L65.0 Telogen effluvium

Name of the Condition

• Telogen effluvium

Summary

Telogen effluvium is a temporary form of hair loss characterized by excessive shedding of hair. It occurs when a significant number of hair follicles enter the resting (telogen) phase prematurely, leading to increased hair loss. This condition typically affects the scalp but may involve other hair-bearing areas. The shedding is often diffuse and not localized to specific regions.

Causes

Telogen effluvium is triggered by various physiological or psychological stressors that disrupt the normal hair growth cycle. Common causes include major surgery, severe illness, high fever, significant weight loss, nutritional deficiencies (e.g., iron, protein, biotin), childbirth, emotional stress, or discontinuation of certain medications. The condition arises when the body shifts a large proportion of hair follicles from the growth (anagen) phase to the resting (telogen) phase simultaneously.

Risk Factors

• Recent major physical or emotional stress (e.g., illness, surgery, trauma)
• Nutritional deficiencies (e.g., iron, zinc, vitamins)
• Hormonal changes (e.g., postpartum, thyroid disorders)
• Certain medications (e.g., retinoids, beta-blockers, anticoagulants)
• Rapid weight loss or crash dieting
• Chronic illness or infection

Symptoms

• Sudden, diffuse hair shedding, often noticed during washing or brushing
• Thinning of hair, particularly at the scalp crown
• No scarring or inflammation of the scalp
• Normal hair density in unaffected areas
• Possible eyelash or eyebrow shedding in severe cases

Diagnosis

Diagnosis is primarily clinical, based on the patient’s history and physical examination. A healthcare provider will assess the pattern of hair loss, duration, and potential triggers. Blood tests may be ordered to rule out nutritional deficiencies, thyroid dysfunction, or other underlying conditions. A trichogram (hair pull test) or scalp biopsy may be performed in atypical cases to evaluate hair follicle status.

Treatment Options

• Addressing the underlying cause (e.g., correcting nutritional deficiencies, managing stress)
• Topical minoxidil to promote hair regrowth (optional)
• Ensuring adequate nutrition and hydration
• Gentle hair care practices (e.g., avoiding tight hairstyles, heat styling)
• Patience, as hair typically regrows within 6–12 months once the trigger is resolved

Prognosis and Follow-Up

Telogen effluvium is generally self-limiting, with hair regrowth occurring once the triggering event resolves. Most patients experience full recovery within 3–6 months, though some may take up to a year. Follow-up is typically unnecessary unless symptoms persist or worsen, which may indicate an alternative diagnosis.

Complications

• Temporary cosmetic concerns due to hair thinning
• Psychological distress or anxiety related to appearance
• Rarely, progression to chronic telogen effluvium if triggers are ongoing

Lifestyle & Prevention

• Maintain a balanced diet rich in protein, iron, and vitamins
• Manage stress through relaxation techniques or counseling
• Avoid harsh hair treatments (e.g., chemical processing, excessive heat)
• Treat underlying medical conditions promptly
• Monitor hair loss and consult a provider if it persists beyond 6 months

When to Seek Professional Help

Seek medical attention if hair loss is sudden, severe, or accompanied by other symptoms (e.g., scalp pain, rash, or systemic illness). A healthcare provider should evaluate cases where hair loss does not improve after 6–12 months or if there are signs of scarring or inflammation.

Tips for Medical Coders

When coding for telogen effluvium (L65.0), ensure documentation supports the diagnosis, including the pattern of hair loss, duration, and any identified triggers. Note whether the condition is acute or chronic, as this may impact coding specificity. Avoid coding for unrelated hair loss conditions (e.g., androgenetic alopecia) without clear differentiation.