Telogen Effluvium From Stress: Sudden Hair Shedding in a 33-Year-Old Woman
Patient Presentation
A 33-year-old woman presented as a new patient to Reena Jogi, MD with concerns of sudden, generalized hair loss on the scalp. She described moderate hair shedding that began abruptly and had persisted for approximately one year, with the most excessive shedding occurring over the past six months.
The patient reported that her hair loss began following significant life stressors. She was not currently using any prescription hair loss treatments and noted a family history of hair loss affecting both her mother and father. Her primary concern was ongoing shedding and visible thinning despite no scalp symptoms.
Clinical Examination
A comprehensive dermatologic examination was performed, including detailed scalp and hair inspection, as well as examination of the face, eyelids, lips, nose, and neck. The patient appeared well developed, well nourished, and in no acute distress.
Scalp examination showed diffuse hair shedding without scarring, redness, or inflammation. A positive hair pull test confirmed active shedding of telogen hairs, supporting the diagnosis of telogen effluvium.
Diagnosis
Based on the clinical findings and history, the patient was diagnosed with:
Diffuse Non-Scarring Hair Shedding of the Scalp
Telogen effluvium is a reactive form of hair loss that commonly follows stress, illness, hormonal changes, or nutritional deficiencies and is one of the most frequent causes of sudden hair shedding in women.
Treatment Discussion and Plan
The diagnosis and common triggers of telogen effluvium were reviewed in detail. The patient was counseled that while telogen effluvium is often self-limited, prolonged or severe cases may benefit from medical therapy to reduce shedding and support regrowth.
Treatment options discussed included:
Spironolactone
Nutraceuticals such as Nutrafol or Xtresse
Low-level laser therapy
Platelet-rich plasma (PRP) therapy
After reviewing risks, benefits, and expectations, the patient elected to begin spironolactone therapy.
Spironolactone Counseling
The patient was prescribed spironolactone 50 mg twice daily and counseled extensively on medication safety.
Key counseling points included:
Possible side effects such as:
Breast tenderness
Menstrual irregularities
Fatigue or dizziness
Elevated potassium levels
Risks of birth defects, making the medication unsafe during pregnancy
Need for periodic blood work to monitor kidney function and potassium levels
The patient verbalized understanding of proper use and potential adverse effects. All questions and concerns were addressed.
Expectations and Follow-Up
The patient was counseled that:
Telogen effluvium is reversible once triggers are addressed
Hair shedding typically improves gradually over several months
Medical therapy can help shorten the shedding phase and support regrowth
Stress management and overall health optimization are important parts of recovery
She was advised to contact the office if shedding worsens or fails to improve and was scheduled for a follow-up visit in 3 months to assess response to treatment.
Expert Care for Telogen Effluvium in Katy & Houston, TX
At Reena Jogi, MD, we specialize in diagnosing and treating female hair loss, including stress-related telogen effluvium. Our approach focuses on identifying triggers, providing reassurance, and offering evidence-based treatments to support healthy hair regrowth.
If you are experiencing sudden hair shedding and are looking for a hair loss specialist in Katy or Houston, Texas, our team is here to help.
