Table 1.
Causes and investigations for telogen effluvium.
| Causes of telogen effluvium | Investigations for telogen effluvium |
|---|---|
| Acute illness | FBC |
| Febrile illness | Ferritin/iron studies |
| Blood loss/trauma | ESR |
| Chronic illness | TFT |
| Thyroid dysfunction | Renal and liver function tests |
| Hepatic / renal failure | Calcium/vitamin D |
| HIV / Syphilis | Zinc |
| Malignancy | ANA |
| Nutritional deficiency | ± syphilis serology |
| Protein-calorie malnutrition | ± hormone profileConsider if diagnostic uncertainty:Scalp biopsy |
| Iron/zinc/vitamin D deficiency | |
| Malabsorption | |
| Hormonal changes | |
| Stop/start/or change COCP | |
| Medications | |
| ‘Anti-drugs’ (eg anti-coagulants; anti-depressants; anti-arrhythmic; anti-thyroid) | |
| Retinoids | |
| Beta-blockers | |
| Heavy metal poisoning | |
| Arsenic, thallium | |
| Severe emotional stress | |
| Early androgenetic alopecia |
ANA = antinuclear antibody; COCP = combined oral contraceptive pill; ESR = erythrocyte sedimentation rate; FBC = full blood count; TFT = thyroid function test.