cause complete baldness.
Is telogen effluvium permanent?
No. Telogen effluvium does not damage the hair follicles, so it is almost always temporary and the hair grows back once the underlying trigger is dealt with. It does not cause complete baldness. Occasionally it can unmask an underlying tendency to pattern hair loss, which is worth discussing with a doctor.
Can stress cause telogen effluvium?
Yes. Major physical or emotional stress is one of the most common triggers. Because of the delay in the hair cycle, the shedding usually appears about 2 to 3 months after the stressful event, by which time the stress itself may have eased.
Can telogen effluvium affect the hairline or temples?
Telogen effluvium thins the whole scalp, but many people notice it most around the temples and hairline, where hair is finer and thinning shows sooner. This is also where a fine fringe of new regrowth often appears first, which is a good sign. Persistent thinning that is confined to the temples, however, can also point towards pattern hair loss, so it is worth having it assessed.
Can telogen effluvium cause bald spots?
No. Telogen effluvium causes diffuse thinning across the whole scalp and a loss of overall volume, rather than distinct bald patches or bald spots. Round, well-defined bald patches point instead to another condition such as alopecia areata, so patchy loss is worth having checked by a doctor.
What is the difference between telogen effluvium and anagen effluvium?
Telogen effluvium is shedding during the resting phase of the hair cycle and is usually mild and temporary. Anagen effluvium is shedding during the active growth phase, caused by an acute insult such as chemotherapy, toxins or radiation. It comes on within weeks, is more severe and can cause near-total hair loss, which telogen effluvium does not.
Is telogen effluvium the same as alopecia?
Alopecia simply means hair loss, so telogen effluvium is one type of alopecia, but it is not the same as alopecia areata. Alopecia areata is an immune condition that causes distinct bald patches, whereas telogen effluvium causes diffuse thinning across the whole scalp without bald areas.
Will my hair grow back after telogen effluvium?
In the great majority of cases, yes. Once the trigger has passed the follicles return to their normal cycle and the hair regrows over several months, gradually returning to its usual thickness. If shedding continues beyond 6 months, or you are worried, see your GP or a dermatologist to check for treatable causes such as iron deficiency or a thyroid problem.
The bottom line
Telogen effluvium is a common, temporary form of diffuse hair shedding that happens when a trigger tips too many follicles into the resting phase at once, usually showing up a couple of months later. It thins the hair all over rather than causing bald patches, and because the follicles are unharmed, it almost always recovers once the underlying cause is addressed. The most useful steps are to look for and treat any trigger, such as stress, iron deficiency or a thyroid problem, to be patient while the hair regrows, and to see a GP or dermatologist if the shedding is heavy, lasts beyond 6 months or is affecting your wellbeing.
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