Managing Chronic Telogen Effluvium in a 40-Year-Old Woman
At our dermatology clinics in Houston and Katy, Texas, we frequently see women with diffuse hair shedding that worsens over time. This case of a 40-year-old female patient highlights the evaluation and management of chronic telogen effluvium (TE) and how modern treatments can help restore confidence.
Patient Presentation
The patient reported gradual, generalized hair loss over several years. She described the shedding as moderate in severity, with noticeable hair fall during daily activities. She had not tried any treatments prior to her visit.
On clinical exam, findings were consistent with chronic telogen effluvium, a non-scarring type of hair loss characterized by increased shedding and diffuse thinning.
Diagnostic Considerations
Telogen effluvium can be triggered or worsened by several factors, including:
Stress or illness
Iron deficiency
Thyroid disease
Hormonal imbalance
Medications
Because of its diffuse presentation, TE is sometimes mistaken for female pattern hair loss. A detailed history, examination, and monitoring help establish the diagnosis.
Treatment Counseling
We reviewed multiple treatment options for chronic telogen effluvium, including:
Spironolactone (for women)
Supplements such as Nutrafol
Low-level laser caps
After an extensive discussion, the patient elected to start oral minoxidil (2.5 mg daily) and spironolactone (50 mg twice daily).
Medication Counseling
Oral Minoxidil: Side effects may include increased heart rate, dizziness, shortness of breath, swelling of the ankles, or low blood pressure. She was advised that shedding may worsen temporarily in the first 8–10 weeks before improvement occurs.
Spironolactone: Risks include breast tenderness, menstrual irregularities, fatigue, and elevated potassium levels. It should not be used during pregnancy. Blood work may be needed to monitor liver and kidney function.
The patient expressed understanding and agreed to proceed. Baseline photos were taken for future comparison, and follow-up was scheduled in 6 months.
Takeaway for Patients in Houston & Katy
This case highlights how chronic telogen effluvium can significantly affect quality of life, but with the right treatment approach—including oral minoxidil and spironolactone—patients can achieve meaningful improvement.
At our dermatology clinics in Houston and Katy, Texas, we specialize in diagnosing and treating women’s hair loss, offering advanced therapies including PRP, Alma TED, low-level laser devices, and prescription medications tailored to each patient’s needs.
