What triggers telogen effluvium?

Diffuse haaruitval zoals gezien bij telogeen effluvium, zonder patroongebonden haarverlies.

Understanding the underlying causes of sudden, diffuse hair shedding

Telogen effluvium is a form of diffuse hair shedding caused by a temporary disruption of the normal hair growth cycle. Unlike pattern-based hair loss, it is usually triggered by a systemic or physiological stressor, leading to a larger-than-normal number of hair follicles entering the resting (telogen) phase at the same time.

Identifying the trigger is important, as recovery largely depends on resolving the underlying cause rather than on the shedding itself.

In practice, telogen effluvium is rarely caused by a single, isolated event. More often, it reflects the combined effect of multiple overlapping triggers acting over time.

How triggers affect the hair growth cycle

Hair follicles normally move independently through the growth (anagen), transition (catagen), and resting (telogen) phases. At any given time, only a small proportion of hairs are in the resting phase.

In telogen effluvium, a physiological or systemic trigger disrupts this balance. A larger-than-normal number of hair follicles are prematurely shifted into the telogen (resting) phase at the same time, without structural damage to the follicles themselves.

Because hairs are shed only at the end of the telogen phase, increased hair loss typically becomes noticeable weeks to months after the triggering event. By that time, the original cause, such as illness, stress, or hormonal change, may already have resolved.

This delayed response often makes telogen effluvium difficult to recognise and explains why many people struggle to identify a clear cause when shedding begins.

This mechanism explains why people often notice hair loss long after the triggering event has passed, and why identifying a single cause is often difficult.

Factoren die telogeen effluvium kunnen uitlokken, zoals stress, ziekte en lichamelijke belasting.

Common triggers of telogen effluvium

These triggers rarely act in isolation. In many individuals, more than one factor is present at the same time.

Telogen effluvium is most often triggered by factors that place temporary stress on the body, disrupting the normal regulation of the hair growth cycle.

These triggers are typically systemic rather than local, meaning they affect overall physiological balance rather than damaging hair follicles directly.

Physical stress and illness

Acute illness, high fever, surgery, or significant physical trauma can temporarily disrupt normal biological processes, including the hair growth cycle. Telogen effluvium commonly appears 2 to 3 months after such events, even when the acute illness has already resolved.

Psychological or emotional stress

Severe or prolonged psychological stress can act as a physiological stressor. While everyday stress is usually insufficient on its own, intense or sustained stress may contribute to diffuse hair shedding.

Examples may include prolonged burnout, major life events, or sustained sleep disruption.

Hormonal changes

Hormonal fluctuations strongly influence hair follicle behaviour. Common examples include:

  • Postpartum hormonal changes
  • Starting or stopping hormonal contraception
  • Thyroid dysfunction
  • Perimenopause or menopause

Nutritional deficiencies

Insufficient intake or absorption of nutrients involved in hair follicle metabolism may contribute to telogen effluvium, especially when combined with other stressors. Restrictive diets, rapid weight loss, or gastrointestinal conditions can play a role.

Chronic or ongoing systemic strain

When stressors persist over time—such as chronic illness, inflammation, or repeated life events—hair follicles may struggle to fully re-establish a stable growth cycle. This can result in prolonged or recurrent shedding.

Because these triggers can overlap and vary between individuals, understanding telogen effluvium within the broader context of hair loss patterns is important. You can find a complete clinical overview in our telogen effluvium guide.

Why multiple triggers often overlap

In many individuals, telogen effluvium is not caused by a single factor, but by a combination of overlapping physiological stressors.

This overlap explains why recovery timelines vary and why addressing only one factor does not always lead to immediate or complete improvement.

This overlap is one of the main reasons recovery timelines vary significantly between individuals.

For example, illness may coincide with stress, nutritional changes, or hormonal imbalance, amplifying their combined effect on the hair growth cycle.

Because triggers can overlap and vary between individuals, recovery timelines often differ. Learn what this means for recovery and regrowth timelines in our detailed article on how long telogen effluvium lasts.

Can telogen effluvium be triggered more than once?

Yes. Telogen effluvium can recur if new triggers arise, or if the original cause is not fully resolved between episodes.

Each episode remains potentially reversible, provided the hair follicles remain structurally intact and the triggering factors are addressed.

Recurrent episodes may feel continuous when triggers overlap, but this does not necessarily indicate permanent hair loss.

Recurrent episodes do not mean permanent hair loss, but they do indicate that triggers may still be present or recurring.

When no clear trigger can be identified

In some cases, no obvious trigger is found. This does not exclude telogen effluvium. Subtle or cumulative stressors may still disrupt the hair growth cycle over time and assessment often focuses on patterns and timing, rather than a single identifiable event.

In these cases, telogen effluvium is often identified retrospectively based on the course of shedding and recovery.

Collage van afbeeldingen die verschillende vormen van haaruitval en hoofdhuidproblemen.

Unsure what may be triggering your hair shedding?

Hair shedding is often influenced by multiple overlapping factors. A structured assessment such as the TRIX Hair Check can help clarify whether telogen effluvium is the most likely explanation and which factors may be contributing.

A structured assessment focuses on timing, pattern, and associated factors rather than on identifying a single triggering event.

Start the TRIX Hair Check (2 minutes)

Based on more than 20 years of dermatological expertise

Support options during recovery

In cases of telogen effluvium, recovery focuses on supporting normalisation of the hair growth cycle while addressing contributing factors such as stress, illness, hormonal changes, or nutritional imbalance.

Within the TRIX Basic system, TRIX Basic Beta is formulated to support individuals experiencing diffuse, reactive hair shedding associated with telogen effluvium. It is intended to be used as part of a broader, structured approach, rather than as a standalone solution. Suitability depends on the individual situation and underlying triggers.

Use is typically considered during the recovery phase, alongside broader lifestyle and health-related measures aimed at restoring balance.