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Hair Loss/9yr old daughter hair loss

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Question
Hi Dr. Fisher,

My 9 year old daughter has been losing quite a bit of hair for the past couple of weeks.  I'm noticing it on her bed, in the bath and everyday when I sweep our floors.  She is not losing it in patches.  The bulbs are all on the lost hair.  I'm worried.  Can you give me some insight as to what may be going on?

6 months ago (Jan), she experienced this also after removing braids she had put in during our vacation to The Dominican.  It resolved after a month.  Could this have anything to do with it?  

Should I be testing her for anything?

Thanks,
Diane

Answer
Telogen effluvium is the name for temporary hair loss due to shedding of resting or telogen hair after some shock to the system. New hair continues to grow. Telogen hair has a bulb or club-shaped tip.
It should be distinguished from anagen effluvium, in which the hair shedding is due to interruption of active or anagen hair growth by drugs, toxins or inflammation.

Telogen effluvium
What is the cause of telogen effluvium?
In a normal healthy person's scalp about 85% of the hair follicles are actively growing hair (anagen hair) and 15% are resting hair (telogen hair). A hair follicle usually grows anagen hair for 4 years or so, then rests for about 4 months. The resting or telogen hair has a club or bulb at the tip. A new anagen hair begins to grow under the resting telogen hair and pushes it out.
Thus, it is normal to lose up to about 100 hairs a day on one's comb, brush, in the basin or on the pillow, as a result of the normal scalp hair cycle.
If there is some shock to the system, as many as 70% of the anagen hairs can be precipitated into telogen, thus reversing the usual ratio. Typical precipitants include:
Illness, especially if there is fever
Surgical operation
Accident
Childbirth
Nervous shock
Weight loss or unusual diet
Certain medications
Discontinuing the contraceptive pill
Overseas travel resulting in jetlag
Excessive sun exposure

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Michael S. Fisher, <B>Ph.D., M.D.</B>

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