How do I know if my telogen effluvium is getting better?

Telogen effluvium (TE) is a common form of hair loss caused by stress, illness, or other triggers that push more hairs than normal into the shedding phase of the hair growth cycle. If you have telogen effluvium, you may be eagerly waiting for signs that your hair loss is slowing down and new growth is starting to come in. Here are some tips for how to tell if your TE is getting better.

Look for decreased shedding

One of the first signs that your TE is improving will likely be a reduction in the amount of hairs you are shedding. At the peak of TE-related hair loss, you may have noticed large amounts of hair coming out during brushing, washing, or just running your hands through your hair. As your hair starts to recover, you should notice less hair falling out day to day. Keep in mind that some shedding is totally normal – most people lose 50-100 hairs per day. It’s the excessive shedding over 100 hairs per day that indicates a problem. So if you are shedding less than that, it’s a good sign.

Count your shed hairs

To get a more objective view of whether your shedding is decreasing, try counting the hairs you lose during a typical wash and styling session. For example:

  • Before you wash your hair, place a clean towel on the floor in front of you.
  • When you get out of the shower, bend over and shake your head back and forth over the towel to shed any loose hairs.
  • Count the number of hairs on the towel – make sure to only count the ones that are around 6 inches or longer, as shorter ones likely broke mid-shaft rather than shedding.
  • Record the number each time you wash your hair.

If you count for a few weeks or months and notice the number going down, that’s a sign the TE is improving.

Notice decreased hair density

As TE progresses, you may notice less overall hair density or thin spots starting to show in areas like your part line, temples, or crown. This is because TE causes more hairs than normal to temporarily go dormant and fall out in a short period of time. As new hair starts to grow back in, you should start to notice some improvement in density and thickness of those thin areas. It can help to take periodic photos of your hair part or thinning spots to compare over time. Any areas that look fuller over the course of a few months are likely areas of regrowth.

Look for new baby hairs along the hairline and temples

One of the most telling signs that TE is reversing is the appearance of short, fine new hairs growing back along your hairline, temples, and crown. These “baby hairs” are new hair follicles starting their growth cycle again after shedding. Seeing these sprouts indicates that your hair follicles are recovering and your TE is starting to improve. You may first notice these baby hairs 1-3 months after the trigger that caused your TE in the first place.

What do new growth hairs look like?

New hairs from TE regrowth will exhibit these features:

  • Very short – ranging from 1/4 inch to 2 inches long
  • Thinner diameter than the original hair
  • Light color – may be hard to see depending on your natural hair color
  • Fine, downy texture – soft vs. wiry
  • New hairline hairs may stick straight out or up vs. lying flat

Be patient for significant new growth

Don’t expect to see a huge difference right away. On average it takes at least 3-4 months for the new hairs to grow out to a visible length. But any sign of baby hairs emerging means recovery is underway. Over time the hairs will increase in length, thickness and pigment until they eventually blend in with the rest of your hair.

Notice if your hair part is filling in

Some people with TE notice a widened hair part or thinning along their part line, where more scalp becomes visible. As recovery progresses and shedding slows down, you may notice the part looking less wide and full. New baby hairs will emerge along the part and gradually fill it in with new growth.

It can be helpful to monitor your part width over time. After a few months, pull your hair back and use a ruler or measuring tape to measure your part at its widest point. Compare it monthly. Any decrease in width is a positive sign.

Before and after photos

You can also track progress by taking close-up photos of your part each month, using the same lighting and angle each time. That will allow you to directly compare photos over time and visualize any areas of improvement.

Look for decreased miniaturization

Telogen effluvium sometimes occurs alongside androgenic alopecia, a hereditary hair loss condition also called male or female pattern baldness. If this is the case, you may notice that the new growth is not only smaller diameter but also more “miniaturized.”

Miniaturization means the emerging hairs are becoming progressively thinner and finer over time. This results in less scalp coverage because the miniaturized hairs have lost density and fullness.

But if your TE is recovering and miniaturization slowing down, you should notice the following signs of improvement over several months:

  • New growth hairs are less miniaturized – thicker diameter
  • Overall scalp coverage is increasing
  • You need less concealer powder or fiber to cover scalp

This indicates the hair follicles are getting stronger and producing better quality hairs again.

Notice reduced hair fall out when styling

As your TE improves, you should notice significantly less hair falling out when you wash, brush, comb or style your hair. Here are some specific things to look for:

Less hair left in your brush and comb

During active TE shedding, you may see clumps of hair coming out each time you brush or comb. As shedding decreases, you should notice visibly less hair getting caught in the teeth of your brush or comb. You may also need to clean them out less frequently.

Less hair rinse-out after shampooing

When you are actively shedding TE hairs, your scalp and shoulders may look like it is snowing strands when you rinse out your shampoo. As your hair recovers, you should notice fewer hairs washing down the drain. You may also see less hair stuck to your hands and hanging from your fingers when shampooing.

Fewer hairs on your clothes and furniture

During TE you may find hairs all over your clothing, furniture, car seats and other surroundings. This shedding should diminish drastically as your hair stops falling out excessively. You’ll notice less hair to pluck off your shirt or sweater during the day. And your hairbrush won’t be overflowing with strands each time you clean it out.

Your scalp and hair feel healthier

When TE is at its worst, your scalp may feel tender, itchy or irritated from all the hairs cycling out of resting phase at once. As your scalp recovers, this tenderness should subside. Your scalp may look and feel healthier, with less flaking or redness.

Additionally, because less hair is falling out, the hair strands you have retained may start to feel fuller and stronger. Many people notice their hair looks and feels shinier, softer and more vibrant as TE improves. It may be easier to style and have more body.

Less oil production

Chronic TE can also trigger excess oil production on the scalp. As your hair normalizes, your scalp may switch from overproducing oil to regulate itself.

New growth feels thicker

Early regrowth may feel downy soft at first. But as the new hairs grow out, they should start to feel thicker, fuller and more like your original hair.

Ask your dermatologist to assess progress

While you can look for all of the above signs that your TE is reversing course, it’s also a good idea to follow up with your dermatologist. They have the training and tools to diagnose TE in the first place, and to monitor your improvement over time.

There are a few ways your dermatologist can assess whether you are regrowing hair after TE:

Clinical exam

The dermatologist will examine your scalp closely and use magnification tools to look for new baby hairs along the hairline, part or thinning areas. They can also judge whether overall density appears to be improving.

Hair pull test

They may do a hair pull test, where they gently tug on small sections of hair to count how many strands come out. More than 6 indicates active shedding. As TE improves, less should come out during this test.

Hair count

For a more quantitative measurement, your dermatologist may pick a small target area of your scalp and actually count the number of hairs within that section. They can periodically recount the same area to check for increased hair density.

Scalp biopsy

In some cases, they may recommend scalp biopsy to examine hair follicles and determine if they are getting stronger and more productive. This test can help confirm if any miniaturization is reversing.

Standardized photos over time

Some dermatologists will photograph certain areas of your scalp using consistent lighting and magnification. This allows side-by-side comparisons over months or years to visually track any new growth.

How long until I see signs of improvement?

It’s normal to start seeing signs within a few months that your TE is turning around, but timeframes can vary:

  • Decreased shedding is often the first sign, within 1-3 months of the TE trigger ending.
  • Visible new hair growth may start appearing around month 3-4, though significant length takes 6 months or longer.
  • It can take 6 months to a year for your hair to completely return to normal fullness.
  • In some cases, recovery can take up to 2 years for more severe TE.

The key is patience. Stick with your treatment plan and nourish your hair through the regrowth process. With time, your hair should regain its former thickness.

What if I’m not seeing improvement?

If you have been treating your TE for over 6 months without signs of decreasing shedding or new growth, check in with your dermatologist. There may be an underlying issue preventing your hair from recovering, that needs to be addressed.

Reasons you may not be seeing improvement include:

  • The trigger causing your TE is still happening, like severe stress or nutrient deficiency.
  • You have developed secondary androgenic alopecia, complicating recovery.
  • You need testing to check for other hair loss conditions like lupus, thyroid disorder, or iron deficiency.
  • You need to try a new or adjusted treatment approach for better results.

Don’t lose hope – there are always further steps you can take to get your hair regrowth on track. Work with your doctor or dermatologist to find out what is standing in your way, and how to overcome it.

How can I maximize hair regrowth?

While patience is key during recovery from TE, there are some things you can do to support your hair regrowth:

  • Reduce stress – Ongoing high stress prolongs TE shedding. Try yoga, meditation, counseling, or other stress relief tactics.
  • Eat nutritious foods – Choose a high protein, iron-rich diet with plenty of fruits and veggies. Consider supplements if diet is lacking.
  • Take biotin – 10,000 mcg of biotin per day may help strengthen hair and stimulate follicles.
  • Use botanical oils – Rosemary, peppermint, and lavender oils may encourage growth when massaged into scalp.
  • Try platelet-rich plasma therapy – PRP injections can accelerate TE recovery and thickness.
  • Ask about minoxidil – Rogaine foam 5% applied to the scalp may help speed up regrowth.
  • Avoid heat styling – Limit use of hot tools like curling irons, straighteners and blow dryers.
  • Handle gently – Brush hair gently, avoid tight hairstyles, and use soft scrunchies.
  • Stay patient – Stick with your treatment plan and give your hair time to recover fully.

Conclusion

Telogen effluvium can be a stressful experience, but you can find comfort in knowing the shedding is temporary. Look for decreasing shed hairs, new baby hair growth, and improved thickness as signs your TE is reversing course. Work closely with your dermatologist to monitor your progress. With time and care, your hair should make a full recovery.

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