The Link Between Stress and Hair Loss: What You Need to Grasp

Stress is a ubiquitous part of modern life, but its effects can extend beyond emotional well-being and manifest in physical ways. One common, and often distressing, symptom of stress is hair loss. But how exactly does stress contribute to hair loss, and what can be done about it?

How Does Stress Cause Hair Loss?

During stressful times, the body increases production of cortisol, the primary stress hormone, as part of the “fight-or-flight” response. This hormone impacts the entire body, including hair growth. “When cortisol levels stay high, hair follicles may switch from growth mode into a resting phase,” explains Melissa Piliang, MD, FAAD, Chairman of the Department of Dermatology at Cleveland Clinic . “That can lead to increased shedding seen days, weeks or even months later.”

Hair growth requires significant energy and nutrients. When the body is under stress, it prioritizes vital organs – the brain, heart, and lungs – and may divert resources away from hair growth. “It’s a matter of priorities,” says Dr. Piliang. “Hair isn’t essential for your survival. Your organs are.”

Stressors That Can Trigger Hair Loss

Stress isn’t solely emotional. Physical stressors can likewise contribute to hair loss, including:

• Rapid weight loss
• Nutritional deficiencies
• Illness
• Surgery
• Poor sleep
• Smoking
• Alcohol use

“Any of those stress factors could trigger hair loss,” emphasizes Dr. Piliang.

Signs of Stress-Related Hair Loss

Stress-related hair loss presents differently in individuals. Common signs include:

• Increased hair shedding in the shower or on a hairbrush
• Overall thinning of hair
• A widening part
• A thinner ponytail
• Sudden, patchy hair loss

Other signs of stress, such as trouble sleeping, increased anxiety, or changes in appetite, may also be present.

Types of Stress-Related Hair Loss

Telogen Effluvium

Telogen effluvium (TE) is the most common type of stress-related hair loss. It occurs when a large number of hair follicles enter the resting phase and shed simultaneously. This can happen two to three months after a particularly stressful event .

Alopecia Areata

Alopecia areata is an autoimmune condition where the immune system attacks hair follicles, resulting in patchy hair loss. Stress can potentially trigger a flare-up in individuals prone to this condition. “Stress can definitely throw off your immune system and maybe tip it to the point where you see alopecia areata,” notes Dr. Piliang.

Trichotillomania (Hair Pulling)

Trichotillomania is a less common response to stress, involving an urge to pull out hair as a coping mechanism. This behavior can lead to noticeable hair thinning or bald patches. “It’s kind of similar to chewing nails,” says Dr. Piliang. “Every time you pull out a hair, it causes a little pain. That little bit of pain is like an endorphin that temporarily distracts your mind and dulls stress.”

What Can You Do About Stress-Related Hair Loss?

If you’re experiencing troubling hair loss, it’s best to consult a healthcare provider for a diagnosis. “It’s always best to get a medical evaluation,” advises Dr. Piliang. “Many different things can cause hair loss, including thyroid problems or nutrient deficiencies. Don’t just assume it’s because of stress.”

If stress is the underlying cause, several approaches can help:

• Waiting it out: Hair naturally grows and sheds. TE often resolves with new growth within a few months.
• Medications: Corticosteroids or minoxidil (Rogaine®) may be recommended for hair loss related to alopecia areata.
• Stress Management: Addressing the root cause – stress – is crucial. Consider:
• Mindfulness activities like yoga, meditation, and breathing exercises
• Spending time in nature
• Regular exercise
• Improving sleep quality
• Talking to a therapist

“So many people live their life at a very high baseline stress level — and it can affect your health in so many ways,” says Dr. Piliang. “That’s why learning how to manage stress is so key.”