Telogen Effluvium
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Telogen Effluvium. Now there’s a strange and unfamiliar term to many people, even physicians. To understand this medical term, let’s first take a look at the three stages of hair growth. They are the Anagen phase, Catagen phase, and Telogen phase.

The Anagen phase is the period of growth. Hair actively grows from the roots on average between 2 and 7 years before becoming dormant.

The Catagen phase is called the transitional phase where hair stops growing and detaches itself from the blood supply.

The Telogen phase is the final stage or what is called, the resting stage. This phase typically lasts about three months.

Telogen Effluvium is a form of temporary hair loss that usually happens in a small percentage of the population after a major shock to the body, such as a major stressful event, severe anxiety, surgery, or even occurs from certain medications. During the “event” as many as 30%-50% of active hair follicles are pushed prematurely into the Telogen phase. Once this happens, there is literally nothing you can do to prevent what is to come next. Between 3-6 months after the “event”, the hair will begin to shed, typically in large numbers.

The typical person has about 100,000 hair follicles. At any given time, that typical person has approximately 85% to 90% of their scalp hair follicles active; Anagen phase. Less than 1% of their hair follicles are in the transitional Catagen phase which usually lasts about three weeks. And approximately 10% of their scalp hair follicles are in the resting phase; Telogen phase. It is normal to shed between 50-150 hairs a day. With telogen effluvium, sufferers can experience dramatically higher shedding between 200 and as high as 1,000 in a single day. This is extremely upsetting to the individual and further increases their anxiety level–which, in turn, can further exacerbate the condition.

The following are some photos of my hair about 18 months before I began to experience Telogen Effluvium (T.E.). While short, notice the density and thickness of my hair.

Approximately 18 months prior to T.E.

As my transition continued, my hair remained thick and healthy. The next photo was taken at the salon about 8 months later.

Just two months before my first bout with T.E.

This is the photo taken after an extremely long makeover for the cover of my book and approximately 1 month before I began experiencing rapid hair loss.

One month before my first bout with T.E.

It would be the better part of a year before I would be able to snap another selfie. This is six months after my first bout with Telogen Effluvium and about a month after my last dark color treatment. Trust me, I am a magician when it comes to making my hair look better or fuller than it really was.

About 8 months after first bout with T.E.

Now, here is the reality of my hair from round one of Telogen Effluvium. I had experienced major hair loss. After seeing a dermatologist, they explained that I had already experienced about a 35% reduction of my hair.

This photo was taken during COVID-19 isolation just a couple months ago. Obviously all of my salon hair color was also completely washed out.

The photo below was taken last week while at my pre-surgical appointment in Pennsylvania. You can see my hair is not as thick as usual, and I wear a color-coordinated hair wraparound my head to mask much of the old hair loss.

About four days ago, I began experiencing round two of T.E. This time it has been far more aggressive. Each day for the past four days, I have lost between 500 to 1,200 hairs every day. I have begun to fear washing my hair even though I must. Two days ago, I literally filled my bathroom sink with an estimated 1,200 hairs. At this point, all of the hair in the previous photo is all but gone. I have huge bald spots on my head. and my hair is so thin and sparse, I am (at least in one regard) happy to be isolated for now. My dermatologist has told me this week that is it incredibly severe. As of today, they have calculated I have lost nearly 60%-65% of my hair. The hair in the photo above no longer exists as of this morning.

I literally filled my bathroom sink with an estimated 1,200 hairs.

I finally have my Gender Confirmation Surgery on August 4th. Ironically, each time I have surgery, several months later I will experience more hair loss. This, the most important surgery of my life, may actually make me completely bald. I know. I know. 1st world problem. Yes COVID-19 is devastating. Yes, I have friends with Alopecia and one with Anogen Effluvium caused by chemotherapy. So trust me when I say, I take this all in stride and within context.

But just as humanity is diverse, so are each of our situations and perspectives. I can only account for my own feelings. And, I am devastated. One can’t help feeling quite miserable when you have, after all of these years, finally become authentically you, just to have a major attractiveness feature cut away from you.

I am told I have a 50/50 chance of recovery. However, at my age, they wonder it my hair follicles will ever be able to support long hair ever again; not to mention it took me two and a half years just to get the growth I used to have. The story of my complicated journey and rebirth continues. My ability to drink my own Kool-Aide and face adversity with enormous strength and determination, at the moment is beaten down. But just as I have written in my book and the included quote below, we must overcome adversity.

Wigs are fashionable and versatile, but with COVID-19, it not easy to get an appointment for custom sizing. So a headwrap will most likely be my go-to until it is safe (mostly for me) to get an appointment.