Pregnancy implies profound transformations in the female physique, and although it is really talked about very little, it also brings profound changes in the life cycle, growth and death of the hair mainly due to the inevitable changes in the hormonal set-up.

Under normal conditions, about 10-20% of the total follicles are in Telogen all together, but in pregnancy this number changes dramatically.[1] A pregnant woman tends to have a percentage of hairs in Telogen, out of the total, slightly lower than the standard range, this precisely because of the changes to the normal hormonal pattern imposed by pregnancy.[2] During that period, in fact, women experience an approximate ninefold increase in the blood concentration of Progesterone, fourfold for estrone, eightfold for estradiol, and ninefold for estriol [3]: these hormones have a profound influence on the hair follicle, by virtue of the fact that they tend to lengthen and stimulate the anagen growth phase.

Normally, the hair cycle is divided into 3 phases:

• Anagen, the phase in which follicle mitosis activity is highest and in which hair growth occurs
• Catagen, the phase in which mitosis slows to a halt and coincides with the end of hair growth
• Telogen, the stage when follicle mitosis is finished and the hair separates from the follicle, dying and being expelled

The normal length of these phases is about 1000 days for anagen, 10 for catagen, and 100 for telogen. With the lengthening of the anagen period during pregnancy, there is a “synchronization” of follicles, which would otherwise naturally have an asynchronous cycle, with important and visible consequences.[4]

With childbirth, women’s hormonal set-up changes again and abruptly: blood values for the previously mentioned hormones in fact return to their pre-pregnancy levels within 2-4 days, thus rapidly leading to the end of anagen, and about 8 weeks after childbirth, hair will begin to be in large amounts in the telogen phase at the same time.[5]

Such sudden return to pre-pregnancy hormonal values in fact leads to a well-known consequence that afflicts about 1 in every 2 women, namely postpartum telogen effluvium.[6]

In such a situation, a woman can find herself with up to 30 percent of her hair in the telogen phase, with noticeable thinning spread over the entire surface of the scalp.[7]

This condition is benign in itself and does not lead to long-term consequences on the patient’s health or cosmetic situation, although it is often experienced with apprehension and understandable psychological distress by the patient. Reassurance of the patient is therefore necessary in order to calm her concerns. If possible, such an intervention can also be assisted by supplementing the diet with products containing N-Acetylcysteine and 5-OH Tryptophan: a good example is Restax Effluvium, the first ever supplement formulated specifically for the treatment of telogen effluvium, which also helps to stabilize the patient’s mood and minimize hair loss.

In some cases, postpartum alopecia can help detect latent situations of alopecia that until the consistent aggravation of the problem also caused by postpartum effluvium had gone unnoticed, such as situations of androgenetic alopecia from hypersensitivity to androgens in the scalp or chronic telogen effluvium from vitamin D or iron deficiency.[6]

Such a situation may also be optimal time to check for other scalp diseases, such as psoriasis or seborrheic dermatitis. [5]

How can postpartum telogen effluvium be treated?

It is therefore clear that in the treatment of the issue it will be necessary to shed light on what the causes of this “wave of shedding” of the hair are, and if it is only telogen effluvium related to postpartum hormonal changes, it can be treated with a product such as Restax Effluvium to keep the patient’s mood under control, whose stress is undoubtedly a contributory cause of hair loss, associated with RestaX Women’s Lotion, which, thanks to the presence of phytoestrogens, is able to stimulate the transition of follicles from Telogen to Anagen and thus maximize hair growth.

When, on the other hand, postpartum effluvium highlights another trichological pathology, a more specific treatment is required, and one that is aimed not only at counteracting the effluvium itself, but also the other secondary pathologies coexisting with the effluvium, so as to prevent them from proceeding to aggravation.[6]

In such a case, it may therefore be useful to check with hematochemical analysis the values of Iron, Copper, Zinc, Vitamin D, B vitamins, and thyroid hormone, to assess whether one is in a concomitant situation of nutritional deficiency or estrone deficiency hypotrichia associated with postpartum telogen effluvium: each of these conditions can be treated, but will require different therapy.

For micronutrient deficiencies that cause weakening and hair loss, one may opt for Restax Pre-Effluvium, in association if necessary with Fertop, Diviken Spray, and Restax Women’s Lotion, while forestrone deficiency hypotrichia associated with postpartum effluvium, one may rely on an association of Restax Effluvium, Restax Women’s and Restax Women’s Lotion.