excessive hair loss

My wife is 37 yrs old. She gave birth to our 5th child on 11/8/10. She's always experienced some hair loss while nursing in the first 6-9 months. It appears to be much worse this time and she has periods of fatigue occasionally. The area of hair just above her temples has thinned tonthe point that it's noticeable. There has been a lot of stress in our lives due to financial issues as well as the arduous task of keeping up with all the kiddos. I recently took on a p/t job and work 75-80 hrs per week between that and my f/t job, she stays home with the kids. I'm very concerned and we're going to sched an appointment with her Gyn this week. Any ideas on what might be causing the fatigue and extreme hair loss? Sorry for the long winded post. Thank you!

[Bhupinder Kaur, MD]

Hello,
These symptoms can be due to telogen effluvium. See the growth cycle of hair is in two phases, anagen or growth phase and telogen or resting phase. During pregnancy hair usually enter the anagen phase and after delivery they enter the telogen phase. In telogen effluvium, a large number of hair enter telogen at one time.

It is nonscarring alopecia characterized by diffuse hair shedding, often with an acute onset. There is a chronic form also which persists for a longer duration and starts with insidious onset. Chronic telogen effluvium is hair shedding lasting longer than 6 months. Treatment consists of medications like Minoxidil, surgical approach(hair transplantation) and improvement in diet.

My sincere advice is to consult a trichologist. It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.