The most simple and straightforward way to find out if you have Telogen Effluvium is to conduct a hair pull test. This test will help you to determine if a majority of your hair follicles are in their telogen phase and if you are shedding more hair than usual. This is generally the most effective way in which Telogen Effluvium can be self diagnosed.
Below are the detailed step-by-step instructions to conducted a hair pull test in order to properly diagnose a period of Telogen Effluvium.
Step 1: Make sure that you wash your hair on a daily basis for at least 1 week prior to conducting the hair pull test. Irregular washing may result in an inaccurate diagnosis, as it may cause more telogen hair follicles to remain on your scalp or more hair follicles to loosen when they are pulled.
Step 2: Using your thumb and middle finger, pinch a group of hairs anywhere on your scalp. You should grab around 30-35 hairs per pinch. Once you have done this, give your hair a sharp pull.
Step 3: Repeat the above step 15 times in various locations throughout your scalp.
Usually, in normal conditions, you will manage to pull out anywhere between 1 to 3 hairs with each pull. This is due to the fact that around 10% of those hairs are in TELOGEN phase. Therefore, these hairs are easier to dislodge compared to ANAGEN hairs. However, if you manage to pull out more than 4 to 5 hairs, it may indicate that you have are experiencing a period of TE.
It’s also recommended that you examine your scalp thoroughly in conjunction with the hair pull test when diagnosing Telogen Effluvium, as well as reviewing your recent history. Here are a few other ways to determine whether or not you may have Telogen Effluvium:
Have you experienced any traumatic events? Review your recent life events. Go over what has occurred within the last 6 months or so, and try to recall if there have been any possibly traumatic events that have taken place. Generally, stress or a traumatic incident can trigger TE. (The triggers for TE will be discussed in length later on in the book.)
What does your shedding look like? Carefully examine your scalp. TE typically does not exhibit a specific pattern of hair loss, as pattern baldness does. Instead, you will notice that your entire scalp region is showing signs of diffuse thinning.
What do your shed hairs look like? You will also notice that the hair follicles which you have shed are typically telogen hairs. Telogen hairs are characterized by a small bulb of keratin on the root end. Whether the keratinized lump is pigmented or unpigmented makes no difference whatsoever; the hair fibers are still typical telogen hairs. (see image below)
What does your scalp look like? Scalps of those that suffer from TE are usually normal in appearance, with no visible inflammation. In general, TE affects only the hair follicles themselves. Therefore, there should not be any scarring or widespread alopecia. Instead, scalps that exhibit TE symptoms will sometimes have areas which are covered in short, new hairs.
If your hair pull test is negative for TE, but you doubt the diagnosis, then you may want to try what is known as a “daily hair count”. To do this, simply comb your hair first thing in the morning and count the amount of hairs that are shed. You will repeat this over a 14 day period, and monitor the number of hair follicles that are present each morning. Hair counts that are greater than 100 are considered to be abnormal. However, if you carry out the count after shampooing, you can expect numbers reaching 250 or thereabouts.
Other methods of diagnosing Telogen Effluvium. In some cases a scalp biopsy may help to diagnose cases of Telogen Effluvium. However, it is rarely a necessary step in the detection process, as you should be able to diagnose a phase of TE based upon a simple hair pull test and a closer look at recent personal events. Therefore, a scalp biopsy is typically just a way to confirm a diagnosis, rather than a valid diagnosis method. In addition, lab testing will typically reveal very little about whether or not you do, indeed, have Telogen Effluvium.
Determining whether you have acute or chronic TE. It’s also important to determine whether you have chronic TE or acute TE. While acute Telogen Effluvium usually only lasts for a short duration, be it a few days to a few months, chronic TE can last for several years. Here is a brief explanation of the two types of TE, so that you are able to better understand which type of Telogen Effluvium you are potentially suffering from:
Acute Telogen Effluvium. Acute TE is usually brought on suddenly by a change within your life, and usually one that is either extremely traumatic or stressful. As mentioned before, it will only last for a short while, and recovery should occur within months of the onset of the Telogen Effluvium. Examples of life events which can trigger acute TE include: childbirth, short term illnesses and sudden mental stress. As a general rule, the length of your TE will depend greatly upon the shock that you suffered or the severity of the trauma that the life event brought about.
Chronic Telogen Effluvium. Unlike Acute TE, this type of Telogen Effluvium may carry on for years in patterns which fluctuate. Chronic Telogen Effluvium is a long term condition. Instead of sudden loss of hair, you might experience gradual diffusing of your hair over a period of years. Other key differences include: severe hair loss in the early stages that may lead to large clumps of hair being dislodge when brushing or pulling the hair, associated hair and scalp pain, as well as no particular trigger for the onset of Chronic TE. It’s important to note that the hair and scalp pain that may occur in chronic TE sufferers is thought to be more of an emotional side effect of the condition rather than a physical one.
Chronic TE typically occurs when you are undergoing prolonged stress, shock or suffering from iron deficiency. If you don’t get your triggers under control your acute TE can very well develop into Chronic TE. It should also be stressed that, in some instances, the cause for chronic TE does not have to necessarily be a traumatic event or one which involves an extraordinary amount of stress. In fact, some chronic TE sufferers are unable to identify the main trigger for the onset.
While telogen effluvium can be quite perturbing, the hair follicles are not unchanged indefinitely. Once you correct the original trigger your hair growth cycle will resume back to normal. The time it takes for the hair follicles to resume their normal healthy hair cycle, however, varies from person-to-person. The Daily and Nightly TE scalp tonic were both formulated specifically for Telogen Effluvium sufferers to accerate the hair growth process by stimulating and nourishing the hair follicles.