Managing Hair Loss After Relocation: A Case of Telogen Effluvium in a 47-Year-Old Woman
Hair loss can be triggered by a variety of factors—from genetics and hormones to stress and environmental changes. For one 47-year-old woman, a recent international move contributed to a noticeable increase in shedding. She visited Dr. Reena Jogi, board-certified dermatologist and hair loss specialist in Houston and Katy, Texas, to continue care for female pattern hair loss and evaluate her new hair shedding pattern.
Case Overview
The patient had been under dermatologic care in Singapore since 2022 for female pattern hair loss managed with oral minoxidil, spironolactone, and Diane-35 oral contraceptive. After relocating to the United States in August, she began experiencing diffuse shedding that started two weeks post-move and persisted for several months.
The patient reported that her hair thinning initially began after the COVID-19 lockdown and that she had gradually regained thickness with treatment. However, the recent relocation appeared to retrigger telogen effluvium (TE) — a temporary hair shedding condition often caused by stress or environmental changes.
Examination and Diagnosis
During examination with a dermatoscope, Dr. Jogi observed diffuse hair shedding and a positive hair-pull test for telogen hairs, consistent with telogen effluvium. No signs of scarring alopecia or inflammation were noted. The patient’s presentation suggested reactive shedding overlying chronic female pattern hair loss (androgenetic alopecia).
Treatment Plan and Management
Dr. Jogi emphasized a comprehensive, individualized approach focusing on both stabilizing the shedding and maintaining long-term regrowth.
1. Continue Current Medications
Oral Minoxidil 2.5 mg daily – Continue the current dose to maintain results and avoid abrupt withdrawal, which can increase shedding.
Spironolactone 75 mg daily – Continue as prescribed, with regular potassium monitoring due to potential effects on electrolyte balance.
Transition from Diane-35 to Yaz – Patient to consult a local OB-GYN for ongoing contraceptive management and transition support.
2. Supportive Care Recommendations
Explore water softener installation – Hard water can contribute to scalp dryness and hair breakage.
Nutrafol or Viviscal supplements – For additional follicle nourishment and reduction in shedding.
Low-Level Laser Therapy (LLLT) – To boost scalp circulation and promote regrowth.
PRP or Alma TED procedures – Discussed as elective options for enhanced density (cosmetic, not insurance-covered).
3. Counseling and Education
Dr. Jogi explained that telogen effluvium is typically self-limited, resolving once the underlying trigger (in this case, stress and relocation) stabilizes. Continued use of minoxidil and spironolactone will help sustain follicle activity and minimize future thinning.
She also reviewed potential side effects for all medications, including:
Oral Minoxidil – risk of leg swelling, low blood pressure, dizziness, or unwanted hair growth
Spironolactone – possible electrolyte imbalance and need for periodic lab monitoring
Oral Contraceptives (Yaz) – potential vascular risks, hormonal changes, and mood fluctuations
Follow-Up and Ongoing Care
Dr. Jogi advised the patient to:
Continue current therapy and avoid dose changes until stability is achieved.
Forward her prior treatment letter from Singapore to ensure seamless transition of care.
Schedule annual dermatology visits for hair health monitoring and medication management.
The patient expressed relief and understanding of her diagnosis and was reassured that shedding related to TE is temporary with continued adherence to her regimen.
Expert Hair Loss Care in Katy and Houston, Texas
Dr. Reena Jogi specializes in advanced hair loss management, including telogen effluvium, androgenetic alopecia, and hormonal hair loss. At Village Dermatology in Katy and Houston, Texas, Dr. Jogi offers comprehensive treatment plans combining medical therapies, nutrition, and in-office procedures like PRP and Alma TED to help restore healthier, fuller hair.
If you’ve recently noticed increased shedding after stress, travel, or life changes, contact Dr. Jogi to create a personalized plan for long-term scalp health.
