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Postpartum alopecia

Postpartum alopecia is classified as telogen effluvium. This process depends on the influence of hormones on hair follicles; in particular, this influence is connected to the reduction of estradiol and tyroxine levels in the postpartum period. The influence of these hormones on hair follicles during pregnancy causes a decrease of the number of hairs in the telogen phase (inactive phase) by about half. Hair loss following childbirth is therefore an expression of the body returning to the situation from before pregnancy (hair "stopped" in active growth phase by pregnancy hormones starts to fall out, as well as hair that was supposed to fall out in this period). Some authors point out a certain correlation of postpartum alopecia with the prevalence of postpartum depression, which may be caused by the same hormonal factors.

Symptoms
Postpartum alopecia is diffused (20-30% of hair from the final stage of pregnancy) and appears quite suddenly, from approximately the 2nd or 3rd month following childbirth. No complete hair loss is observed.

Course of disease
The spontaneous hair regrowth usually occurs within 6 to 9 months after childbirth. In breastfeeding women, the hair regrowth may take longer due to the influence of prolactin on hair follicles.

Diagnosis
It is simple to diagnose due to the childbirth history. A trichoscopy allows to exclude other disease entities.

Treatment
In general, no routine treatment of postpartum alopecia is used, in particular in breastfeeding women. In case of significant hormonal disorders, thyroid hormones and estradiol supplementation is implemented, and sometimes hormonal contraceptive drugs are administered. In breastfeeding women, therapeutic possibilities are limited due to the potential adverse effect on the baby.