Can Stress Cause Hair Loss?

Why stress causes hair loss 

Stress interrupts the hair growth cycle and forces hair follicles into the resting phase before their natural time.  

This can be due to highly difficult or demanding physical life events such as childbirth, which may lead to postpartum hair loss or emotional stress such as trauma, job loss or divorce. 

Hair shedding can also be caused by hormonal fluctuations, particularly the release of cortisol which is a primary stress hormone. 
 

The different types of stress related hair loss 

Telogen effluvium  

Telogen effluvium happens when many hair follicles suddenly enter the resting phase of the hair growth cycle at the same time. It is usually caused by prolonged periods of stress and anxiety.  

Telogen effluvium symptoms include: 

• Hair falling out rapidly, often in large clumps  
• Slow hair growth 
• Hair thinning 

This is usually a temporary condition, and your hair is likely to grow back. 
 

Alopecia areata  

Alopecia areata is an autoimmune disorder which happens when the immune system attacks hair follicles and causes hair loss.  

It causes patchy hair loss, mainly on the scalp, but it can also affect the eyebrows, eyelashes, and beard. Affected areas are usually smooth bald patches, with no sign of inflammation or irritation on the skin.  
 

Trichotillomania  

Trichotillomania is hair loss characterised by recurrent, irresistible urged to pull hair from one’s scalp, eyebrows, eyelashes, or other parts of the body.

Trichotillomania is usually induced by feelings of stress, tension, or anxiety. This action results in noticeable hair loss.

It is classed as a mental health disorder which can have significant emotional and psychological effects, including feelings of embarrassment, shame, and low self-confidence.  
 

What about androgenetic alopecia?

Androgenetic alopecia is the most common type of hair loss. It is a genetic condition which affects both men and women and is widely known as ‘male-pattern baldness ‘or’ female-pattern hair loss’.  This type of hair loss is not reversible, however, it can be managed and treated with medication, or medical procedure.

Men (male pattern baldness)

Male pattern baldness is caused by high levels of DHT (dihydrotestosterone), a by-product of testosterone. DHT shrinks hair follicles to a point where they no longer produce hair.

Female pattern baldness is usually caused by aging, and changes in hormone levels.  

In men, hair shedding often begins with recession and hair thinning at the front, and thinning of the hair on the crown, eventually leading to partial or complete baldness.  
 

Women (female pattern hair loss)

In women, the hairline is not usually affected, and hair loss is limited to the crown.  

It can also present as generalized thinning across the whole scalp.

There can be many different causes of hair loss in women. Hormone fluctuations during perimenopause, menopause, pregnancy, childbirth, and breastfeeding can cause a decline in estrogen levels and a rise in androgen levels. Hair follicles are more sensitive to androgens causing them to shrink, which results in hair thinning and hair loss.

Common thyroid disorders, such as hypothyroidism or hyperthyroidism, may also disrupt the balance of hormones and cause hair to shed.  
 

How to regain hair from stress  

The good news is that it is possible to regain hair that has been lost because of stress. Treatment can vary depending on the type of hair loss you are experiencing, so the first step should involve identifying the type of hair loss you are experiencing. 

Below, we outline some of the treatment options.
 

Treatment for Telogen effluvium 

Telogen effluvium can be triggered by stress, but also illness, medication, hormonal changes, or nutritional deficiencies. It is important to identify the underlying cause to treat the condition correctly. 

Over-the-counter topical treatments such as regaine extra strength foam, which contains the active ingredient minoxidil, can help to stimulate hair regrowth and reduce shedding.  

You should also ensure that you are getting adequate amounts of essential vitamins and minerals, which is important for normal cell growth and function.  
 

Treatment for alopecia areata  

Topical steroids are usually the first-line treatment for alopecia areata. They work by reducing inflammation and suppressing the immune response where hair loss has occurred, promoting hair regrowth. The treatment is available as a cream, ointment or solution which is applied directly to the scalp.  

Topical immunotherapy is another treatment option. This process involves applying a chemical irritant to the scalp to cause an allergic reaction, stimulating an immune response and in turn, hair re-growth. In some cases, oral corticosteroids may be prescribed for severe cases of alopecia areata or if other treatments have not been effective.
 

Treatment for trichotillomania 

Treatment usually involves addressing the underlying behaviors and psychological factors which lead to hair pulling.  

Cognitive-behavioral therapy (CBT) is a type of talking therapy which is most widely recommended for people with trichotillomania. It is structured to help identify triggers and behaviors and teach you coping strategies to modify these patterns. Habit reversal training (HRT) is a specific technique that is often used, which involves replacing hair pulling with alternative behaviors, such as fist-clenching.  

In some cases, medication such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed if anxiety or depression are thought to be contributing factors. 
 

Treatment for androgenetic alopecia  

There is no cure for androgenetic alopecia, however, hair loss treatments can help to slow down hair loss and promote hair regrowth.  

Finasteride is one of the most common treatments for male pattern baldness. Finasteride tablets work by blocking the conversion of testosterone to dihydrotestosterone (DHT), the hormone which stops hair follicles from producing hair.  

Minoxidil is another effective treatment, which works by promoting blood flow to the scalp. This provides hair follicles with oxygen and nutrients, enabling hair regrowth. Minoxidil is available as a topical solution for both men and women.   
 

What else can I do to help hair loss caused by stress? 

Diet 

To tailor your diet to reduce hair loss, consider incorporating the following nutrients:

Protein: Ensure adequate intake of protein-rich foods like lean meats, fish, eggs, dairy, legumes, and nuts. Hair is primarily made of protein, so getting enough is crucial for hair health.

Iron: Include iron-rich foods such as red meat, poultry, fish, lentils, beans, tofu, spinach, and fortified cereals. Iron deficiency can contribute to hair loss.

Omega-3 Fatty Acids: Consume sources of omega-3 fatty acids like fatty fish (salmon, mackerel, sardines), flaxseeds, chia seeds, and walnuts. These promote a healthy scalp and may help reduce hair loss.

Vitamins: Ensure sufficient intake of vitamins A, C, D, and E, as well as B vitamins like biotin (B7) and niacin (B3). These are found in a variety of fruits, vegetables, whole grains, nuts, and seeds.

Antioxidants: Eat a variety of colorful fruits and vegetables to obtain antioxidants, which help protect hair follicles from damage.

Zinc: Incorporate zinc-rich foods such as oysters, beef, lamb, pumpkin seeds, and lentils. Zinc deficiency has been linked to hair loss.

Hydration: Drink plenty of water to maintain hydration, which is essential for healthy hair growth and scalp health.

Limit processed foods: Minimize consumption of processed and sugary foods, as they can contribute to inflammation, which may negatively impact hair health.

Limit sugar intake: Excessive sugar consumption can lead to insulin resistance and hormonal imbalances, including increased levels of androgens. High androgen levels are associated with hair loss, particularly in individuals with genetic predispositions. By reducing sugar intake, you may help stabilize hormone levels and decrease the risk of hair thinning and loss.
 

Stress management 

Stress and hair loss go hand in hand. By reducing stress, you can help to stop hair loss. Strategies to help manage stress include:

Regular exercise: Engage in regular physical activity, such as walking, jogging, yoga, or dancing, to help reduce stress levels and promote relaxation. Exercise releases endorphins, which are natural stress-relievers.

Deep breathing and relaxation techniques: Practice deep breathing exercises, meditation, progressive muscle relaxation, or mindfulness techniques to calm the mind and reduce stress responses in the body.

Healthy lifestyle habits: Maintain a balanced diet, get adequate sleep, and avoid excessive alcohol and caffeine consumption. A healthy lifestyle can support your body's ability to cope with stress.

Time management: Prioritize tasks, set realistic goals, and break large projects into smaller, manageable steps. Effective time management can help reduce feelings of overwhelm and stress.

Limit stressors: Identify sources of stress in your life and take steps to minimize or eliminate them when possible. This may involve setting boundaries, delegating tasks, or seeking professional help if needed.

Hobbies and relaxing activities: Engage in activities you enjoy, such as reading, gardening, listening to music, or spending time in nature. Taking time for yourself can help recharge your batteries and reduce stress levels.

Seek professional help: If stress becomes overwhelming or unmanageable, consider seeking support from a mental health professional, such as a therapist or counselor. They can provide coping strategies, support, and guidance tailored to your individual needs
 

Sources

1. NHS. (Year). Hair Loss. NHS. Available at: https://www.nhs.uk/conditions/hair-loss/ (Accessed: May 2, 2024).

2. NHS. (Year). Coping Tips for Women. Hair Loss. NHS. Available at: https://www.nhs.uk/conditions/hair-loss/coping-tips-for-women/ (Accessed: May 2, 2024).

Whilst all of our content is written and reviewed by healthcare professionals, it is not intended to be substituted for or used as medical advice. If you have any questions or concerns about your health, please speak to your doctor.