Managing Stress-Induced Hair Loss: Understanding and Overcoming the Condition

You may have heard that going through severely stressful situations can cause clumps of your hair to suddenly fall out. But is stress-induced hair loss a myth, or can it happen? And if you’re noticing more hair going down the drain, what can you do about it?

Here’s what we know about stress-induced hair loss and how you can overcome the condition.

Does stress cause hair loss?

The simple answer is yes, stress can cause hair loss. Most hair loss resulting from stress is temporary, but it can also be chronic, depending on the situation.

This doesn’t mean all hair loss is stress-related; several factors, including genetics and aging, can contribute to hair loss. However, studies have shown that periods of high stress can cause hair to fall out.

There are a few specific types of stress-related hair loss you could experience. These include:

Telogen effluvium

Telogen effluvium is a type of abrupt hair loss associated with severe stress. You don’t typically lose all of your hair with telogen effluvium; usually, it causes your hair to fall out in patches. In some severe cases, people start losing hair on other body parts like their face or genitals.

On top of severe stress, telogen effluvium can be caused by^[1]:

• Fever
• Thyroid problems
• Severe infection
• Childbirth
• Protein deficiency
• Some medications
• Major surgery

People with telogen effluvium often start losing hair around three months after a stressful event or injury. You might not make the connection, especially if the stressful event has already resolved itself.

Hair loss related to telogen effluvium is temporary and reversible. Even without treatment, hair typically grows back within 3 to 6 months.

Telogen effluvium is one of the top causes of hair loss, especially for women..

Stress-induced alopecia

Alopecia areata is an autoimmune disorder that affects over 6 million people in the United States alone. This condition leads your immune system to mistakenly attack healthy hair follicle cells.

Like telogen effluvium, alopecia causes patches of hair loss all over the scalp (and, in severe cases, on the body). It can affect people of any sex.

Autoimmune conditions like alopecia have no clear cause. Experts believe a combination of genetic and environmental factors play a role. One of those environmental factors could be stress. Research has found the relationship between stress and alopecia is complex, but stress can worsen alopecia symptoms, at least in some cases^[2]. Alopecia and stress can also get locked in a vicious cycle, as emotional distress is a common result of living with alopecia.

Trichotillomania

Finally, trichotillomania deserves a mention as a form of stress-induced hair loss, even though the hair loss in this case is self-induced.

Trichotillomania is a mental health condition related to obsessive-compulsive disorder (OCD) that causes people to pull out their hair, eyebrows, or eyelashes^[3]. People with trichotillomania use their fingers, tweezers, or other tools to pull hair out.

Trichotillomania is OCD-related, which means the hair-pulling is a compulsive behavior. People with trichotillomania have an intensely difficult time stopping themselves from this behavior. Stress and anxiety are common triggers.

Just like OCD, trichotillomania has many risk factors. Stress can make symptoms worse, but it doesn’t directly cause trichotillomania.

The link between stress and hair follicles

Recent research has finally provided clearer answers on how stress is related to hair loss (especially sudden hair loss, like that seen in telogen effluvium).

To understand the connection, we must first understand how hair grows. Hair follicles have 3 stages: the growth stage, the transitional stage, and the resting/shedding stage. The cycle through these stages is driven by stem cells^[4].

Growth stage (anagen)

At any given time, up to 90% of your hair follicles are in the anagen stage. In this stage, the hair shaft grows from the follicles, leaving the scalp – becoming the “hair” you see on your head. Hair can grow from your follicle in the anagen stage for several years before entering the next phase.

Transitional stage (catagen)

Around 5% of your follicles are in the catagen, or resting, stage. This is when your hair stops growing and transitions into the next stage. The catagen stage of hair growth typically only lasts a couple of weeks.

Resting stage (telogen)

In the final stage of hair growth, the hair follicle is dormant. Your hair shaft is no longer growing. Up to 15% of your hair follicles are resting at any time.

Some experts consider the telogen stage the shedding phase as well. Others have identified a fourth stage called the exogen stage, when hair falls out from the follicle, often aided by brushing or washing. It’s normal to lose 50 to 100 hair shafts daily during the exogen phase, which lasts several months.

2021 mice study

Stress-related hair loss (like telogen effluvium) affects hair follicles in the telogen stage. Follicles can enter into a prolonged resting (telogen) phase without regenerating.

A groundbreaking 2021 study^[5] examined how stress affects hair follicles and growth in mice. The researchers found that removing the rats’ adrenal glands—responsible for releasing stress hormones like corticosterone (or cortisol in humans)—led hair follicles to cycle through the stages more rapidly. Hair regenerated even when the mice got older, suggesting that removing stress hormones makes hair grow faster.

On the other hand, when the mice were exposed to stress, their hair growth slowed. Hair stayed in the resting phase for longer, similar to what happens to humans who have telogen effluvium.

Further, the researchers found that stress hormones don’t directly affect hair follicles. Instead, they affect the dermal papilla—a cluster of cells found directly under the follicle.

Although more research is needed to examine the effect in humans, this study gave us more answers about how stress affects hair loss.

How to regain hair loss from stress

Regaining hair loss from stress depends on the condition causing the hair loss.

In most cases, telogen effluvium resolves itself within a few months. However, if extreme stress continues, you could experience hair loss. Alopecia is an autoimmune disorder that has no cure. Stress could make symptoms worse, but even when stress is well-managed, many people with alopecia continue losing hair. Trichotillomania requires mental health treatment.

On top of managing stress, there are some things you can try to regain hair loss from stress. However, it’s important to always talk to a healthcare provider about your hair loss before trying any medications or treatments. A professional can help identify the root causes behind your hair loss and refer you to appropriate next steps.

Some things that can help you regain the hair you’ve lost include:

• Over-the-counter hair loss medications like minoxidil
• Supplements like biotin
• Scalp massage^[6]
• Shampoos or other hair treatments designed to promote hair growth
• Prescription-strength corticosteroids (for alopecia)^[7]

If you’re pulling out your hair due to trichotillomania, a specific type of cognitive-behavioral therapy called Habit Reversal Training can help^[8].

How to manage stress

The best way to manage stress-induced hair loss is to lower stress levels. On top of causing hair loss, stress can have other negative effects on your health, including:

• High blood pressure
• Heart problems, including increased risk of stroke
• Digestive problem
• Muscle tension and pain
• Sleep problems
• Weight gain
• Increased risk of diabetes
• Increased risk of mental health conditions like depression, anxiety, and substance use disorder

One of the biggest challenges with stress-induced hair loss is stress, and hair loss can become locked in a vicious cycle. Stress can contribute to hair loss, which is very difficult for many people to live with. Although hair loss doesn’t impact your overall health, most people who experience hair loss find it at least mildly distressing emotionally. You might feel embarrassed about hair loss or feel socially impacted by it.

This, in turn, can increase your stress, contributing to further hair loss – and so on.

By finding healthy ways to manage your stress, you are holistically taking care of your health and breaking this cycle.

Consider these simple and research-backed ways to lower your overall stress levels.

Physical exercise

Moving your body is one of the best ways to reduce stress and manage mental health. It can also help prevent mental health problems like depression and anxiety. If you work out, ensure you get enough protein, as protein deficiency can also cause hair loss in some people.

Get enough sleep

Most healthy adults need between 7 to 9 hours of restful sleep every night. You’re more likely to feel stressed when you don’t get enough sleep. Sleep deprivation can also lead to many other negative health effects. Practice good sleep hygiene to ensure you get enough high-quality sleep each night.

Nutritious meals

Nourish your body with healthy, nutritious meals. This can reduce stress and may also contribute to hair growth. Avoid strict fad diets, which may lead to nutritional deficiencies that can worsen hair loss.

Seek professional support

Working with a mental health therapist can not only help you find effective strategies to manage your stress, but it can also give you a safe and non-judgmental environment where you can process the distressing feelings you may be having about hair loss.

Mental health support in Washington State

Our mental health treatment programs at The Center • A Place of HOPE can help you address every aspect of your health and well-being, including stress. You may not be able to avoid stress, but you can learn how to manage it well so it no longer contributes to hair loss.

1 – https://my.clevelandclinic.org/health/diseases/24486-telogen-effluvium
2 – https://www.sciencedirect.com/science/article/pii/S0022202X1534361X
3 – https://www.mayoclinic.org/diseases-conditions/trichotillomania
4 – https://www.ncbi.nlm.nih.gov/books/NBK499948
5 – https://pubmed.ncbi.nlm.nih.gov/33790465/
6 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4740347/
7 – https://www.aad.org/public/diseases/hair-loss/types/alopecia/treatment
8 – https://www.ncbi.nlm.nih.gov/books/NBK493186/