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Last updated on April 2nd, 2002 by Karen Shelton

Introduction

Hair by Barbara Lhotan Makeup: Linzie Wilford

Tom Carson All Rights Reserved

Every time I see ads for "get thin fast" diets I am reminded of the serious damage that quick weight loss can impose upon unsuspecting hair follicles.

While juice fasts and other popular quick reduction diets may help shrink some into skinny jeans overnight, it can often cause luscious hair to shrink along with the fat.

It is unfortunate but many people are unaware of the dangers of quick weight loss and the stress that occurs to their strands. Craving chocolate in the middle of the night is only one side effect of crash dieting. Sudden and prolonged hair loss can hit unsuspected weight watchers before they can enjoy their svelte new shapes.

Sudden Hair Loss & Strict Diets

It is a proven scientific fact that a diet that weighs in at less than 1,200 calories a day can trigger sudden hair loss known as "Telogen effluvium".

Note: Telogen effluvium (TE) is not the same as Anagen effluvium (AE) with is sudden hair loss from chemotherapy or radiation treatments.

The body will often react to the physical stress of severely reduced calories or necessary nutrients by falling out in clumps. Diets that are especially low in protein are most suspect.

When the body is deprived of sufficient protein, through dieting or other abnormal food consumption, it will become malnourished. The human body is an amazing machine. When threat of survival is present, the body will shut down all production of hair. It does this as a means to devote all of its energies towards conserving vital body organs

Hair by Barbara Lhotan

Tom Carson All Rights Reserved

The body will save protein by shifting healthy hairs that are in a normal growth phase (anagen) into a sudden resting phase. Under healthy conditions about 85-90 percent of all hair is in the growing phase. Only 10 percent of hair is usually in a resting phase before it ultimately falls out after a few months as part of the standard hair growth cycle.

Telogen effluvium does ot usually cause bald patches but it does prematurely force a much larger percentage of scalp hair into a sudden resting phase. Hair that is forced into an early resting period will almost always react by thinning and falling out.

According to Teloptosis, a turning point in hair shed biorhythms, an abstract, published by the Department of Dermatopathology at the University of Liege, in Belgium (Pierard-Franchimont C, Pierard GE) "the timing regulation of the hair growth phases is quite complex.

Teloptosis is the termination of the telogen phase with hair shedding. The initiation of the next anagen phase is independent from teloptosis. Both events are triggered by distinct factors. Teloptosis is the result of the loss of adhesion between cells of the club hair and those of its epithelial envelope".

This document also points out that "teloptosis synchronization is perceived as telogen effluvium, related or not to shortening of the anagen phase. Subtle changes leading to early or delayed teloptosis affect hair density. It is possible to distinguish two types of telogen hairs on a trichogram. Those with an epithelial sheath indicate strong binding, suggesting early telogen, whereas the absence of an epithelial sheath indicates loose binding, conveying teloptosis."

Hair Loss Cycles During Crash Dieting

Hair by Barbara Lhotan

Tom Carson All Rights Reserved

Massive hair shedding may not happen immediately after a new fast or similar crash diet is started. In some cases there is a two to three month delay between the actual start of the diet and the actual beginning of hair loss.

Sometimes a person will have stopped crash dieting only to experience the sudden hair loss months later. This can cause confusion regarding the cause of the "sudden" hair loss.

The reality of the situation is that if you crash diet for two months and ultimately experience Telogen effluvium hair loss, your hair may not stop falling out until several weeks after you discontinue the dieting. The re-growth cycle for hair lost to TE can last anywhere from 6 to 12 months after the Telogen effluvium related hair loss subsides.

This means that the total hair loss and re-growth cycle can last 6 months, or possibly longer, when induced by physical stress of calorie deprivation.

The physical stress of extreme weight loss may increase the production of androgens, the male sex hormones that are destined to kill hair follicles. One the androgen production is increased and the hair follicles are destroyed no re-growth will occur.

Although most people will experience total hair re-growth, some people will not be so fortunate. Limited caloric diets and large weight fluctuations may trigger more permanent genetic hair loss conditions to appear earlier than normal.

Prolonged crash dieting by people who are genetically predetermined towards hair loss can result in hair that is lost forever.

Dermatologists & Tests For TE

Hair by Barbara Lhotan

Tom Carson All Rights Reserved

A good dermatologist or other hair loss specialist can make a proper diagnosis to determine what type of hair loss you have. Although some people assume that their sudden hair loss is TE, it might be some other hair loss condition that was coincidentally triggered because of a TE type of situation.

Some women after childbirth or during menopause will also experience TE. This is a temporary form of hair loss that is triggered by hormonal changes, but also by crash diets (loss of over two pounds a week) or prolonged emotional stress. If is determined that you have pattern hair loss, though, this is more difficult to treat. Rogaine may help this form of hair loss, but it may not.

Some hair loss physicians will recommend a thyroid and iron (serum ferritin) test to determine your current hair loss condition and possible cause. Other hair loss experts will be able to make a complete diagnosis with a complete history and simple examination. Laboratory testing may not be necessary is some cases since there are actually just a few common causes of hair loss which can be related to most cases by a true hair loss expert. Scalp biopsies are rarely necessary except in extreme cases.

Be prepared for your appointment. Read what you can about your suspected condition and take a notebook with your concerns and questions listed. Ask questions about what may have caused the condition and ask how you can best treat your loss. As a rule doctors usually give you more attention if they feel you are knowledgeable.

Women Are At Most Risk

Although both women and men are susceptible to Telogen effluvium, dermatologists and other hair specialists report that women have a higher risk of experiencing the condition from prolonged crash dieting.

Some prescription drugs such as Meridia and Xenical used in weight loss programs may also cause temporary hair shedding in some users. Many of the Vitamin A related drugs such as Retinol can impact hair loss when applied topically. Some of the more popular antidepressant drugs are also suspected of to causing TE related hair loss. Other drugs suspected of causing hair loss include some blood thinners like Comarin and Heprin as well as some of the cholesterol drugs such as Clofibrate.

Besides crash dieting, women will often experience Telogen effluvium immediately after giving birth, during times of chronic emotional or physical stress, and from hormonal swings. TE hair loss has also been reported by women approximately 3-4 months after terminating a pregnancy.

Studies have shown that women taking oral contraceptives for many years have some risk of developing the sudden hair loss condition.

Other causes of TE may include:

  • Diabetes
  • Lupus
  • Thyroid Malfunction
  • Anaemia

People suffering from eating disorders such as bulimia and anorexia are also prone to experience sudden hair loss at some point during the disease.

Permanent Or Temporary Hair Loss?

Although there are various professional opinions about TE and its ultimate impact, dermatologist and other hair experts generally agree that for the majority of people that experience the condition, the hair loss is not permanent.

According to Hair loss: An Overview ("hair loss can be categorized as hair shaft abnormalities, permanent alopecia, or nonpermanent alopecia. Nonpermanent alopecia, the most common type, includes androgenetic alopecia, telogen effluvium, alopecia areata and traction alopecia. The hallmark of this group is the possiblity of complete regrowth with adequate treatment." Dermatol Nurs 2002, Aug: 13(4): 269-72, 277-8, Mulinari-Grenner F, Bergfeld WF. Departments of Dermatology and Pathology, Cleveland Clinic Foundation, Cleveland, OH, USA).

In general Telogen Effluvium will stop approximately four to fourteen weeks after the cause of the condition is resolved.

There are exceptions to every rule and some people have reported TE related loss and re-growth lasting for up to one year. Other TE victims have even experienced chronic Telogen effluvium (CTE). In the case of chronic TE the hair re-growth may be interrupted by more periods of sudden shedding.

There have been cases reported where TE was triggered, went into remission and continued to start again over a multiple year period. Everyone is different and will experience TE in their own unique way.

According to Shedding: how to manage a common cause of hair loss "Although telogen effluvium, or shedding-the most common type of diffuse hair loss in both women and men-is usually self-limiting, the condition may become chronic if the trigger is not identified and corrected". Bergfeld WF, Mulinari-Brenner F.

Sprironolactone

Some dermatologists that specialize in hair loss may prescribe Spironolactone (brand name Aldactone) or "Spiro" to help with Telogen effluvium conditions. Spiro is an anti-androgen which blocks the androgens from the hair follicle. There have been reports of interrupted TE related hair loss as a result of taking Spironolactone

Ironically Spironolactone is not FDA approved for hair loss and is approved as an prescribed aide to lower blood pressure. Some patients discovered that the drug will actually stop the TE shedding and will help to speed hair growth. Even more encouraging is the fact that Spiro does not seem to cause hair loss when the drug is discontinued.

Check out the book, The Good News About Women's Hormone's by Geoffrey Redmond which covers the Spiro drug and its pros and cons.

Not everyone can handle Spiro and some will experience a worsening of their hair loss condition. Only a dermatologist or other hair loss specialist can decide whether a patient is a good candidate for the spiro.

No one should ever consider taking Spironolactone without the specific advice of their dermatologist of physician.

Head For The Rogaine

The Dermatology Association of America officially recommends that "rogaine 5% (the Upjohn brand of minoxidil) should be used in cases of chronic telogen effluvium". Not everyone agrees with this recommendation for a number of reasons. Some hair loss specialists have concerns about a 5% formulation of rogaine. The concern is that the 5% formula may cause ultimate long term systemic problems for the body. Some experts are concerned because there has not been enough long term history to really know what happens when a high dose of rogaine is used for more than short periods of time.

Do you have to take rogaine forever once you start? There is a lot of disagreement about this topic but many experts believe that using rogaine for 6-12 months will help to resolve chronic TE and allow normal hair growth resumption.

The manufacturer of rogaine disagrees. In some literature Upjohn suggests that rogaine must be taken for life once the treatment is started. While this may be true for some hair loss conditions, this not seem to be the case for most people with TE.

There are other known problems with Rogaine. Some people report that it can cause anything from mild to extreme itchiness. It can also be messy and cause surrounding hair to appear greasy.

Prevention Is The Best Medicine

Although controversial, some weight loss specialists believe that taking special nutritional supplements and hair vitamins during a weight loss program will prevent the hair loss that can be associated with dieting.

While this may be the case with a slow weight reduction program, nutritional supplements and vitamins can't and won't completely stop hair loss that is tied to rapid and massive weight loss.

Alternative Treatment Options

Although many people suffering from TE will work with a dermatologist or other licensed hair loss professional to halt the hair loss, others have found some measure of success with alternative treatments.

Aromatherapy, acupuncture and acupressure have been proven to work for some. Herbal formulas and essential oil massage treatments enjoy a measure of success. While many of the treatments will work for a large majority of TE sufferers, not all treatments will necessarily work for everyone. Do your homework before you select alternative treatment methods and talk to others with similar TE hair loss issues to get their experiences.

There are several excellent message boards on the Net that cater specifically to TE. Check out Tom Hagerty's Hair Loss site and TE related messageboards to help in your decision making process.

Some alternative products include the following:

Phytotherathrie PhytoCyane Treatment. This is a revitalizing treatment that addresses female temporary hair loss from dieting, pregnancy, stress, hormonal imbalances.

The treatment includes grape seed extract & gingko biloba to protect & revitalize hair. Clinical efficacy testing showed 83% positive results. Delays gray hair onset.

Summary

Telogen effluvium can be prevented by consuming the proper amount of protein and calories during a reducing diet. If you love your hair it is important to avoid any diets that cause you to lose more than 1 or 2 pounds per week or consider the fact that you may have to buy a new wig to go with your skinny new jeans.

If you want to talk more about this or other hair care articles on HairBoutique.com or anywhere else, please post a message on HairBoutique.com's Hair Talk Forums.

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