What Does Telogen Effluvium (TE) Hair Loss Look Like? I’ll Tell You

Over the weekend, I received an email from a woman who asked me “what, exactly, does TE or telogen effluvium look like?”  I wrote back and asked her for a bit of clarification, but she meant what I thought and assumed that she had meant.  Basically, she wanted to know what the hair of a person with TE will look like and if there is any pattern or appearance to the hair or scalp that would indicate that the shedding or hair loss is due to TE rather than something else.  I will discuss these things in the following article.

How Does Hair That Is Shedding Due To Telogen Effluvium Look?: Sometimes, there are changes in hair texture before the shedding actually starts.  That’s because the effected hair moves into the resting stage and these strands are no longer deeply embedded in the scalp or being properly nourished.  So, the result is flyaway or unruly hair that doesn’t quite lay down flat.

Once the shedding actually starts, you may not notice any changes of volume or any thinning spots at first.  Most people begin with much more hair than they think, so it takes a certain period of shedding before the changes are noticeable to others.  You may see spent or falling hair sort of hanging down at the ends and friends, coworkers, or complete strangers will pluck hair from your clothing (which can be quite embarrassing.) You may also see that your scalp is pink or red because so many follicles are being affected at once. 

After a while, you might start to see some thinning in areas that aren’t quite as thick to begin with like the bangs, temples, or crown.  Now, some people will panic and think that they have AGA or androgenic alopecia, but this isn’t always the case.  Often those areas have less hair to begin with so they are going to thin out more quickly than other areas.  However, generally speaking (although there are very commonly exceptions,) people will TE will generally have overall or diffuse shedding and loss, while people with genetic loss will have patterned loss that is mostly limited to the top, temples, and crown.

Over time, it can be harder and harder to tell the difference between TE and AGA just by looking at the hair and scalp.  Because prolonged shedding is going to thin out your hair even if you’re regrowing quite steadily.  Now, with telogen effluvium, the quality and quantity of your regrowth should not be adversely affected, unless you have some inflammation issues.  So, the regrowth that you do have should be relatively healthy and thick.  However, because something is making your hair continue to cycle through the resting phase, your regrowth may not have the impact that you might have hoped because the growth just can not keep up with the loss.

What’s The Deal With The White Bulb? Does The White Bulb Mean That I Definitely Have Telogen Effluvium?: I’m asked the question so often. People really want the reassurance that this shedding might one day stop, so they are very hopeful that the white bulb on the end of the hair is indicative of temporary shedding. The truth is though, that almost all forms of hair loss have the white bulb.  The exception is if you actually pull your hair from your scalp. 

But, hair that has reached the end of it’s life cycle will fall out on it’s on and that bulb is just where it’s not embedded and nourished anymore.  If you pull out one of your hairs right now, you will see a brown sheath around the end. This is still a healthy and growing hair and that’s the difference.  That hair did not meet a natural end.  But, your hair doesn’t know why it is being forced into the resting phase.  It just knows that it’s in this phase and it responds accordingly.

Now, if the bulb is sort of yellow and is large, that well may be sebum build up which, depending on how often you wash your hair, may be indicative of androgens adversely affecting and clogging your hair and scalp. It’s pretty easy to tell the difference though because the sebum build up looks more like a plug and is much larger than the white end that most of us see.