Stress and Hair Loss: Exploring the Connection and Coping Strategies

Discover the link between stress and hair loss, and learn strategies to manage its effects. Explore the impact of stress on hair health and find practical tips 

Experiencing an increased amount of hair on your brush, pillow, or shower drain can be distressing, especially when the cause is unclear. The most common reason for male hair loss is androgenic alopecia, also known as male pattern baldness. This type of hair loss is triggered by a genetic sensitivity to DHT. However, there are other factors that can contribute to hair loss as well.

Emotional stress is one such factor that can cause or exacerbate hair loss. If you are feeling overwhelmed by stress from work, personal relationships, or other sources, it is possible that this stress could lead to mild hair thinning or significant hair loss. In this article, we will explore the mechanisms by which stress can lead to hair loss and discuss various treatment options to help you regrow lost hair caused by stress.

Can Stress Cause Hair Loss?

Yes, stress and hair loss can be related. Stress can cause hair loss. Our bodies have a natural response to stress, known as the “fight or flight” response, which triggers the release of hormones that can affect our hair growth cycle. When we experience chronic or severe stress, this can disrupt the normal hair growth cycle and lead to hair loss.

Stress-induced hair loss is often temporary and will usually grow back naturally once the underlying cause of the stress has been addressed or resolved. However, in some cases, hair loss may become chronic, and treatments such as minoxidil may be necessary to encourage regrowth.

Stress-induced hair loss is not the same as male or female pattern baldness, which is caused by genetics and hormonal factors. If you’re experiencing hair loss, speak to a healthcare professional to determine the cause and appropriate treatment.

Types of Stress-Related Hair Loss

There are different types of hair loss associated with stress, and not all hair loss is stress-related. Here are three types of hair loss that have been linked to high-stress levels:

1. Telogen effluvium (TE) 

TE occurs when the number of hair follicles actively producing hair changes. This can lead to shedding during the telogen (resting) phase of hair growth, resulting in thinning hair. TE may be visible in patches, especially around the center of the scalp, and can affect both men and women of any age. However, scalp hair is usually not entirely lost, and the hair loss is reversible. The duration of hair regrowth depends on the cause of the TE.

2. Alopecia areata (AA) 

AA is an autoimmune disease where the immune system attacks hair follicles, resulting in hair loss. Stress can be a trigger for AA. Hair loss in AA is usually in round patches on the scalp, but it can also be across the entire scalp, and in severe cases, across the entire body. The hair may grow back and fall out repeatedly, and there is no known cure for AA. However, some prescription medications may help those with more than 50% hair loss.

3. Trichotillomania

Trichotillomania is a hair-pulling disorder characterized by the urge to pull hair from the scalp or other parts of the body. It is considered an impulse control disorder that may occur unintentionally or as a means to relieve stress or negative emotions. Hair pulling from the scalp, eyebrows, and eyelashes may be noticeable and cause additional stress, perpetuating the cycle of the disorder. Although trichotillomania usually develops in preteens, it can last a lifetime, and genetics may play a role in its development.

Common Signs of Stress-Related Hair Loss

Hair loss due to stress typically presents with several recognizable symptoms, including 

• finding extra hairs on your pillowcase or bedding, 
• noticing more stray hairs on your bathroom floor or in the shower, and 
• observing less density and thinness in your hair, especially under bright light. 

Since hair loss can be subtle, it might not be immediately noticeable on a day-to-day basis, but taking photos of your hair regularly can help you track any changes in thickness over time. You can also try counting the hairs you lose, with an average loss of around 100 hairs per day being considered normal. In the case of telogen effluvium, however, this number can increase to around 300 hairs, making it more apparent that there has been a change in hair shedding.

Could hair loss caused by stress be permanent?

The good news is that it is usually temporary, and hair can grow back with time. However, the rate of regrowth may vary among individuals.

The hair growth cycle is composed of four phases, namely 

• anagen (growth), 
• catagen (shrinkage), 
• telogen (rest), and 
• exogen (shedding). 

Each of the approximately 100,000 hair follicles on the human scalp is in a different phase at any given time. Telogen effluvium disrupts the natural hair growth cycle by affecting the hair during its resting phase. During the growth cycle, the hair follicle detaches from the skin, new hair grows to replace the old one, and the old hair falls out.

Most of the hair is in the anagen phase, during which the hair grows to its full length, and this phase can last up to six years. In contrast, about five to ten percent of hair is in the telogen phase at any one time, during which the hair is in a resting state.

With telogen effluvium, up to 30 per cent of hair can suddenly enter the telogen phase, leading to hair shedding. It is important to note that stress-induced telogen effluvium is a temporary condition, and hair regrowth can occur by managing stress levels.

If your hair loss is due to stress, manage your stress levels to promote healthy hair growth. This may be the key to returning to a normal rate of hair growth.

When it comes to hair loss, stress is not linked to male pattern baldness, which causes permanent hair loss around the hairline, temples, and crown of the scalp. However, stress can cause and worsen a temporary form of hair loss known as telogen effluvium, which is different from androgenetic alopecia.

Is There a Way to Prevent Telogen Effluvium?

Unfortunately, there is no established method to prevent or halt an occurrence of telogen effluvium, and it should eventually resolve on its own with time. However, certain measures may promote overall hair health. Maintaining a well-balanced diet, particularly with adequate protein intake (0.8 grams/kilogram/day), is crucial since hair mainly comprises protein (keratin). Therefore, sufficient protein is necessary to maintain and grow hair. Also, avoid hairstyles that are too tight, hairstyles that use heat, or chemical treatments, as these can contribute to hair loss or breakage.

Caring for emotional well-being and implementing coping strategies, such as meditation, may also be beneficial in reducing the impact of a stressor.

If your hair loss is chronic, patchy, or linked with redness, itching, or discomfort, consult a dermatologist for medical attention.

Difference between Stress-Related Hair Loss vs. Male Pattern Baldness

When it comes to hair loss, there are distinct differences between telogen effluvium (hair loss potentially triggered by stress) and hair loss from male pattern baldness:

• To begin with, male pattern baldness usually results in permanent hair loss, whereas almost all the hair loss from telogen effluvium will grow back if the underlying cause is addressed.
• Second, the appearance of hair loss from male pattern baldness differs from that of stress-induced hair loss. While male pattern baldness leads to a receding hairline, baldness on the crown, or other balding patterns, telogen effluvium results in diffuse thinning across the scalp.
• Third, unlike male pattern baldness, telogen effluvium is not linked to androgen hormones like DHT, which means that treatments like finasteride that work for male pattern baldness may not be effective for stress-related hair loss.
• Fourth, stress-related hair loss can cause you to lose body hair as well. While telogen effluvium hair loss primarily affects the scalp and may result in patchy hair loss, it can also cause more hair to fall out from other parts of the body or cause a reduction in overall body hair.

If you’re experiencing hair loss and are unsure if it’s due to stress or male pattern baldness, it’s recommended to consult a healthcare professional. A dermatologist can perform several tests, such as a hair pull test, to diagnose telogen effluvium.

Treatments for Stress-Related Hair Loss

There is no one-size-fits-all treatment for telogen effluvium, as the condition may have various causes. If your hair loss is triggered by a one-time stressful event, such as surgery or a traumatic experience, your hair will typically regrow naturally over a few months.

• Medications 

Medications like finasteride, which block the hormone dihydrotestosterone (DHT) to combat hair loss from male pattern baldness, are not effective for stress-related hair loss, as it is not related to DHT. If your hair is not regrowing quickly enough, your healthcare provider may prescribe minoxidil, a medication that can improve hair growth rate and quality.

Minoxidil works by increasing the blood supply to hair follicles, prompting them to enter the growth phase. Although it can take a few months to see noticeable results, studies have shown that it is highly effective at promoting hair growth.

• Nutrition

Balanced and nutritious eating is crucial for the overall health of your body, including your hair. Although all essential vitamins are important in a healthy diet, there are some that can significantly impact hair growth:

1. Vitamin C is crucial for building collagen, which is found in hair follicles. Foods that are high in vitamin C include broccoli, citrus fruits, bell peppers, and strawberries.

2. Vitamin B complex promotes a healthy metabolism, skin, and hair. Dark leafy greens, nuts, avocados, and beans are good sources of vitamin B.

3. Vitamin E contains potent antioxidants that can promote a healthy scalp. Sunflower seeds, spinach, broccoli, shrimp, and olive oil are some foods rich in vitamin E.

If you are not getting enough of these nutrients in your diet, talk to your doctor about taking supplements. Do not add supplements to your routine without your doctor’s supervision.

Stay properly hydrated, as every cell in your body relies on water to function properly. Men should aim for 15 1/2 cups of water per day, and women should aim for 11 1/2 cups per day. Drinking eight glasses of water per day is a reasonable goal, and you can get the rest from your diet and other beverages.

• Stress Management

Managing stress effectively can help reduce the risk of further hair loss, but finding the right techniques may take some trial and error.

Here are some popular methods for reducing stress:

1. Exercise: Engaging in physical activity can be an effective way to reduce stress. This could include light daily walks, dance classes, or yard work.

2. Hobbies: Finding enjoyable activities to occupy your time can also help reduce stress. Consider volunteering, joining a community theater group, gardening, or starting an art project.

3. Writing: Taking a few minutes each day to write about your feelings and stress triggers can help you discover coping mechanisms.

4. Breathing and meditation: Meditation and breathing exercises can help you focus on the present moment. You may also want to try combining meditation with physical exercises, such as yoga or tai chi.

Final Thoughts 

Stress-induced hair loss can be a common occurrence, but it is typically not a cause for concern when experienced occasionally. A few bad days or a difficult week will generally not lead to hair loss.

However, if the stress is chronic or caused by severe trauma, it can result in temporary hair loss. In such cases, it is recommended to consult a healthcare provider to address the underlying cause of the stress.

Hair loss due to stress is typically reversible and natural regrowth can be expected over time. In instances of chronic hair loss caused by stress, treatments such as minoxidil can be effective.