Postpartum telogen effluvium

What it is

Telogen effluvium is a form of diffuse, nonscarring hair loss that appears as a transient or chronic loss of hair. It comes from an abnormal shift in follicular cycling that leads to premature shedding of hair, and there is no clinical or histological evidence of inflammation. The postpartum state is one of its physiologic forms.

Causes and risk

The causes are:

• Shedding of the newborn, which is physiologic.
• The postpartum state, which is physiologic.
• Chronic telogen effluvium, with no attributable cause or illness.
• Postfebrile, after extremely high fevers such as malaria.
• Severe infection.
• Severe chronic illness, such as HIV disease or systemic lupus erythematosus.
• Severe, prolonged psychological stress.
• Postsurgical, which implies a major surgical procedure.
• Hypothyroidism and other endocrinopathies, such as hyperparathyroidism and hyperthyroidism.
• Crash or liquid protein diets, starvation and malnutrition.
• Drugs: discontinuation of oral contraceptives, retinoids such as acitretin and isotretinoin and vitamin A excess, anticoagulants especially heparin, antithyroid drugs such as propylthiouracil and methimazole, anticonvulsants such as phenytoin, valproic acid and carbamazepine, interferon, heavy metals, and beta blockers such as propranolol.