L-19   TELOGEN EFFLUVIUM: THE CLINICAL IMPLICATIONS

DH Rushton, MJ Morris School of Pharmacy & Biomedical Sciences, University of Portsmouth, Portsmouth, Hants, UK.

Telogen effluvium (TE) is a significant problem in dermatology and while females are more likely to complain of increased hair shedding, males also present with TE. Although TE is not normally associated with any serious underlying medical condition, in those that it affects it can cause a great deal of anxiety and distress. Diagnosing TE may appear a simple task but in reality it is not. Frequently patients with TE (or TE lasting six months or more:- chronic telogen effluvium, CTE) have no obvious sign of hair loss. This causes problems for many physicians and even family members often express some disbelief of them having hair loss. Thus sufferers may feel guilty for wasting the physician's time or for affecting family life. Left only to self-help, the Internet, and lay press they desperately seek advice. They may adopt different hair care habits resulting in a perceived increase in hair shedding. In some a scaling problem develops, further complicating their condition. Hair density, diameter, and the anagen/telogen % characterise the physical changes occurring in hair disturbances. In primary TE there is only a relative increase in the number of hairs in the telogen phase. Parting width is unaffected even after many years of persistent increased shedding. Complications occur when TE or CTE is a secondary aspect and in particular, where a decrease in hair density has occurred due to a delay in the initiation of the new anagen phase. This situation increases the measured telogen % though there may be no true increase in the number of hairs entering the telogen phase. In the initial active phase of androgenetic alopecia TE can be a significant feature, which affects both men and women and it may persist for six months or more (CTE) before changes in hair density occur. Consequently some clinicians feel (wrongly) that CTE is the first stage of androgenetic alopecia and thus advocate unnecessary therapy: A balance needs to be struck. TE / CTE can be a feature of androgenic alopecia, or a separate entity and an accurate diagnosis is critical to considering therapy. This presentation is aimed at clinicians who have difficulty evaluating TE / CTE and how they can address the clinical implications of TE.