Hair loss is more than a cosmetic issue—it can have a profound emotional impact. At our San Francisco dermatology practice, we recognize the emotional toll of hair loss and provide 30-minute, in-depth consultations to uncover the root cause. We do not accept insurance, which allows us to focus entirely on personalized care and not on what insurance will or will not cover for you.  We are able to support in making the best decision throughout your hair restoration journey.

One of the most common concerns we treat is telogen effluvium (TE)—a temporary but distressing form of diffuse hair shedding often triggered by physical or emotional stress.

What Is Telogen Effluvium?

Telogen effluvium occurs when a significant number of hair follicles prematurely enter the resting (telogen) phase of the hair cycle. This leads to noticeable shedding, typically 2–3 months after a triggering event.¹

Common Triggers of Telogen Effluvium

1. Postpartum Hair Shedding

• Cause: Hormonal changes following childbirth, especially a sudden drop in estrogen levels.  This can also occur when a patient stops oral contraceptive pills.

• Onset: Shedding typically starts 2–4 months after delivery

• Duration: Hair often regrows within 6–12 months postpartum²

2. Stress-Induced Shedding

• Cause: Major emotional or physical stressors (e.g., trauma, surgery, illness)

• Onset: Begins 2–3 months after the inciting event

• Duration: Temporary if the stress resolves, though chronic stress may prolong it³

3. COVID-19-Related Hair Loss

• Cause: Physiological stress from illness or emotional stress from the pandemic

• Onset: Commonly occurs 6–12 weeks after infection

• Duration: Variable; may be prolonged in some individuals⁴

Diagnostic and Treatment Approach

We offer a thorough and empathetic evaluation process designed to identify and address all underlying factors contributing to telogen effluvium.

• Medical and Scalp Evaluation: Detailed clinical history and examination, often paired with blood tests to assess ferritin, vitamin D, thyroid function, and more⁵

• Topical Minoxidil: An FDA-approved vasodilator shown to prolong the anagen (growth) phase⁶

• Low-Dose Oral Minoxidil: Increasingly used off-label for chronic TE and diffuse shedding⁷

• Nutritional Support: Correction of deficiencies in iron, vitamin D, zinc, and protein intake, all of which are vital for hair growth⁸

• Stress Management Support: Incorporating psychological wellness and referrals when appropriate

• Adjunctive Therapies: Low-level laser therapy (LLLT), platelet-rich plasma (PRP), and micro-needling may also be considered 

• Mesotherapy: Injections of minoxidil or other anti-inflammatories can be considered for severe or chronic forms of TE

Why Choose Our San Francisco Practice?

• 30-minute consultations focused on in-depth patient education and individualized treatment

• A patient-centered model that addresses the emotional and medical aspects of hair loss

• Evidence-based treatments offered by providers with expertise in hair restoration

• Convenient and often same day dermatology care for Bay Area patients from Sausalito, Tiburon, Mill Valley, Walnut Creek, Danville, Napa, Sonoma, Burlingame, San Mateo, Palo Alto, Los Altos, Woodside and all surrounding areas seeking specialized dermatologic evaluation

Book Your Consultation

If you're experiencing unexpected hair shedding, let us help you take control. Schedule a consultation with our team to begin your personalized treatment plan.

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References

1. American Academy of Dermatology. Do you have hair loss or hair shedding? Accessed April 2025. https://www.aad.org/public/diseases/hair-loss/insider/shedding

2. American Academy of Dermatology. Hair loss in new moms. Accessed April 2025. https://www.aad.org/public/diseases/hair-loss/insider/new-moms

3. American Academy of Dermatology. Stress and skin conditions. Accessed April 2025. https://www.aad.org/public/diseases/a-z/stress-skin-conditions

4. American Academy of Dermatology. Can COVID-19 cause hair loss? Accessed April 2025. https://www.aad.org/public/diseases/hair-loss/causes/covid-19

5. American Academy of Dermatology. Hair loss: Diagnosis and treatment. Accessed April 2025. https://www.aad.org/public/diseases/hair-loss/treatment/diagnosis-treat

6. American Academy of Dermatology. Thinning hair and hair loss: Could it be female pattern hair loss? Accessed April 2025. https://www.aad.org/public/diseases/hair-loss/types/female-pattern

7. Randolph M, Tosti A. Oral minoxidil treatment for hair loss: A review of efficacy and safety. J Am Acad Dermatol. 2021;84(3):737–746. https://www.jaad.org/article/S0190-9622(20)32109-5/fulltext

8. Olsen EA, Messenger AG, Shapiro J, et al. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol. 2004;50(4):569–589. https://www.jaad.org/article/S0190-9622(04)01058-8/fulltext