A 28-year-old woman presents with diffuse hair shedding 3 months after delivery of her baby. Trichoscopy shows increased proportion of telogen hairs and short regrowing hairs (upright regrowing hairs). The pathophysiology is:

• A Premature entry into catagen phase due to androgenic stimulation of postpartum prolactin
• B Prolonged anagen phase during pregnancy with synchronous entry into telogen postpartum ✓
• C Destruction of hair follicle stem cells in the bulge region by oestrogenic withdrawal
• D Autoimmune attack on follicular antigens triggered by postpartum immunological reconstitution

Explanation

Postpartum telogen effluvium occurs because elevated oestrogen during pregnancy prolongs the anagen (growth) phase, retaining hairs that would normally shed. Postpartum oestrogen drop triggers synchronous entry of many anagen follicles into telogen, resulting in diffuse shedding 2-4 months after delivery. This is a physiological, self-limiting condition. Hair density normalises within 6-12 months. No specific treatment is required beyond reassurance and nutritional support.

Reference: Neena Khanna Illustrated Synopsis of Dermatology & STD, 6th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.