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A 27 year Old Woman presents With Sudden Excessive Hair Loss

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A 27-year-old woman , a mother of 2 children and who is now 6 months postpartum complains of excessive hair loss.
The most likely diagnosis is
A) Alopecia areata
B) Telogen effluvium
C) Trichotillomania
D) Tinea capitis
E) Hypothyroidism

The answer is
B. (Telogen effluvium)

Discussion:
Telogen effluvium is sudden, diffuse hair loss that occurs 3 to 6 months after a stressful event.

The causes include:

  • medications (heparin, coumarin, propranolol, haloperidol, and lithium), 
  • neoplasms, 
  • infection, and 
  • crash diets. 

The stressful event triggers the hair follicles to go into a rest phase, and once the cycle returns a larger amount of hair is lost at one time. Typically, 30% to 50% of the scalp hair is affected.

No treatment is needed. Patients should be reassured that normal hair growth should resume.

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