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Hair Loss/27/f hair loss


QUESTION: Hello, I'm a 27 year old female suffering from hair loss. A little background, I had two telogen effluviums from changing birth control pills and lost about 60% of my hair and it stopped about a year ago. I see lots of short hairs growing that range from 3 inches to a quarter inch and my hair seemed to be getting little better until i noticed this month again it seems that I lost more hair all over diffusely but I haven't had any triggers.

I still see lots of growth but since my hair shed a bit of the regrowth it doesn't feel or look thicker. I can see scalp above my ears, temples are totally see through, and the top is very see through.

I don't know any people in my family who have hair loss or balding. My mother has thin hair but she's always had thin hair. My dad has thinned a little in the front but he's 60 now and still has a head full of thick hair.

All of my blood tests came out normal aside from vitamin D so I take a supplement. My OBGYN and dermatologist said it's most likely not genetic but I feel like I should have seen a vast improvement after a year of normal growth cycle. Is it possible because I had two TEs that it will take a much longer time to see improvement in density?

I'm terrified only being 27 and suffering with such a rapid severe loss and don't know what to do anymore.

Thank you for any advice you can offer.

ANSWER: In most cases of young women with an episode or two of TE the hair begins to see small new hairs coming back in 4 months after the TE. Since hairs only grow 1/2 inch per month it may take a year to see and feel the increased density. Every time a TE happens it uses up a life cycle which can translate to 5 years of growth for that particular hair. Every hair is preprogrammed to have only a certain number of life cycles and if you have too many TE's early in life you can end up being prematurely thin. There is no way I can promise you that you will be happy with full density returning by the end of the year. With only 2 TE's most women wouldn't notice the difference but with your mother and father having thin hair it is possible you could hasten the time when you too will have thin hair. It could be that you aged some of your scalp hairs by ten years.
  This may not be genetic loss now but it could cause genetic loss to show up earlier than it should. You have good cause to try to take a pro-active approach and try to prevent more aging. I am assuming your serum ferritin is above 60 if your dermatologist checked it as said you were okay.
  I would suggest you talk to your dermatologist and GYN about taking Yaz to prevent progression of Androgenetic Alopecia and or spironolactone.
 An extreme example of multiple TEs leading to premature genetic alopecia was a patient of mine who was totally bald when I saw him at age 70 and he told me that he had been that way for 50 years and no one else in his family ever went bald until they were in their 70s. It turned out that he worked on the Panama Canal when he was 20 and developed Malaria and every time he had the high fever with shaking chills he ended up with a TE a month later. He only needed ten such episodes over a period of a year to become completely bald.
 I wrote about this case in my book Hair Loss Answers:--you can read it for free online


Stress can cause a type of hair loss called telogen effluvium. This condition is not caused by the general accumulated stress of ordinary interactions with people at home and at work, but rather by sudden severe emotional or physiological incidents. Severe stressful events can cause some or most actively growing hair follicles to prematurely shift into the regression phase, and then the resting phase, during which the hairs fall out easily.

There is usually a delay of a few weeks to a few months before the shedding is noticeable, but after this delay the shedding seems to occur quite suddenly. Because the shedding is delayed, this type of hair loss is often a mystery to the person suffering the condition. The stressful event that triggered it is frequently forgotten, and it is rarely thought to be connected with the “new problem.”

Examples of sudden severe emotionally stressful events include the death or terminal illness of a family member or close friend, marriage, divorce, and unexpected job loss. Severe physiological stressful events shock the body, and some examples are heart attacks, major surgery, and illnesses with prolonged high fever such as malaria, viral pneumonia, and severe cases of the flu.

In most cases of telogen effluvium, the hair follicles recover and soon shift back to the regular growth cycle.

However, repeated instances of telogen effluvium can result in premature hair loss in people predisposed to lose their hair late in life. The average growth cycle of a hair follicle takes about five years, but each follicle is “genetically programmed” for only a limited number of growth cycles. For example, if a particular hair follicle were “genetically programmed” for only ten growth cycles, after about fifty years that follicle would stop producing new hairs. When all the follicles at the hairline or crown of the head are “genetically programmed” this way, a receding hairline or bald spot appears after all the growth cycles for the follicles in those areas have been cycled through.

Each incidence of telogen effluvium uses up one “life” of the affected hair follicles. So instead of having a receding hairline or bald spot at age fifty, the hair loss may occur a few years earlier. This is not a significant issue if telogen effluvium occurs once or twice in a lifetime; however, accelerated hair loss can result from repeated severe stressful events, if each instance triggers a new round of telogen effluvium.

I had a patient who was totally bald when I met him at age seventy, and he had lost all his hair by age twenty-two. He had worked on the Panama Canal fifty years earlier, and for two straight years starting when he was twenty he suffered repeated bouts of severe fever from episodes of malaria. Each time he suffered from malaria induced fever he experienced telogen effluvium, lost what hair he had, and his hair follicles lost another “life.” After ten or fifteen malaria stress cycles, at the age of twenty-two, he had the hair he would have had at age seventy. Which unfortunately for him was no hair at all.

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QUESTION: Thank you for your advice. Is it possible because I had two TE's it will take quite a while to feel increased density from regrowth? I see new baby hairs coming up each month since they ended a year ago but I haven't noticed an increase in density on top. Even if I don't have a full recovery, I would imagine I should recover a decent amount of hair with no history of genetic balding in my family and all my blood levels are okay? My ferritin was in the 70s when I last checked and I hve also increased my protein since I'm vegetarian.

ANSWER: Your assumptions seem valid. If there is no balding in your family you should be able to get most of your hair back in time- perhaps a year.

A serum ferritin of 70 is good enough to allow you to grow hair back even if you are a vegetarian.

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QUESTION: Thank you! I have one more question I forgot to ask. I have seborrheic dermatitus on my scalp and forehead. Can this cause extreme hair loss? I thought only a little bit if hair gets caught in the scales. Mine only really flares up in winter which is why I was thinking some regrowth was shedding.

Seborrheic Dermatitis does not cause hair loss. If you use a shampoo which has ketoconizole or zinc pyrithione in it as the active ingredient then you will find it not only helps kill the yeast which causes dandruff but also may help your hair loss because both of those active ingredients inactivate the 5 alpha reductase enzyme thus lowering the DHT being produced in the hair follicle.
 I personally use DHS zinc shampoo with 2% ZnP - on a daily basis.

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Peter J. Panagotacos, <B>M.D.</B>


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery.


I have 30 years experience in the field of medical and surgical Hair Restoration and am Board Certified in Dermatology and Hair Restoration Surgery. More information can be found at my website

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