Postpartum Telogen Effluvium

The letter to the editor discusses the findings of Gizlenti and Ekmekci regarding postpartum telogen effluvium (TE), a condition where women experience significant hair shedding after childbirth. The authors commend the original study for its long-term observation of pregnant women, a challenging group to study due to high dropout rates. They point out that while an increased telogen/anagen ratio was observed at 4 months post-delivery, this does not necessarily equate to a clinical diagnosis of TE. In their own experience, only 4 out of 20 women exhibited clinically significant TE, with hair loss ranging from 113 to 1824 hairs, as measured by the Modified Wash Test. They agree that while a large proportion of women experience an increase in telogen hairs after delivery, only about 20% experience hair shedding severe enough to be clinically relevant. The authors suggest that postpartum TE may be caused by a combination of hair cycle synchronization during pregnancy and stress-induced premature entry into the telogen phase, particularly after a first delivery when emotional stress is typically higher.