We enjoyed the stimulating article on telogen effluvium by John J. Headington in the March 1993 issue of the Archives.1 We believe that the perpetuation of this concept obscures the important role of catagen in the hair cycle. His concept ''that shedding of the club hair is also an active biologic process'' has not been substantiated, to our knowledge. Surely, the shedding of the club hair is the inevitable consequence of catagen. We have previously demonstrated the importance of catagen in the moulting of mice.2 Recent work on the control of apoptosis (programmed cell death) by putative oncogenes and suppressor genes (eg, bcl-2, myc, p53, and APO-l/Fas)3,4 provides a molecular-based explanation for catagen and reinforces our view that this is pivotal to the subsequent shedding of hair.
Weedon D, Strutton G. Telogen Effluvium. Arch Dermatol. 1994;130(2):254. doi:10.1001/archderm.1994.01690020124022