What to Avoid

Telogen effluvium is a temporary hair loss condition that occurs when a significant number of hair follicles shift from the growth phase (anagen) into the shedding phase (telogen) earlier than usual. This shift is often triggered by physical or emotional stress, illness, medication changes, or nutritional deficiencies. While telogen effluvium does not cause permanent baldness, the sudden increase in hair shedding can be distressing and may feel worse if extra stress is placed on the hair or scalp.

Understanding what makes shedding worse is crucial for managing telogen effluvium. Certain avoidable factors-such as harsh chemicals, heat styling, tight hairstyles, over brushing, and crash dieting-can increase breakage or scalp irritation, making hair loss appear more severe. While gentle washing and combing do not cause telogen effluvium, rough handling or restrictive diets can worsen the experience. This guide explains what to avoid, practical swaps, and when to seek medical advice.

What to avoid with telogen effluvium

Telogen effluvium is triggered when a stressor causes more hair follicles to enter the shedding phase. While the root cause is often internal, certain external factors can make shedding seem heavier or prolong recovery. Avoiding harsh hair care practices, scalp irritation, and nutritional pitfalls can help minimize additional hair breakage and support regrowth.

Key things to avoid include harsh chemicals (like bleach and strong dyes), excessive heat styling, tight hairstyles, aggressive brushing, and restrictive diets. Emotional stress and anxiety can also worsen the perception of hair loss, leading to stress spirals and harsher hair care choices. Instead, focus on gentle hair routines, balanced nutrition, and coping strategies that reduce anxiety without harming your hair or scalp.

Common triggers to avoid or reduce

Several triggers can set off or worsen telogen effluvium. While not all are fully avoidable, understanding them can help you take steps to minimize their impact. Addressing these triggers early can support a quicker return to normal hair growth and reduce the emotional burden of shedding.

Major triggers include crash dieting, severe stress, illness or fever, and changes in medication. Each of these can disrupt the hair growth cycle, pushing more follicles into the telogen phase. Being aware of these factors allows for better prevention and management of telogen effluvium.

Crash dieting and rapid weight loss

Crash diets and rapid weight loss deprive the body of essential nutrients, especially protein, iron, and key vitamins. Hair follicles are highly sensitive to nutritional changes, and a sudden drop in calories or protein can trigger excessive shedding. Restrictive eating plans, juice cleanses, or skipping meals can all contribute to telogen effluvium.

To support hair health, aim for steady, balanced meals with adequate protein and a variety of vitamins and minerals. Avoid fad diets and consult a healthcare provider or registered dietitian before making significant dietary changes.

Major life stress and “stress spirals”

Emotional stress, such as bereavement, job loss, or chronic anxiety, is a well-known trigger for telogen effluvium. Stress can disrupt the normal hair cycle, causing more hairs to enter the shedding phase. Ongoing worry about hair loss can create a stress spiral, where anxiety leads to harsher hair care habits and increased shedding.

Managing stress through relaxation techniques, support networks, and healthy routines can help break this cycle.

Illness, fever, and recovery periods

Physical stress from illness, surgery, or high fever can trigger telogen effluvium. The body may redirect resources away from hair growth during recovery, leading to increased shedding two to three months later. This is a common pattern after viral infections or major health events.

While illness cannot always be avoided, supporting your body with rest, hydration, and balanced nutrition during recovery can help minimize the impact on hair. If you notice heavy shedding after illness, it is likely temporary and should improve as your health stabilizes.

New or changed medications (do not stop on your own)

Certain medications can trigger telogen effluvium as a side effect. These may include some blood pressure drugs, antidepressants, or hormonal medications. However, never stop or change prescribed medicines without first consulting your clinician.

If you suspect a medication is contributing to hair loss, discuss your concerns with your healthcare provider. They can help determine if an alternative is appropriate or if the shedding is likely to resolve on its own.

Hair care habits that can make shedding worse

While gentle hair washing and combing do not cause telogen effluvium, rough handling can increase breakage and make shedding seem more dramatic. Certain hair care habits can also irritate the scalp or damage fragile hairs, compounding the effects of telogen effluvium.

Focusing on gentle, supportive routines can help protect new growth and reduce the appearance of hair loss. Avoiding aggressive techniques and choosing the right tools are important steps in minimizing additional hair damage.

Over brushing, aggressive detangling, and wet-hair pulling

Brushing hair too frequently or with excessive force can lead to unnecessary breakage, especially when hair is wet and more vulnerable. Aggressive detangling or pulling at knots can snap hairs that are already in the shedding phase, making hair loss appear worse.

Swap harsh brushes for wide-tooth combs and detangle gently, starting from the ends and working upward. Avoid brushing wet hair unless necessary, and use a leave-in conditioner to ease knots. Gentle handling preserves both shedding and regrowing hairs.

Frequent washing myths vs gentle washing

Many people worry that washing their hair too often will increase shedding. In reality, gentle washing does not cause telogen effluvium. Washing simply removes hairs that have already detached from the follicle and would have fallen out naturally.

Use a mild, fragrance-free shampoo and avoid vigorous scrubbing. Focus on scalp health rather than washing frequency.

Scratching and picking at the scalp

Scratching, picking, or rubbing the scalp can lead to irritation, inflammation, and even infection. This can disrupt the hair growth environment and potentially worsen shedding or delay regrowth.

If you experience scalp itch or discomfort, try switching to a gentle, hypoallergenic shampoo and avoid scratching. Persistent scalp symptoms should be evaluated by a healthcare provider.

Harsh hair products and scalp irritation

Many hair products contain chemicals or fragrances that can irritate the scalp or weaken hair strands. For those with telogen effluvium, the scalp may be more sensitive, and harsh products can make symptoms worse.

Choosing gentle, non-irritating products and minimizing chemical treatments can help maintain a healthy scalp environment and protect regrowing hair.

Harsh chemicals (bleach, strong dyes, relaxers, perming)

Chemical treatments such as bleaching, strong dyes, relaxers, and perms can damage the hair shaft and irritate the scalp. These processes can weaken already fragile hairs, leading to increased breakage and a rougher texture.

If you choose to color or chemically treat your hair, opt for milder formulas and space out treatments. Always perform a patch test before using new products, and consider consulting a professional stylist for safer options.

Fragranced or irritating shampoos and heavy build-up products

Shampoos with strong fragrances, sulfates, or other harsh ingredients can cause scalp irritation, especially in sensitive individuals. Heavy styling products or oils can also build up on the scalp, clogging follicles and potentially worsening shedding.

Look for fragrance-free, hypoallergenic shampoos and lightweight conditioners. Rinse thoroughly to avoid residue, and limit the use of heavy styling products. If irritation persists, consult a dermatologist.

“Hair growth” serums that sting or inflame the scalp

Some over-the-counter hair growth serums contain ingredients that can cause stinging, redness, or inflammation. While these products may promise rapid results, irritation can disrupt the scalp environment and delay recovery from telogen effluvium.

Always patch-test new serums before applying them to the entire scalp. If a product causes discomfort, discontinue use and focus on gentle care. Consult a healthcare provider before starting any new topical treatments.

Heat styling and over styling

Excessive heat styling and over styling can weaken hair strands and increase breakage. For those experiencing telogen effluvium, minimizing heat and tension on the hair is especially important to prevent additional loss and support healthy regrowth.

Simple swaps-such as lowering the temperature on styling tools, using heat protectants, and choosing looser hairstyles-can make a significant difference in hair strength and appearance.

High heat tools (flat irons, curling wands) and blow-drying too hot

Flat irons, curling wands, and hot blow dryers can cause thermal damage, making hair brittle and prone to snapping. High heat can also dry out the scalp, leading to irritation and discomfort.

Reduce the frequency of heat styling, use the lowest effective temperature, and always apply a heat protectant spray. Allow hair to air dry when possible or use a cool setting on your dryer.

Frequent tight ponytails/buns and traction stress

Tight hairstyles such as ponytails, buns, or braids can place tension on the hair shaft and follicles. This traction can lead to breakage and, over time, may contribute to traction alopecia if not addressed.

Opt for loose styles and soft hair ties. Alternate hairstyles to reduce repeated stress on the same areas.

Extensions, weaves, and tight braids

Hair extensions, weaves, and tight braids can add significant weight and tension to the scalp. This can exacerbate shedding and increase the risk of breakage, especially during periods of active telogen effluvium.

If you use extensions or braids, choose lightweight options and avoid prolonged wear. Give your scalp regular breaks from added tension to support recovery.

Nutrition mistakes to avoid (and what to do instead)

Nutrition plays a vital role in hair health. Deficiencies in protein, iron, zinc, and certain vitamins can trigger or worsen telogen effluvium. Crash diets, skipping meals, or relying on supplements without guidance can all disrupt the hair growth cycle.

Instead, focus on balanced meals that include a variety of nutrients. Avoid unnecessary supplements and restrictive diets unless recommended by a healthcare professional.

Skipping protein and overall under-eating

Hair follicles are primarily made of protein. Inadequate protein intake can slow hair growth and increase shedding. Under-eating or skipping meals deprives the body of the energy and nutrients needed for healthy hair.

Include protein-rich foods such as eggs, beans, fish, and lean meats in your diet. Aim for regular, balanced meals to support hair regrowth and overall health.

Unnecessary supplements and megadoses

Many supplements marketed for hair growth contain high doses of biotin, zinc, or other nutrients. However, excess supplementation is rarely helpful and can sometimes interfere with lab tests or cause side effects.

Most people can meet their nutritional needs through food. Only take supplements if you have a confirmed deficiency or your healthcare provider recommends them. Avoid megadoses and focus on a balanced diet.

Restrictive elimination diets without guidance

Eliminating entire food groups without medical supervision can lead to nutrient deficiencies that impact hair health. Restrictive diets may lack essential vitamins, minerals, and protein needed for hair growth.

If you need to follow a special diet for health reasons, work with a registered dietitian to ensure you are meeting your nutritional needs and supporting hair recovery.

Anxiety, checking behaviors, and coping strategies

Telogen effluvium can cause significant emotional distress. Anxiety about hair loss may lead to frequent checking behaviors, such as counting shed hairs or taking constant photos, which can worsen stress and prompt harsher hair care routines.

Developing healthy coping strategies and supportive routines can help reduce anxiety and support both emotional well-being and hair recovery.

Counting hairs and constant mirror checks

It is normal to lose up to 100 hairs per day, but telogen effluvium can increase this to as many as 300 hairs daily. Constantly counting shed hairs or checking the mirror can fuel anxiety and make hair loss feel even more overwhelming.

Try to limit checking behaviors and focus on overall hair health rather than daily fluctuations. Remember that most cases of acute telogen effluvium resolve within six months.

Helpful routines that reduce worry without harming hair

Establishing gentle hair care routines, practicing stress management techniques, and seeking support from friends or professionals can help break the stress spiral. Activities such as mindfulness, journaling, or light exercise may also reduce anxiety.

Focus on what you can control-like gentle detangling, balanced meals, and self-care-rather than the number of hairs shed each day.

What to do after you slip up (damage control)

It is common to make mistakes during recovery, such as using a harsh chemical or skipping meals during a stressful period. The key is to minimize further damage and support your hair and scalp as they recover.

Gentle care, patience, and small adjustments can help reverse the effects of a setback and get you back on track.

If you used harsh chemicals or heat

If you have recently used bleach, strong dyes, or high heat tools, focus on hydrating and protecting your hair. Use a gentle, nourishing conditioner and avoid further chemical treatments or heat styling until your hair feels stronger.

Trim split ends if needed and allow your hair to air dry. Give your scalp a break from styling products and consider using a silk pillowcase to reduce friction.

If you had a diet setback or a stressful period

If you experienced a period of poor nutrition or high stress, return to regular, balanced meals as soon as possible. Include protein, iron, and a variety of fruits and vegetables to support hair regrowth.

Practice stress-reduction techniques and seek support if needed. Remember that hair recovery takes time, and most setbacks are temporary.

Signs it may not be telogen effluvium

If your hair loss is patchy, affects your hairline, or is accompanied by scarring or redness, it may not be telogen effluvium. Other conditions, such as alopecia areata or androgenetic alopecia, have different patterns and may require specific treatments.

Persistent or worsening hair loss should be evaluated by a dermatologist to determine the underlying cause and appropriate management. For comparison, see Telogen Effluvium vs Androgenetic Alopecia.

Symptoms that suggest a scalp condition

Scalp symptoms such as pain, itching, redness, scaling, or sores may indicate an underlying scalp disorder or infection. These conditions can contribute to hair loss and require medical evaluation.

If you notice any of these symptoms, seek prompt care from a healthcare provider or dermatologist for diagnosis and treatment.

What your clinician may check (history, exam, basic labs)

Your clinician will typically take a detailed history, perform a scalp examination, and may order basic laboratory tests to rule out nutritional deficiencies or thyroid problems. This helps confirm the diagnosis of telogen effluvium and guides further management.

Open communication with your healthcare provider is essential for accurate diagnosis and effective treatment planning.

FAQ

Does washing my hair more often increase telogen effluvium shedding?

No, gentle washing does not cause telogen effluvium or increase shedding. Washing simply removes hairs that have already detached from the follicle. Focus on gentle scalp care rather than washing frequency.

Can I color my hair if I have telogen effluvium?

It is best to avoid harsh chemical treatments such as bleaching or strong dyes during active shedding. If you choose to color your hair, opt for milder formulas and perform a patch test to minimize scalp irritation.

Are tight hairstyles really a problem, or is that only traction alopecia?

Tight hairstyles can cause both breakage and traction stress, which may worsen the appearance of shedding during telogen effluvium. Looser styles are recommended to protect fragile hair and reduce additional stress on the scalp.

Do biotin or other supplements help telogen effluvium?

Most people do not benefit from extra biotin or supplements unless they have a confirmed deficiency. Excess supplementation is rarely helpful and can sometimes interfere with lab tests. Focus on a balanced diet unless advised otherwise by your healthcare provider.

How long should I avoid heat styling?

It is best to minimize heat styling until shedding slows and hair feels stronger. Lower heat settings, less frequent use, and heat protectant sprays can help reduce damage during recovery.

Can stress alone cause telogen effluvium, and how do I stop a stress spiral?

Yes, significant emotional stress can trigger telogen effluvium. Breaking the stress spiral involves gentle hair care, stress management techniques, and limiting checking behaviors. Support from friends, professionals, or support groups can also help.

What’s the difference between normal shedding and telogen effluvium?

Normal shedding is up to 100 hairs per day, while telogen effluvium can cause up to 300 hairs to shed daily. Telogen effluvium typically causes diffuse thinning rather than patchy or permanent baldness.