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Chronogenic effluvium

Hair is a visible reflection of internal health. When physiological balance is disturbed, one of the most common signs is diffuse hair loss, often linked to telogen effluvium, a disruption in the hair growth cycle. When this condition lasts longer than usual, it becomes chronic telogen effluvium.

This type of non-scarring alopecia can cause significant concern among individuals experiencing persistent hair shedding over months or even years. Understanding its causes, progression and treatment options is crucial for improving quality of life and supporting hair regrowth.

What is chronic telogen effluvium?

Chronic telogen effluvium (CTE) is a condition where a large number of hair follicles prematurely enter the telogen (resting) phase, resulting in diffuse hair loss across the scalp.

Unlike acute telogen effluvium, which lasts 2 to 4 months and often resolves spontaneously, chronic TE lasts more than 6 months, often occurring in cycles of shedding and partial regrowth.

It doesn’t lead to bald patches, but causes thinning and reduced hair volume, often with emotional distress.

Who is affected by chronic telogen effluvium?

CTE can affect anyone, but it is more common in women aged 30 to 60. It is frequently observed in those with iron deficiency anemia, thyroid disorders, polycystic ovary syndrome (PCOS), and following intense stress or hormonal changes such as postpartum or stopping oral contraceptives.

Common triggers include:

  • Chronic physical or emotional stress
  • Restrictive diets or nutritional deficiencies
  • Autoimmune or infectious diseases
  • Major surgeries or trauma
  • Long-term use of medications like retinoids, antidepressants, or blood thinners

How long does chronic telogen effluvium last?

The duration of CTE varies. Some people experience recurrent shedding episodes lasting months or even years, with alternating phases of improvement and relapse.

Without proper treatment, shedding can continue and lead to significant thinning over time.

A frequent question is: Can chronic telogen effluvium be cured?
Yes—chronic telogen effluvium is reversible in most cases. It is not scarring, which means the follicles are inactive, not destroyed. With the right approach, hair regrowth is achievable.

How to treat chronic telogen effluvium

Treatment must be personalized. A multidisciplinary approach involving dermatology, internal medicine and nutrition is often the most effective.

1. Diagnosis and lab tests

  • Blood tests: iron, ferritin, zinc, vitamin D and B12, TSH, sex hormones
  • Digital trichoscopy to assess follicle health
  • Comprehensive patient history

2. Nutritional supplementation

  • Iron (especially if ferritin < 70 ng/mL)
  • Vitamin D
  • Biotin and B-complex vitamins
  • Zinc and antioxidants
  • Sulfur-rich amino acids like cystine

3. Stress management

  • Cognitive therapy or mindfulness
  • Regular exercise
  • Improved sleep quality

4. Topical or medical treatments

  • Topical minoxidil
  • Platelet-Rich Plasma (PRP) therapy
  • Hair mesotherapy
  • Systemic antioxidants

If CTE is combined with androgenetic alopecia, treatments such as finasteride or dutasteride may be considered under medical supervision.

In summary: chronic telogen effluvium can be reversed with early diagnosis, customized treatment and ongoing care. Hair loss is not permanent in most cases, and recovery is possible with the right strategy.