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Covers telogen effluvium and central centrifugal cicatricial alopecia (CCCA), including trigger assessment, scalp hair-pull test interpretation, typical timelines, and evaluation considerations such as CBC/CMP/TSH and ferritin. Reviews red-flag features, pathogenesis clues, and practical management options including reassurance, addressing nutritional or medication causes, and selected topical or systemic therapies.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/benign-hair-and-nail-disorders-4pdf/403314/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/benign-hair-and-nail-disorders-4pdf/403314.png","ImageObject",300,407,{"name":92,"@type":93},"Liam","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-27",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",13,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What is telogen effluvium and what mechanism drives it?","Question",{"text":113,"@type":114},"Telogen effluvium is a common nonscarring hair loss caused by premature transition of more hairs into the telogen (shedding) phase, leading to more rapid hair shedding.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"What history and lab considerations are important for a telogen effluvium workup?",{"text":118,"@type":114},"Perform drug history and detailed review of stressful events, life changes, diet changes, and medical issues in the preceding months. Consider ferritin and TSH testing, and CBC/CMP/TSH are normal in the presented case.",{"name":120,"@type":111,"acceptedAnswer":121},"How is central centrifugal cicatricial alopecia (CCCA) characterized and managed?",{"text":122,"@type":114},"CCCA is a scarring alopecia predominantly affecting women of African descent, with unknown exact pathogenesis and likely multifactorial contributors including hair-trauma practices. Management options listed include topical and intralesional steroids, topical minoxidil, oral antibiotics, antimalarials, and topical metformin, with emphasis on preventing worsening.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},403314,1790663736,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":140,"language":141,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":142,"faqs":143,"seo_title":144,"seo_description":67,"update_tm":145,"read_time":146,"preview_page_count":4},8796095461564,"https://ap-avatar.wpscdn.com/davatar_155a257f0dc6eb9ab79c44ca47cae57d","3/18/2024  \n\n| Benign Hair Disorders\u003Cbr>|  |\n| --- | --- |\n| Stephanie Trovato, MD, FAAD\u003Cbr>Assistant Professor\u003Cbr>Department of Dermatology |  |\n| \u003Cbr>The Ohio State University Wexner Medical Center | |\n\nObjectives  \n• Follow case-based discussion on patient hair complaints  \n• Identify benign hair disorders  \n• Discuss classic presentations and findings of benign hair disorders  \n• Evaluate treatment options  \n• Examine features that raise concern  \nCase 1  \n29-year-old woman presents with new onset hair shedding.  \nDenies any known chronic medical problems  \nDenies family history of hair thinning  \nReports COVID19 infection  \n3 months prior  \nSource:DermNet-[https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3](https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3)  \n[CC BY-NC-ND 3.0 NZ](CC BY-NC-ND 3.0 NZ)  \n\n| Case 1 |  |\n| --- | --- |\n| | Exam reveals diffusely thin hair on scalp\u003Cbr>Hair pull test is positive\u003Cbr>Lab values for CBC, CMP, TSH are within normal limits |\n| Source:DermNet-[https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3](https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3)[ ](https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3)[CC BY-NC-ND 3.0 NZ](CC BY-NC-ND 3.0 NZ) |  |\n\n3/18/2024  \nCase 1  \nDiagnosis?  \nSource:DermNet-[https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3](https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3)  \n[CC BY-NC-ND 3.0 NZ](CC BY-NC-ND 3.0 NZ)  \n\n| Case 1 |  |\n| --- | --- |\n| | Telogen effluvium |\n| Source:DermNet-[https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3](https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3)[ ](https://dermnetnz.org/quizzes/hair-loss-14-cases/case/3)[CC BY-NC-ND 3.0 NZ](CC BY-NC-ND 3.0 NZ) |  |\n\nTelogen effluvium  \n􀂃 Common nonscarring hair loss  \nTelogen effluvium  \n􀂃 Typically – in normal scalp:  \no 90% of scalp hair is in anagen (growth) phase  \no 10% of scalp hair is in telogen (shedding) phase  \n3/18/2024  \nTelogen effluvium  \n􀂃 In patients with telogen effluvium:  \no 80% of scalp hair is in anagen (growth) phase  \no 20% of scalp hair is in telogen (shedding) phase  \nTelogen effluvium  \n􀂃 Premature transition of more hairs to the telogen phase  \nleads to more rapid hair shedding  \nTelogen effluvium  \n􀂃 Numerous Triggers:  \no Emotional/psychological stressors  \no Systemic illness  \no Hormonal changes  \no Surgery  \no Medication changes  \no Diet/abrupt weight loss  \no Nutritional deficiencies  \nTelogen effluvium  \n􀂃 Most common alopecia associated with systemic illness  \n3/18/2024  \nTelogen effluvium  \n􀂃 Common medications implicated:  \no Acitretin  \no Isotretinoin  \no Beta blockers  \no Captopril  \no Antidepressants  \no Anticonvulsants  \no Diabetic drugs  \no Oral contraceptives  \nTelogen effluvium  \n􀂃 Interval between inciting event/agent and shedding  \no Typically weeks to few months  \nTelogen effluvium  \n􀂃 Hair loss noted as increase in shedding  \n􀂃 May persistent for 6-12 months  \n􀂃 Chronic form is less common but can persistent for years  \n\n| Telogen effluvium\u003Cbr>􀂃 Exam shows diffuse thinning across the scalp\u003Cbr>􀂃 Gentle pull test with 10-20 hairs – perform gentle traction – will yield~10 hairs. Normally 1-2 hairs should come out from the bulb (white hair bulbs noted on ends) | |\n| --- | --- |\n\n3/18/2024  \n\n| Telogen effluvium\u003Cbr>􀂃 Perform drug history\u003Cbr>􀂃 Perform extensive history gathering related to any stressful events, life changes, diet changes, or medical issues in the months preceding onset of hair loss\u003Cbr>􀂃 Consider ferritin and TSH testing | |\n| --- | --- |\n\n\n| Telogen effluvium\u003Cbr>􀂃 Management:\u003Cbr>o Reassurance\u003Cbr>o Address any nutritional deficiencies\u003Cbr>o Address any culprit drugs, underlying medical problems, or persistent stressors | |\n| --- | --- |\n\n\n| Telogen effluvium\u003Cbr>􀂃 Management:\u003Cbr>o Consider topical minoxidil 5% foam or solution\u003Cbr>o Severe or persistent cases may benefit from oral minoxidil | |\n| --- | --- |\n\n\n| Case 2 |  |\n| --- | --- |\n| 􀂃 40 yo F presents with worsening hair loss for y","cbCaieQpzxD7KPKK","https://ap.wps.com/l/cbCaieQpzxD7KPKK","pdf",1593480,22,"English","# Objectives\n## Case 1: New onset hair shedding\n## Telogen effluvium overview and triggers\n## Telogen effluvium diagnosis and management\n## Case 2: Worsening hair loss with family history\n## Central centrifugal cicatricial alopecia (CCCA)\n## Case 3: Itching scaling plaques with burning","[{\"question\":\"What is telogen effluvium and what mechanism drives it?\",\"answer\":\"Telogen effluvium is a common nonscarring hair loss caused by premature transition of more hairs into the telogen (shedding) phase, leading to more rapid hair shedding.\"},{\"question\":\"What history and lab considerations are important for a telogen effluvium workup?\",\"answer\":\"Perform drug history and detailed review of stressful events, life changes, diet changes, and medical issues in the preceding months. Consider ferritin and TSH testing, and CBC/CMP/TSH are normal in the presented case.\"},{\"question\":\"How is central centrifugal cicatricial alopecia (CCCA) characterized and managed?\",\"answer\":\"CCCA is a scarring alopecia predominantly affecting women of African descent, with unknown exact pathogenesis and likely multifactorial contributors including hair-trauma practices. Management options listed include topical and intralesional steroids, topical minoxidil, oral antibiotics, antimalarials, and topical metformin, with emphasis on preventing worsening.\"}]","Benign Hair and Nail Disorders - 4.pdf | PDF",1790538863,55]