Abstract
The human hair cycle has four recognised phases – anagen, catagen, telogen, and exogen – with the duration of each phase being site specific. In scalp hair, telogen lasts for around 12 weeks, following which the telogen hair is shed, a process instigated by unknown factors in the exogen phase. Any disturbance to the hair cycle will induce a relative change in the equilibrium between growth and rest, initiating an acute telogen effluvium. It is essential therefore to identify the inducing factor so as to consider if any intervention is required; reassurance is frequently all that is needed. However, if the increase in hair shedding persists for 6 months or more (chronic telogen effluvium), then biochemical investigations are required. Frequently hair loss induces changes in the patient’s hair care and grooming routines resulting in an artificial increase in the observed shedding; understanding this potential exacerbating factor is essential. Finally, increased hair shedding can initially occur in patients in whom reduced hair density (hair per cm2) will ensue; diagnostic and treatment options will only be briefly discussed in such situations.
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Rushton DH. Management of hair loss in women. Dermatol Clin. 1993;11:47–53.
Rushton DH, Ramsay ID, James KC, Norris MJ, Gilkes JJ. Biochemical and trichological characterization of diffuse alopecia in women. Br J Dermatol. 1990;123(2):187–97.
Further Reading
Cash TF. The psychological effects of androgenetic alopecia in men. J Am Acad Dermatol. 1992;26(6):926–31.
Dawber RPR, Van Neste D. Hair and scalp disorders, common presenting signs differential diagnosis and treatment. London: Martin Dunitz; 1995. 262 p.
Deloche C, Bastien P, Chadoutaud S, Galan P, Bertrais S, Hercberg S, et al. Low iron stores: a risk factor for excessive hair loss in non-menopausal women. Eur J Dermatol. 2007;17(6):507–12.
Du X, She E, Gelbart T, Truksa J, Lee P, Xia Y, et al. The serine protease TMPRSS6 is required to sense iron deficiency. Science. 2008;320(5879):1088–92.
Hård S. Non-anemic iron deficiency as an etiological factor in diffuse loss of hair of the scalp in women. Acta Derm Venereol. 1963;43:562–9.
Holler PD, Cotsarelis G. Retinoids putting the “a” in alopecia. J Invest Dermatol. 2013;133(2):285–6.
Kantor J, Kessler LJ, Brooks DG, Cotsarelis G. Decreased serum ferritin is associated with alopecia in women. J Invest Dermatol. 2003;121(5):985–8.
Kingsley DH. The development and validation of a quality of life measure for the impact of androgen-dependent alopecia [PhD]. Portsmouth: University of Portsmouth, School of Pharmacy & Biomedical Sciences; 1999.
Olsen EA, Reed KB, Cacchio PB, Caudill L. Iron deficiency in female pattern hair loss, chronic telogen effluvium, and control groups. J Am Acad Dermatol. 2010;63(6):991–9.
Park SY, Na SY, Kim JH, Cho S, Lee JH. Iron plays a certain role in patterned hair loss. J Korean Med Sci. 2013;28(6):934–8.
Puolakka J. Serum ferritin in the evaluation of iron status in young healthy women. Acta Obstet Gynecol Scand. 1980;95(Suppl):35–41.
Rasheed H, Mahgoub D, Hegazy R, El-Komy M, Abdel Hay R, Hamid MA, et al. Serum ferritin and vitamin d in female hair loss: do they play a role? Skin Pharmacol Physiol. 2013;26(2):101–7.
Rook A, Dawber RPR. In diseases of the hair and scalp. Oxford: Blackwell Scientific Press; 1982.
Rushton DH. Investigating and managing hair loss in apparently healthy women. Can J Dermatol. 1993;5:455–61.
Rushton DH. Nutritional factors and hair loss. Clin Exp Dermatol. 2002;27(5):396–404.
Rushton DH, Barth JH. What is the evidence for gender differences in ferritin and haemoglobin? Crit Rev Oncol Hematol. 2010;73(1):1–9.
Rushton H, James KC, Mortimer CH. The unit area trichogram in the assessment of androgen-dependent alopecia. Br J Dermatol. 1983;109(4):429–37.
Rushton DH, Ramsay ID, Norris MJ, Gilkes JJ. Natural progression of male pattern baldness in young men. Clin Exp Dermatol. 1991;16(3):188–92.
Rushton DH, Dover R, Sainsbury AW, Norris MJ, Gilkes JJ, Ramsay ID. Reference limits for haemoglobin and ferritin. BMJ. 2001;323:806–7.
Rushton DH, Dover R, Sainsbury AW, Norris MJ, Gilkes JJ, Ramsay ID. Iron deficiency is neglected in women’s health. BMJ. 2002;325:1176–7.
Rushton DH, Norris MJ, Dover R, Busuttil N. Causes of hair loss and the developments in hair rejuvenation. Int J Cos Sci. 2002;24:17–23.
Rushton DH, Dover R, Norris MJ. Is there really no clear association between low serum ferritin and chronic diffuse telogen hair loss? Br J Dermatol. 2003;148(6):1282–4.
Rushton DH, Ramsay ID, Gilkes JJH, editors. The use of placebo or untreated controls in male pattern hair loss leads to a significant and permanent loss of hair. London: Dermatology; 2006.
Rushton DH, Bergfeld WF, Gilkes JJ, Van Neste D. Iron deficiency and hair loss-nothing new? J Am Acad Dermatol. 2011;65(1):203–4; author reply 204–6.
Rushton DH, editor. Hepcidin, the iron-regulating peptide – what you need to know about its role in hair loss and, in particular, chronic telogen effluvium (CTE). Proceedings of the 7th World Congress for Hair Research. Edinburgh: J Investigative Dermatology. 2013.
Sinclair R. There is no clear association between low serum ferritin and chronic diffuse telogen hair loss. Br J Dermatol. 2002;147(5):982–4.
St. Pierre SA, Vercellotti GM, Donovan JC, Hordinsky M. Iron deficiency and diffuse nonscarring scalp alopecia in women: more pieces to the puzzle. J Am Acad Dermatol. 2010;63(6):1070–6.
Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. J Am Acad Dermatol. 2006;54(5):824–44.
Van Neste DJ, Rushton DH. Hair problems in women. Clin Dermatol. 1997;15(1):113–25.
Van Neste D, Leroy T, Conil S. Exogen hair characterization in human scalp. Skin Res Technol. 2007;13(4):436–43.
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Rushton, D.H. (2015). Acute and Chronic Telogen Effluvium. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D’Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-45139-7_96
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