Nov 22

Scalp Injections With Telogen Effluvium

I sometimes hear from people who have been dealing with severe telogen effluvium for quite some time. Because of this, they are ready to do something drastic to stop the shedding. I’ve been asked about injections into the scalp and whether or not this will help with telogen effluvium.

Before I attempt to answer, I have to stress that I am not a doctor or specialist. I am just a layperson who has gone through this and, because of that, has done a good deal of research. It is my understanding that dermatologists sometimes use cortisone or steroid injections directly into the scalp for autoimmune or scarring conditions like alopecia areata, or for scarring alopecia due to lichen planopilaris. This is usually done in situations where there is an alarming amount of inflammation and the hair loss could be permanent without treatment.

Typically, telogen effluvium does not rise to the extremely high level of inflammation that we are talking about. These injections are typically performed by a dermatologist only when a scalp biopsy has shown an extremely high degree of inflammation that could cause scarring. Yes, sometimes, ongoing and severe telogen effluvium CAN cause inflammation. But this is often a by product of the condition. It is not the initial trigger for the condition. Most often a person with telogen effluvium will be given topical anti inflammatories (or told to use an anti inflammatory shampoo) rather than getting injections. The idea is to try non invasive methods.

I’d certainly encourage anyone with telogen effluvium to see a dermatologist, but I would not push for injections unless my scalp biopsy showed something alarming that made injections medically advisable. This is just based on my personal experience where I was able to kick back TE inflammation using more natural topicals that I could use at home and did not need to inject. Certainly, there are medical conditions of the skin and scalp that are severe and will require medical intervention. Telogen effluvium typically does not fall into that category because it usually ends on its own once the trigger is removed and the inflammation is dealt with. (Typically, the hair cycles reset themselves after these things happen.)  Even androgenetic alopecia is not typically treated with scalp injections. It is usually very specific, severe, and potentially scarring or permanent conditions that require the injections. I do not want to discourage you from seeing a dermatologist. In fact, I encourage that. It’s just that it’s my understanding that most dermatologists only perform scalp injections for specific conditions. But if you have very severe inflammation with your telogen effluvium, a dermatologist might be able to offer you some topical anti inflammatories or even put your might at ease. Also, I do know a few people who were thought to have telogen effluvium, but who later learned that they had something else entirely after a scalp biopsy, so it never hurts to have your scalp checked if your TE is ongoing and severe.

As I alluded to, I had decent success with natural, topical anti inflammatories combined with occasional dandruff shampoo (even though I didn’t have dandruff.) You can read more about what helped my triggers, my regrowth, and my inflammation on my blog at

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Nov 21

Can The No Poo Method Help With Hair Loss?

By: Ava Alderman:  Before I try to answer this question, I want to clarify what “no poo” means as it relates to hair.  Essentially, it means that you are going to commit to washing your hair and scalp with something other than commercially available shampoo, which can contain harsh chemicals that strips your hair and scalp of the natural oils that many people feel are healthy.

People use different substances to get their hair clean without shampoo.  Some just use water.  Others use baking soda.  Or apple cider vinegar.  Or even gentle conditioner, since conditioners have less harsh ingredients with enough of a cleaning agent to get your hair clean.

Many people with curly or wavy hair embrace the “no poo” movement because it allows their curls to not get fried by shampoo.  It makes curls soft and it helps control frizz.

If you are suffering from hair loss, “no poo” may sound very intriguing to you. During the worst parts of my hair loss, I hated washing my hair so much.  It was traumatic every time.  So I tried “no poo.”  And I can tell you what happened for me and for some others who tried this experiment with me.  Initially, it was a relief because less hair was coming out during grooming.  But within a week or two, my hair loss got worse.

And here is my theory as to why. I believe that my hair loss (which was chronic telogen effluvium with some miniaturization thrown in) was always made worse by inflammation.  Not washing it as much didn’t allow the inflammation to get kicked back or under control. In my own case, I found that using an anti-inflammatory shampoo helped me both in terms of hair loss and the pain in my scalp. So when I was no longer using something strong enough to help with inflammation, the loss got worse, at least that’s my theory.

Plus, if you are losing hair due to androgens or DHT, no poo may not allow you as much of an opportunity to at least wash some of those substances off of your scalp.

Now, my experience may not be true of every one.  If your hair loss was due to some sort of allergic reaction to harsh grooming or hair products, then no poo may help.  Baking soda and diluted apple cider vinegar can be pretty gentle to even those who are very sensitive.  So I don’t think it hurts to give it a try and then if you notice worsening hair loss, you can stop.

What I wouldn’t recommend is just not washing at all.  Some people use dry shampoo or come to hope that the hair and scalp is self-cleaning.  In my own experience, it’s not. I think that it’s important to clean your scalp of debris and build up.  You don’t want your follicles getting clogged or blocked.  You want as healthy a scalp as possible so that you can support healthy hair growth.

I know that everyone is different.  But for me, the key was bringing the down the inflammation in numerous ways.  No poo just didn’t allow for that.  You can read more about my experiences on my blog at  Now that my hair loss is under control, I do take breaks from shampoo once or twice a week and wash with conditioner only.  This keeps my hair soft and brings out the natural wave.

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Nov 20

Why Is My Shedding Hair Getting So Tangled?

By: Ava Alderman: As if it’s not bad enough to be dealing with shedding hair, many people going through this notice a change in texture also. This change in texture can go so far that you can find yourself with hair that is now fly away and getting tangled.

Someone might say: “I have always had pretty manageable hair. Before my hair started falling out, it wasn’t that much of a chore to comb it and to make it look nice. But ever since it started falling out, it’s been almost impossible to tame. It doesn’t lay down anymore and it’s becoming very tangled. Why is this? And what can I do about it?”

Hair That Is Resting Instead Of Growing: There are a couple of possibilities for what you are seeing. Often, when your hair is shedding, something has happened to cause some of the hairs to change from the growing cycle to the resting cycle. When this happens, the hair that is in the shedding cycle is no longer actively becoming nourished. There is no longer any point to that because that hair is going to fall out soon anyway.

When this process starts to happen with more hairs than normal (as is the case when you have telogen effluvium) it can produce flyaway hair. When your hair is in a normal growth and shed pattern, there are a small amount of hairs being affected so that it is not noticeable. But when a larger number of hairs shift, there can be a very noticeable change in hair texture. And as the hair is often more raised and not laying down, it’s easier for it to become tangled.

In addition to this, many people notice that they lose more hair when they comb it or use conditioner. So many people do this less, which leads to tangling.

Miniaturized Hair: There is one more possibility that I can think of. If you have a hair condition called androgenctic alopecia (patterned thinning) the hair can eventually become miniaturized or more thin. When this happens, the hair doesn’t lay down correctly because the weight of it has been diminished. This can also lead to tangling.

Gentling Addressing The Tangles: It can be frustrating to deal with the tangling because when your hair is falling out, you have to be very gentle with it. That’s why it can help to use a spray in conditioner to help your comb glide through it very easily. Use a very wide tooth comb so that the hair doesn’t pull. Hold your head at the scalp and only comb right before where the tangle is located. By holding your hair firm and not taking long strokes, you’re only affecting the tangled area and this is a more gentle approach to take.

Once you have the tangles taken care of, you can very gently comb the full length of your hair to keep the tangling from coming back for a while. When you wash your hair, allow it to dry flat. Don’t put it up in a towel because this can make the problem worse. (If you want to use a towel, make sure that the hair is not twisted inside of it.)

Tangling was a problem for me when my hair was shedding.  I would often gather my hair in a ponytail when wet and wrap the towel around it that way so that it could not move or twist (and therefore tangle) during the drying process.  The good news is that once I got my shedding to stop, the tangling stopped also.   You can read more about my experience on my blog at

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Nov 19

How Often Should I Wash My Hair With Telogen Effluvium?

By: Ava Alderman: If you are suffering from severe hair shedding, then you probably know that washing your hair can become a traumatic event. This may sound silly or overly dramatic to people who haven’t been through this. But for those of us who know the reality of having hair all over our clothes and floor, we know that it is no dramatization to say that it can almost seem as if you are losing huge, alarming amounts of hair every time that you wash it.

Understandably then, many of us consider washing it less. We aren’t always happy about this since some of us have additional itching when we’re shedding. But we figure if we can forego a wash or two and save ourselves a lot of spent hairs, then perhaps all of this would be worth it. It’s not uncommon for me to hear comments like: “I used to wash my hair every day. But now that I have telogen effluvium and am shedding, it’s psychologically difficult for me to shed my hair. The drain is nearly clogged with my hair. I have read that you really don’t need to wash your hair that much. In fact, I’ve read some celebrities wash their hair about once per week. Would washing less help me? How often should you be washing your hair with telogen effluvium?”

I’m not a doctor or hair specialist, but I do have an opinion on this based on my own experience and research. I completely understand this. Because when I was shedding, I experimented with washing my hair less. Here is what I found, although I would encourage you to see for yourself. Not washing as often didn’t really save me any hairs, I don’t think. Because what happened is that I just shed so much more on the days that I did wash. So I believe that the average number of hairs per day were probably about the same or maybe even a little more.

Not only that, but my hair itched, my scalp burned, and the overall experience was more painful. I was using an anti-inflammatory shampoo at that time and I believe that going days without this benefit wasn’t helpful to my hair, my scalp, or to me. Also, if your hair loss is in any way due to inflammation or a response to androgens, not washing your hair can make these responses more intense, which can lead to more shedding. Plus, your hair tends to take on a bad texture when its shedding and it can be limp and look oily. Not washing your hair can make the appearance of your hair a little worse, and this can be psychologically damaging as well.

So my answer to the question would be that, to the extent that you are able, I would keep up the hair washing regimen that worked for you before the shedding. If this is too difficult, maybe you could add one additional non-washing day without a huge surge in inflammation or oiliness. When my shedding was at its worst, I would wash with regular shampoo one day and dry shampoo the next. But I would not go for so long that you risk your follicles being affected by debris.

Instead, I would try to wash my hair as gently as I could. But I would also understand that if my hair is in the resting or shedding phase, not washing it isn’t going to save it. Hair that has switched phases is going to fall out at some point soon anyway. And this is true whether you are washing it or not.

One thing that helped me with this process was to allow my hair to mostly dry in a towel.  This kept me from seeing the fall out and helped psychologically.  Also, my hair didn’t pull out as much if I styled it when it was mostly dry. If it helps, you can read more about my experience on my blog at

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Nov 18

What Causes Your Scalp To Itch With Shedding Or Telogen Effluvium? Is This DHT?

By: Ava Alderman:  I hear from a good amount of people who are not only shedding hair, but who are also having scalp issues.  Many of them notice a tight, itchy scalp and they do not understand why.  Some of them have never had dandruff or any itching before.  So they can correlate the scalp problem as occurring shortly after the hair shedding started.  They know that the two must be connected, but they don’t know why.

Someone might say: “ever since my hair started shedding badly, my scalp has itched.  I don’t notice any flaking, so I don’t think that it is dandruff.  But it’s really bad.  It’s hard not to notice it all of the time.  Scratching really doesn’t make it any better.  I try not to be obvious with the scratching, but last night my husband asked me if I had fleas. He was only joking, but this means that the scratching is obviously noticeable. Why is this happening?  I’ve read that your scalp can itch with hair loss from DHT.  Is that what is it is? My doctor thinks that I have telogen effluvium.”

In cases of telogen effluvium, the most common cause for the itch (at least in my experience and observation) is inflammation and irritation.  Except for when you’re experiencing telogen effluvium or a severe summer shed, it’s just not normal for so many of your hair follicles to go into shedding mode all at once.  Normally, you may have less than ten percent of hair in this mode.  So when the hair sheds out during a normal cycle, you don’t notice it much or feel any discomfort in your scalp.  But when this is magnified by five times or more (as is the case with TE,) than you most definitely do notice it and you can sometimes see evidence of it on your scalp, which can become irritated and inflamed.

Another reason for the itching is regrowth.  Since you probably have many more follicles growing hair than normal, this can create some tightness, tingling, or itching as the hair begins to fill in.

The inflammation and tightness can often be helped with a little tea tree oil or the commercially available product scalpacin (at least it gave relief in my experience.)  And frankly, even if dandruff is not a problem and never has been, many people with TE get some relief using dandruff shampoo simply because it kicks back inflammation.

As far as DHT goes, if you truly have TE, DHT really should not be the cause of your itching.  However, there is another type of hair loss (androgenetic alopecia) where DHT is most definitely an issue. The scalp becomes overly sensitive to this androgen and the follicles shrink as a result – causing hair loss, and eventually, miniaturization.  This process can cause itching and discomfort also.

But people with TE typically don’t have hair loss caused by androgen sensitivity.  Their hair loss and shedding is caused by stress or change to the body or illness.  It’s important to understand the difference between the two and to differentiate which type you have.  AGA and miniaturization can be addressed if treated early.  But since TE doesn’t permanently affect the follicles and doesn’t include the DHT sensitivity, it’s more likely that the itching isn’t from DHT if you are dealing with telogen effluvium.  It’s most likely from inflammation, irritation, or regrowth. Sometimes, you can have all three going at once, which can be a challenge.  It took me a while to get a handle on my inflammation, but I had CTE (chronic telogen effluvium.)  I often wonder if I would not have developed the chronic variety if I had gotten the inflammation under control earlier.  But I did not know then what I know now. You can read more on my blog at

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Nov 17

The Telogen Effluvium Recovery Process: Step By Step:

By: Ava Alderman:  I sometimes hear from people who think (and very much hope) that they are starting to see some improvement in their telogen effluvium or shedding.  There typically comes a point in this process where you get very tired of seeing the hair falling out and dealing with the lack of volume, so you begin to watch your hair and scalp with an eagle eye.  You start to be on the look out for any signs that you might be in recovery.  The problem can come when you don’t know what is a sign of recovery and what is not.  This article is meant to outline the steps that you might see on your road to recovery.

Step One: The Trigger Is Removed:  This type of shedding is caused by stress to your body.  Sometimes, that is an illness.  Other times, it is a change in hormones.  Occasionally, it can be an inflammatory response or an allergic reaction.  So long as the body is no longer under stress, has recovered, or no longer has a reoccurring trigger,  the affected follicles should eventually go from the shedding phase to the growing phase and recovery begins.  Chronic telogen effluvium occurs when the trigger or stressor is ongoing or another trigger (like inflammation) pops up so that the shedding continues.

Step Two:  Regrowth Begins:  Honestly, as soon as a hair is kicked out of its follicle and sheds out, another hair is in line to take its place.  You won’t be able to see that baby hair replacement for a little while, but rest assured that the process starts long before you realize it.  Since hair only grows 1/2 inch per month and can come in lighter colored or very thin, it can take a while before you get a good look at your regrowth, but it is typically there long before you can actually see it.

Any Inflammation Or Miniaturization Present Shows Up:  Ideally, once you start actually being able to see regrowth without too much trouble (which should happen in a couple of months or so,) the shedding will have started to taper off some.  If the shedding is still going full force with no sign of letting up, it’s probably not a bad idea to examine your scalp for signs of inflammation.  Sometimes, if you have a red, pink, itchy, tingly or painful scalp, you might have inflammation exacerbating the shedding.   The inflammation can be treated, so it makes sense to be on the look out for it.

Another thing you want to look for is miniaturization.  Regrowth hair can look kind of thin and pale when it is first growing.  But once it gains a little length, it should start to look normal.  If you have obvious miniaturization, it makes sense to evaluate for androgen – driven hair loss or AGA.  Now, prolonged and chronic telogen effluvium can cause some mild inflammation (at least in my experience,) but it’s important to be conscious of this because the earlier that miniaturization and the androgens are treated, the better the results are going to be.

Not everyone has inflammation or miniaturization.  Many people do not.   But it’s smart to watch for both because the earlier they are addressed, the better the result.

The Volume Begins To Fill In As Follicles Are In The Growing Phase Again And Hair Gains Length:  As the majority of your hair is back in the growing phase for a while, the strands that are regrowing should start to gain some length.  When many strands gain this length at once, that is when you start to get a gain in volume.  It is when your hair should start looking more full.  And since most of your follicles are getting nourished again, the hair should regain it’s health and sheen. Telogen effluvium hair can look dull, fly away, and dry.  But once you are in recovery for a while, your hair should regain it’s health and look shiny and manageable again.

This process doesn’t always come as fast as we would like.  But as long as the trigger is removed and inflammation / miniaturization are kept at bay, you should eventually get your hair back.  By definition, telogen effluvium is a pause – not a permanent loss.  The hair that is lost grows back. And since the follicles should not be permanently affected, you should theoretically eventually end up with the hair you started with.

Of course, if you have too many cycles of telegen effluvium (which turns into CTE) or you struggle with your trigger, then this process can take longer and be more drastic than any of us would like.

I did have some chronic telogen effluvium.  But that was before I knew how important combating the inflammation truly was.  Once I understood this and embraced preventatives, things got much better.  There’s more about my experience on my blog at

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Nov 13

I Can’t Tell If I Have Miniaturization Or Regrowth. How Do I Tell?

By: Ava Alderman: I sometimes hear from folks who really hope that they are seeing regrowth after a bout of hair loss or shedding. The problem is that they can’t be sure what type of hair they are looking at. They often see wispy, thin, and short hairs that could possibly be either regrowth or hair that has thinned or become miniaturized. Of course, most people hope that they are seeing regrowth, but they can’t be sure.

To that end, you might hear a comment like: “I had a horrible bout of what I believe is telogen effluvium. I lost a lot of weight a couple of months ago and I think that this is what brought on the shedding. It was really bad for a while but it seems to have gotten better. When I pull back my bangs and when I look at the top of my head, I see some tiny little baby hairs that appear to be coming in. My first inclination is that these hairs are regrowth. But, they look a little sickly. They are thinner than the rest of my hair. My father is bald. My brother is thinning. So I suppose it’s not inconceivable that what I am seeing is actually miniaturized hairs. How can I tell which one I’m looking at?”

I agree that it can be difficult. And fear of the unknown can make you begin to worry that you are only seeing what you want to see. Here are a couple of things to look at to help you determine if you are looking at regrowth or miniaturization.

Is The Hair More Thick In Diameter Closer To The Scalp?: Some people are lucky enough to have really robust, and normal looking regrowth. What I mean by this is that even if they are growing in short, baby hairs, those hairs are normal in diameter and they are the normal thickness of a regular hair. But some of us are not so lucky. Many people have commented on my blog that their regrowth came in fine at first but then it thickened up as it grew. I had some areas of my scalp where I noticed this as well. In this case, you might notice that the hair is thicker the closer to the scalp that it is.

Is The End Tapered Or Blunt?: This observation isn’t always going to be applicable. But sometimes, this information is very helpful. Generally speaking, regrowth hair has a tapered end. The reason for this is that you haven’t cut this hair, so it won’t have that blunt, straight across end. Now, if you are looking at miniaturized hair that has been cut, that hair will almost always have a blunt end. But if you are looking at a tapered end, then you are either dealing with regrowth hair or you haven’t cut that hair yet. As I said, this won’t always be applicable, especially if your hair is longer and you don’t cut it regularly. But if the hair is blunt or cut straight across, the chances are good that it’s not regrowth, unless you just got a hair cut and the stylist cut those baby regrowth hairs for some reason.

Do The Feather Test: This isn’t scientific by any means. In fact, I’m not a specialist of any kind. This is just something that I developed myself. This comes from my own observations during my own bout with hair loss. Hopefully, you find it helpful and applicable. I had a couple of areas on my head that were miniaturized and were different from those thin baby hairs that were regrowth. I plucked hairs from both areas of my head and I compared them. Although the regrowth hairs were more thin than my regular hairs, the miniaturized hairs were just so much more light weight. If I took the hair and held it between my fingers and then moved my hand in an upward motion to make the hair fly up, the miniaturized hairs would float down like a feather. They did not have enough weight to make them come down naturally. They would short of hover and float whereas the regrowth hairs would come down more slowly than normal hairs, but they wouldn’t float.

I know that this is probably a weird description. But I found it to be helpful in separating the two types of hairs. I hope that you do as well. I was very upset to determine that I had miniaturized hairs.  But I found a way to support healthy regrowth.  You can read more on my blog at

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Nov 09

How Thin Will My Hair Get If I Have Telogen Effluvium (TE,) Chronic Telogen Effluvium (CTE,) Or AGA?

By: Ava Alderman: People whose hair has been shedding for quite a while or quite dramatically in a short period of time often try to do research as to what might be the cause. And once they rule out medical causes or seasonal shedding, they are often left thinking that they have either telogen effluvium, chronic telogen effluvium, or androgenic alopecia. Many people start out hoping that they have telogen effluvium or TE that passes very quickly. But sometimes as more and more time goes by, they start to get a sinking feeling that this may last for longer than they had hoped. Many start to become afraid that they may have longer term forms of hair loss like CTE or AGA. And then they start to wonder just how thin their hair is going to get if this is the case.

I heard from someone who said: “at first I thought I had seasonal shedding. Then I thought I had TE. But now I’m starting to think I might have CTE or even AGA because it’s been four months now and my shedding shows no sign of slowing down. My ponytail is only a fraction of what it used to be. I’m starting to wonder how thin my hair is really going to get. Are you going to be able to see my scalp? Will I have bald spots? Will I need to wear a wig?” I’ll try to address these questions as best as I can in the following article.

The Depth OF Hair Loss Can Vary From Person To Person And From Month To Month: I know from my own experience that it’s very common to count your hairs and then to try to get estimates further down the road. So, for example, you’d think something like: “I’m shedding about 250 hairs per day. Over the course of a month, that’s 7,500 hairs. In six months, that’s45,000 hairs. In a year, that’s 90,000 hairs. I’ll be bald by then and will need a wig.

I know that this is scary. But you can’t think of it this way. You aren’t likely to lose the exact same amount of hairs every single day. It’s likely there will be some days with improvement and some days that seem a little worse. But it’s the averages that count. Another thing to consider is that unless you have AGA and your ability to regrow hair is severely compromised, you will be regrowing hair as you are shedding it. So, people with telogen effluvium or even chronic telogen effluvium are much less likely to see bald spots or a lot of scalp than someone with AGA who doesn’t have the ability to regrow healthy hair, The reason for this is that because even as the shedding is happening, it is also regrowing and should be offering some scalp coverage. Granted, because the hair is new and short and needs to grow in, you’re not likely to see an increase in volume for quite some time.

A second thing to consider is that you don’t know when you might see this improve or even end. This woman had been shedding for 4 months, but to have a diagnosis of CTE, she had two more months to go. It was possible that next week or next month, the shedding would stop. Finally, keep in mind that we do normally shed some hairs, I know that it is hard to keep this in perspective when it seems as if you are raining hairs. In my own experience, I was sure that I was going to be bald in several months time. That didn’t come to pass even though I was shedding very aggressively for a long time until I began to find some things to improve my situation. I did get temples that very extremely thin. And, my part line widened but my scalp was never completely see through. I did use powder to help blend in my scalp because I became somewhat paranoid.

Don’t Assume The Worst Case Scenario: It might make you feel better when I tell you that many people don’t reach their worst case scenario. And I think it’s important that you don’t just accept that this is where you are heading. There is plenty that you can do to make your hair look presentable as you are going through this. You can also try to minimize inflammation and support regrowth. But to answer the question posed, I unfortunately couldn’t tell this woman how thin her hair would get because I wasn’t sure what type of hair loss she would have, I didn’t know how much longer her shedding would last, and I didn’t know what regimens she was going to try to address things. I could and did tell her that often, things don’t end up being as bad as you had feared and that stress and fear is thought to actually make the shedding worse. So trying to remain calm and being proactive can help.

Unfortunately, I know this because of experience. It took me a long time to determine what my triggers were and how to remove them.  It also took me a while to accept that there were things I could to in order to support myself and my hair during this process. If it helps, you can read my story at

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Nov 01

Why Am I Shedding Short Hairs With Telogen Effluvium (TE)?

By: Ava Alderman?  I often hear from people who can’t help but examine the hairs that they are shedding when they believe that they have telogen effluvium (which is commonly referred to as TE.)  Not only do many people count the hairs, but many look very closely at the length and also at the ends to see if they have any bulbs or markings.  They often have questions about what they are saying. I heard from someone who said: “I’ve been noticing that lately, most of the hairs that I am shedding are very short.  Much have blunt ends.  Why could this be happening?  Does this mean the hair that I am regrowing can’t be maintained?”  I will try to answer these questions in the following article.

Shedding Short Hairs Can Mean That You’re Still Cycling Through Different Hair Cycles Of Growth And Regrowth: Many people assume that once their TE is ending or is over, they will just pick up with normal hair cycles and are able to resume their previously healthy hair schedule.  Unfortunately, this isn’t always the case.  Some people go through a few cycles until their hair growth cycles resume to “normal.”  What this means is that your hair is still shedding while you are also regrowing.  Your body or scalp doesn’t distinguish between long or shot hair.  It just continues to shed. And if you’ve gone through TE, you will often have a good deal of short hair growing in.

This doesn’t necessarily mean that your regrowth will never take hold.  Sometimes, it just takes a few more cycles. Or, the trigger that started the shedding in the first place needs to be eliminated.  Ask yourself where you are in the shedding.  Has it been only a few weeks?  A few months?  Shedding short hairs is more common in chronic telogen effluvium (shedding that lasts for six months or longer) because it takes a few months before you start to see regrowth and a few more for it to obtain some length.  So by the time you see short hairs falling out, more than a few months from the beginning of this process has likely passed. If it’s been more than several months, then it might be time to see if something else is at play.

The Possibility Of Continuing Triggers Or Androgenetic Alopecia: Sometimes, the shedding just continues to go on and you’ve seen several cycles of short hairs continuing to fall out.  At that point, if you’re still confident that you’re looking at telogen effluvium, you may want to look the possibility of continuing or multiple triggers.  Sometimes, what caused the original shedding is over but something else has triggered a new one.  Or, other times there is a continuing trigger like a medical issue or a medication that doesn’t agree with you.

The last thing to consider is that you might be looking at androgen driven loss.  It is possible for the loss to start off as telogen effluvium and then turn into something else like androgentic alopecia (which is often referred to AGA.)  It’s not unheard of for androgenetic alopecia to be thought to be telogen effluvium initially.  And, shedding short hairs with AGA is common because people with this condition have a hard time supporting healthy regrowth.  It can help to look at the quality of the shed hairs.  Are they miniaturized? (This means do they look thin and whisky, like peach fuzz.)

The good news is that either of these cases can be addressed by supporting healthy regrowth, minimizing inflammation, and addressing any androgens.  But to answer the question posed, it can be normal to shed short hairs with telogen effluvium.  But if the hairs are miniaturized or if this process goes on for too long, you might want to see if there is something else at play that can be addressed.

I panicked when I saw a bunch of short hairs coming out.  I assumed that this meant that I had androgenic alopecia. Looking back now, I still believe that I had chronic telogen effluvium. I suspect this because over time, the loss of short hairs improved dramatically. Once I addressed my triggers, I started seeing normal length hair growing in again. But, it was a long, hard, frustrating journey, especially in the beginning. If it helps, you can read the whole story on my blog at

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Oct 31

Drying Your Hair With Telogen Effluvium. Should You Use A Blow Dryer?

I sometimes hear from people who notice that they seem to shed more hair when they use a blow dryer while suffering from telogen effluvium.  Therefore, they can start to think that perhaps the blowdryer is a variable that is making things worse.  They might ask: “Is a blow dryer off limits when you have telogen effluvium?  I have been shedding for about 10 weeks.  I try to be very gentle when I wash and style my hair.  But if I blow dry my hair upside down, it makes my hair look more full.  It makes me look like I have more hair than I actually do.  At the same time, I also notice TONS of fallen hairs on the floor and around my feet after using the blow dryer.  So I feel like I am sacrificing hairs by using it.  Should I stop using the blow dryer when I’m shedding like this?”

If you had a normal hair cycle right now and were not shedding hair, I’d bet you probably wouldn’t even notice much from the blow dryer use (except for hair that might have been noticeably dryer.) However, when you are shedding hair, any additional manipulation can cause the hair that was already poised to fall out to go ahead and fall.  It can feel as if you are losing more hair.  But, hairs that were in the resting phase due to telogen effluvium would have fallen out eventually.   Another issue with blow dryers is that if used on high temperatures or excessively, they can cause some inflammation.   This can be important because inflammation and telogen effluvium are not a good combination, as the inflammation can be an additional trigger and cause more or prolonged shedding.

It was a personal decision, but I decided to ditch my blow dryer as much as possible when I was shedding hair.  I found that I had similar results when I would either allow my hair to dry in a very loose ponytail at the top of my head, or, if I was in a hurry, I would put it up in a towel.  This would give me the volume that I wanted without the additional inflammation and the drying effect of the blow dryer.  Telogen effluvium hair can already be pretty dry, so the additional drying and inflammation of the blow dryer was just not something that I needed.  Of course, there are times when you are in a hurry and you need dry hair in a short amount of time.  In that case, you might have to use the blow dryer, but I used it sparingly.  Although it might only nudge out the hairs that would have fallen out eventually anyway, I just didn’t want the additional inflammation with the potential for a new trigger and the psychological pain of seeing more hair come out than was necessary.  You can read more about what helped my psyche and my hair on my blog at

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