Acute Telogen Effluvium After Pregnancy - Postpartum Hair Loss

The human hair cycle allows every hair on the head to be entirely replaced after every 3 to 5 years. It involves the hair follicles undergoing three distinct stages: the growth phase, apoptosis-driven regression phase, and the quiescent phase. These may also be referred to as the Anagen, Catagen, and Telogen phases in medical terms. While the anagen phase lasts 2 to 6 years, the catagen phase lasts 2 to 3 weeks, and the telogen phase lasts almost three months. The duration of these phases may change during pregnancy, where most hair follicles remain in the anagen phase throughout the pregnancy; however, after the baby's delivery, a majority of the females report hair loss due to t the hormonal changes in the body may undergo. This hair loss is often referred to as Telogen Effluvium. (1)

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Dr. Reena Jogi is a dermatologist who specializes in PRP Hair Restoration in Houston, Texas.


What is Telogen Effluvium?

Telogen Effluvium is defined as a form of hair loss that occurs in a diffuse pattern. This hair loss usually occurs after three months of an event being triggered and has the ability to limit itself in time. Some of the stress-promoting states that may trigger the acute telogen effluvium are fever, mental stress, a major surgery, or alterations in the levels of estrogen hormones, as seen in pregnancy. (2)

The patients who experience hair loss after pregnancy are known to be suffering from postpartum Telogen Effluvium. These females report that their hair started falling out suddenly after a few months after they delivered the baby. Not experienced by all females after delivery, but a good fraction is estimated to be affected by it. This was further studied in Lynfield's study, who investigated the association between Telogen Effluvium and pregnancy by conducting a Trichogram of the temporal scalp. (3

Another similar study conducted in 2013 also investigated this by using a more advanced tool known as the Trichoscan. (4) The results of both the study proved the association between pregnancy and telogen effluvium. The hair of women in both studies was found to fall in high numbers after they delivered the baby.

What Causes Telogen Effluvium?

The main cause of Telogen Effluvium after pregnancy is the drastic changes in hormone levels in the body. While pregnant females using has a peak of HCG at two months of pregnancy, they also experience an eight times increase in estrogen and nine times increase in progesterone. (5)

However, these levels change when the placenta gets detached from the body after delivery. The levels of estrogen and progesterone are seen to return to normal within 2 to 4 days after this. While there is a reduction in estrogen and progesterone, the female may also experience a 20 times increase in Prolactin, which promote milk formation for the baby. (6) Hence, the variation in different hormones during pregnancy ultimately leads to Acute Telogen Effluvium in postpartum females.

Do All Women Undergo Postpartum Hair Loss?

While it is a common condition affecting postpartum women, not all women may experience it after they deliver the baby. For example, a study conducted on 25 pregnant females showed only four experienced hair loss after they delivered the baby. (4) The examination done using a Trichogram showed 7 women with an increased telogen or quiescent phase, while a reduced anagen or growth phase was observed. Hence the study concluded by stating the role of changes in pregnancy on the cell cycles of the females, which may present as postpartum hair loss.

Another study showed differences in the clinical presentation and hair cycle of four months postpartum females. (3 The main differences that were reported in the study were an anagen phase rate of 78.47 at four months postpartum. This was lower compared to its rate during other periods, which were found to be 81.43 approximately.

Management of Postpartum Hair loss

Many remedies and management options have been introduced for postpartum hair loss; however, not many options are available for the prevention of this hair loss in the first place. The methods recommended to minimize the hair loss experienced after delivering a baby include skipping hair styling, eating healthy, taking vitamins, and using volumizing shampoos.

Avoid Styling of Hair

Consuming A Healthy Diet

Consuming a diet that is high in proportion of fruits, vegetables, and proteins is highly recommended for postpartum women. This is because these food sources help boorish the body and prevent any deficiencies, which can lead to even more hair loss. The particular foods which are recommended to be consumed in the highest proportion include green leafy vegetables as they are a rich source of vitamin c and iron, carrots, and sweet potatoes as they are a rich source of beta carotene, eggs as they are a rich source of vitamin d and fish because it contains high levels of omega-three fatty acids and Magnesium.

Taking Vitamin Supplements

After consulting with a doctor, taking supplements rich in important vitamins for the body is another way proposed to help manage hair loss after pregnancy. While no particular vitamin can help prevent hair loss directly, it can help maintain the body's overall health and keep the female well nourished. This can indirectly read to the improvement of hair health as well. Females are often asked to continue their prenatal vitamins after they give birth to the baby, specialty if they are breastfeeding.

The Bottom Line

In most cases, hair loss after pregnancy, also known as Telogen Effluvium, is normal and is a condition that resolves on its own. However, if the hair fall is beyond normal levels where clumps of hair fall every time the hair is brushed, it may be necessary o consult with a dermatologist.

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