Telogen effluvium: a clinically useful concept, with traction alopecia as an example.

Telogen effluvium is the excessive loss of normal club hairs. It can be diagnosed simply by microscopic examination of the hairs that are being shed. These hairs have uniform shaft diameter and normally shaped bulbs that contain no pigment. The causes of telogen effluvium are well known and easily distinguishable. They include parturition, febrile illness, surgical operations and anesthesia, anticoagulant drugs, psychi stress, crash diets, and traction. Traction alopecia often produces recognizable patterns of hair loss and can be diagnosed in many cases with reasonable certainty. It is usually not accompanied by inflammatory changes and the prognosis is excellent provided the causative styling practices-braids, rollers, ponytails, etc-are discontinued. Telogen conversion may be caused by interference with papillary blood flow. Since traction alopecia would seem to be reproducible, it may serve as a model for the study of telogen conversion.