Etiology, management, and outcomes of pediatric telogen effluvium: A single-center study in the United States

Pediatr Dermatol. 2023 Jan;40(1):120-124. doi: 10.1111/pde.15154. Epub 2022 Oct 20.

Abstract

Background/objectives: Telogen effluvium (TE) is a diffuse, rapidly occurring non-scarring alopecia that can be a significant source of distress for patients and caregivers. To date, the disorder has not been extensively studied in a US pediatric patient population. This study aims to characterize the epidemiology, management, and disease course of pediatric TE.

Methods: A retrospective single-center analysis was conducted at the University of Miami including pediatric medical records from 2009 to 2021 with at least one clinic visit coded with the diagnosis of TE.

Results: 76 patients presented with a wide range of age at onset and hair loss duration. 67% of patients (n = 51) had an identified trigger, the most common being emotional stress and acute febrile illness, followed by nutritional deficiencies (specifically iron, ferritin, and vitamin D). Observation was the most common therapeutic approach. Of patients who had a follow-up evaluation (39%), different treatments resulted in similar rates of improvement.

Conclusions: The results of this study demonstrate the variability in potential TE triggers, physical exam findings, and management in children, similar to what is currently observed and practiced in adult patients. Appropriate work-up for common triggers should be included during the initial visit. Greater evidence-based treatment approaches are needed for pediatric TE.

Keywords: “alopecia”; “anemia”; “iron-deficiency”; “pediatric hair disease”; “psychological distress”; “telogen effluvium”.

MeSH terms

  • Adult
  • Alopecia / epidemiology
  • Alopecia / etiology
  • Alopecia / therapy
  • Alopecia Areata*
  • Child
  • Ferritins
  • Humans
  • Retrospective Studies
  • United States / epidemiology
  • Vitamin D

Substances

  • Vitamin D
  • Ferritins

Supplementary concepts

  • Diffuse alopecia