Yesterday, I received an email from a reader who wanted to know if it is possible to see a worsening or acceleration of the shedding of telogen effluvium as recovery begins. In other words, does the molt get worse before it gets better? Does a shed worsening mean recovery is on the way? I will address these concerns in the next article.

My experience with telogen effluvium recovery: I had many episodes of TE and CTE before I could identify my trigger to stop it. In my experience, you see a gradual decline in shedding as recovery approaches. Here is a specific example. A long time ago, I used to count my hair. I would absolutely tell you not to start this practice. It will only annoy you more. It will only make you feel like you will go bald in just a few weeks. It will only make you focus on what is happening right now rather than recovery.

That said, however, it used to count. Over the course of, say, a year, I went from losing more than 250 hairs a day for several months, to losing around 180 a day. Over the course of a month, it went down to around 150. Then to around 90. My average after that dropped to around 50, where it stayed for about three months. Today, you could lose around 15 or more, but that includes shampoo and styling. (I’m not really sure about these numbers. I don’t count anymore. But I did this long enough to be able to look at the spent hairs and know roughly how many there are).

Again, I can’t emphasize enough that you don’t want or need to take actual inventory, but like I said, you can look at what’s missing and know if that amount is decreasing or increasing.

What about people who say the shedding got worse before it got better ?: If you spend any time on hair loss forums, you know there are people out there who will tell you that things were darker before dawn, that they went from extreme rapid hair loss to almost nothing overnight. I don’t doubt these people. But I think what probably happened is that they had a very identifiable trigger that they were able to eliminate overnight (they stopped taking the medications that were causing this or healed their inflamed scalp).

However, what sometimes happens is that people introduce a “treatment” that makes the shed worse. They may be adding some hormones or trying rogaine or a hair growth stimulator that ruins your scalp. What happens then is that they realize that their loss is getting out of hand and they finally give it up. Well, what has happened is that this treatment went ahead and stripped them of the hairs that they were going to lose anyway at once, so when they stopped, the loss accelerated and ended in that period of time.

Again, TE may get worse before recovery, but in my experience this is the exception rather than the rule. Most people see a gradual reduction until finally the amount of hair lost returns to normal levels.