Dr. Roach: Last summer I had two abdominal surgeries, which were very traumatic (17 days hospitalization total) and caused severe pain and very difficult recovery. About 3 months later, my hair started to fall out. Now it’s very short and very thin. My doctor said it was “telogen effluvium” and was the result of the trauma and stress I experienced in the hospital and during recovery. I have been using Rogaine for women for about a month. Can you recommend additional ones I can take or use to help my hair regenerate? My doctor said it was usually temporary, but I haven’t seen any improvement yet.
– PW
Dear PW: Telogen effluvium is sudden hair loss and is usually associated with identifiable factors. (“Telogen” hair is mature hair at the end of the growth cycle. “Telogen” means “flow out” in Latin.) Hair loss is neither momentary nor complete — less than 50% of the scalp. Hair is usually lost, but “short and thin” is a good description of most people’s appearance. The exact cause is unknown, but for some reason the hair enters telogen too early. Telogen is when the hair comes off. Telogen effluvium occurs more commonly in women, but it occurs in both men and women, and at all ages. There are no scars on the scalp, which distinguishes this condition from other types of acute hair loss.
A common cause of telogen effluvium is surgery and medical conditions that require surgery. Childbirth, rapid weight loss, iron and other malnutrition, and psychological stress are all well-known predecessors of telogen effluvium.
Once the cause is identified, it should be removed if possible (for example, to correct malnutrition). In the case of an event like you, your doctor is right that it will usually get better, and the hair will usually get noticeably thicker within 6 months to a year. Minoxidil (Rogaine) is used by some specialists to help hair regrowth.
It is not possible to fully emphasize how difficult hair loss is psychologically for both men and women (especially women in my experience). Many benefit from skilled hairdressers who can help with colors and styles that can camouflage hair loss, while others prefer hair loss.
The only other treatment I know is the replacement of minerals such as iron, zinc, biotin and vitamin D. These may be useful if there is a deficiency, and may not be useful if not, but a reasonable dose (such as 100) of RDA for all these nutrients) is safe.
Dr. Roach: I am a fairly healthy 80 year old and have one stent and pacemaker in my heart. I am taking amlodipine, aspirin and rosuvastatin. It’s cold at night and it gets chills when the temperature is set to 68 degrees. Why is that so? When I sleep, I set the thermostat to 75 and sleep comfortably. Is the medicine I’m taking causing this? I am 6 feet tall and weigh 172 pounds.
– TJ
Dear TJ: Older people tend to get cold. This is partly due to the low body fat under the skin. You have a normal weight (heavy people tend to be less likely to get cold).
Taking amlodipine can open the blood vessels a little and heat loss can be even more of a problem. People with heart obstructions (and those in need of a stent) may have other obstructions. This can also make your body cold. Hypothyroidism can also cause cold. However, wanting a room temperature of 75 is not unusual for an 80 year old.
Readers can email questions to ToYourGoodHealth@med.cornell.edu
