A Canadian Algorithm on the Management of Telogen Effluvium

Telogen effluvium (TE) is a form of transient hair loss in response to a triggering factor. It is a type of nonscarring alopecia, characterized by a generalized hair loss distribution with thinning of the hair and no exposed patches. It is thought to be induced by numerous stressors that cause hair follicles to suddenly switch from the growing (anagen) phase to the resting (telogen) phase. Treatment of TE consists of identifying the triggers and correcting them. TE is very common and affects men and women, with women being more emotionally and psychologically affected by the hair loss and seeking help more often. In the Canadian context, with long waiting lists to see a dermatologist, TE patients are often left alone with their worry and helplessness. This paper consolidates the opinions and recommendations of top Canadian hair-expert dermatologists with regards to TE management. Specifically, this consortium of experts identified the gap in care in Canada when it comes to TE and proposed a unified method to assess and manage TE. Their recommendations include making the proper diagnosis of TE, finding the triggers, which may include ordering appropriate investigations to identify metabolic abnormalities and nutritional deficiencies, and potentially managing treatable triggers of TE. Educating patients on TE is a crucial part of the treatment. The experts also concluded it is beneficial to offer patients a topical product that is safe and accessible.