Exploring the Potential Links between Telogen Effluvium, Alopecia Areata, Pressure-Induced Alopecia, and General Anesthesia: A Narrative Review

BACKGROUND: Alopecia areata (AA), pressure-induced alopecia (PIA), and telogen effluvium (TE) are nonscarring forms of hair loss reported in patients undergoing surgical procedures under general anesthesia (GA). While AA is primarily autoimmune and stress-mediated, PIA arises from prolonged scalp pressure during surgery, and TE is typically triggered by metabolic or physiological stressors that induce a premature transition of anagen hairs into the telogen phase. OBJECTIVE: This review aims to explore the emerging evidence linking GA to the onset or exacerbation of these alopecic types. METHODS: Authors review currently available literature found in MEDLINE and Google Scholar databases and present it in a structured way. RESULTS: Currently available literature supports the existence of a link between GA and AA, PIA, and TE, and proposes several potential mechanisms including immune dysregulation, ischemia, hypoxia, and systemic stress responses on the basis of current findings. LIMITATIONS: Despite existing evidence, significant gaps remain in understanding the associations between various forms of alopecia and GA, owing to a lack of high quality, structured research. CONCLUSIONS: There is a possible link between GA and various forms of alopecia, although further research to clarify the relationships, identify at-risk individuals, and inform perioperative hair loss management strategies is needed.