Hair loss: post pregnancy & trauma

We are asked a lot about how to manage postpartum and post-trauma hair loss and have included Prof Caitriona Ryan’s recommendations below:

‘Excessive shedding of hair is extremely common in new mums in the postpartum period. This is known as telogen effluvium, a form of temporary hair loss that usually happens after a stress or shock to the body. Normally, about 85% to 90% of scalp hairs are actively growing (the anagen phase) and the others are resting (the telogen phase).
Typically, a hair is in the anagen phase for 2-4 years, before resting in the telogen phase for 2-4 months. A new anagen hair begins to grow under the resting telogen hair and pushes the old telogen hair out. The average person naturally loses about 100 hairs a day. After physical or psychological stress to the system, as many as 70% of the anagen hairs can be forced into the telogen phase, thus reversing the usual ratio, with a loss of 300 or more hairs a day.

Triggers include:

◽️Childbirth: postpartum hair loss.
◽️Acute or chronic illness, especially if there is a high fever or severe infection
◽️Surgical operations
◽️Physical trauma or accidents
◽️Psychological stress
◽️Weight loss, extreme changes in diet, or nutritional deficiencies (eg iron, zinc or vitamin D deficiency)
◽️Certain medications
◽️Thyroid disorders
◽️Discontinuing the contraceptive pill
◽️Overseas travel resulting in jetlag
◽️Skin disease affecting the scalp
Because hairs that enter the telogen phase rest for two to four months before falling out, the shedding and hair loss typically doesn’t start until two to four months after the event that caused the problem.
Telogen effluvium rarely lasts longer than six months, although some cases last longer. Although the very significant hair loss can be very alarming to patients, the condition is usually temporary. Each hair that is pushed prematurely into the telogen phase is replaced by a new, growing hair, so baldness will not occur.
Because the hair on the scalp grows slowly, the hair may look thinner than usual for six to nine months. A fine fringe of new baby hair is often evident along the forehead hairline.

No treatment for active telogen effluvium has been proven effective but the condition is self-correcting. Recommendations include:
◽️Gentle handling of the hair, avoiding over-vigorous brushing
◽️Treating any underlying skin or medical conditions
◽️Correcting any nutritional deficiencies and ensuring a nutritious balanced diet, with plenty of protein, fruit and vegetables.
◽️In cases where hair growth has not returned to a satisfactory level, your GP or dermatologist may recommend minoxidil, a lotion/foam which is applied to the scalp and may stimulate hair growth in patients with chronic telogen effluvium.