Long-term or chronic stress can have a wide range of negative health consequences, impacting nearly every system in the body and mind, meaning stress can cause hair loss. This is because prolonged activation of the body’s stress response system and sustained high levels of stress hormones like cortisol can disrupt normal bodily processes. While some of the more common problems caused by stress include anxiety, weight loss/gain and sleep loss, some people will find that enduring prolonged periods of stress can cause hair loss. While there are different ways stress can be leading to hair loss, the good news is in most cases it is temporary. Keep reading below to find out more.
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Different Types of Hair Loss
There are many different types of hair loss. From natural reasons such as age and genetics to more stress induced reasons. When it comes to stress and hair loss, there are 3 main types of hair loss associated with stress. These are:
- Telogen Effluvium
- Telogen Effluvium is the most common cause of stress related hair loss. Hair growth isn’t a continuous, steady process for every single strand on your head. Each individual hair follicle goes through a cyclical process with three main stages:
- Growth (Anagen): This is the active growing phase of the hair and the one which lasts the longest. During this stage, the cells in the hair bulb (at the base of the follicle) divide rapidly, continuously pushing the hair shaft outwards. The hair follicle is actively producing new hair cells and is well-nourished by blood supply.
- Transition (Catagen): This is a short (2-3 weeks), transitional phase that marks the end of the active growth. During catagen, the hair follicle begins to shrink and detach from the dermal papilla (the blood supply that nourishes the hair). Hair growth slows down significantly, and the hair shaft forms what’s called a “club hair” at its base.
- Resting (Telogen): This is the resting phase where the hair follicle is completely inactive, and hair growth stops. The old hair, now a club hair, remains in the follicle, but it’s no longer actively growing or attached to the blood supply. This phase prepares the follicle for the growth of a new hair.
- Shedding (Exogen): While often considered part of the telogen phase, some experts recognize a separate exogen phase as the final shedding stage. During exogen, the old hair is released from the follicle and falls out, often during daily activities like washing or brushing. This shedding makes way for a new hair to begin its anagen phase in the same follicle, starting the cycle anew.
- Telogen effluvium disrupts the normal balance and timing of the phases, specifically by prematurely shifting a large number of hairs from the anagen (growth) phase into the telogen (resting/shedding) phase.
- Telogen Effluvium is the most common cause of stress related hair loss. Hair growth isn’t a continuous, steady process for every single strand on your head. Each individual hair follicle goes through a cyclical process with three main stages:
- Trichotillomania
- Trichotillomania is a condition where individuals experience an irresistible urge to pull out their own hair, leading to noticeable stress-related hair loss and significant distress. This compulsive behavior can affect any part of the body, most commonly the scalp, eyebrows, and eyelashes, and often provides a sense of relief despite repeated attempts to stop.
- Alopecia Aerata
- Alopecia areata is an autoimmune condition where the body’s immune system mistakenly attacks healthy hair follicles, leading to sudden, often patchy stress-related hair loss on the scalp or other body areas. While not directly caused by stress, significant emotional or physical stress can often trigger or exacerbate this unpredictable form of hair loss.
Does Stress Related Hair Loss Grow Back
In most cases, stress-related hair loss does grow back. How hair growth resumes is dependent on the type of hair loss you’re dealing with so it’s important to understand this first. For most cases, it is also important to seek out professional help.
Telogen Effluvium
Hair regrowth is very common in most cases of this type of stress caused hair loss. When your body experiences significant physical or emotional stress – think major life changes, illness, or even intense pressure at work – it can prematurely push a larger than usual number of hair follicles into that final, resting phase. This means that about two to three months after the stressful event, you’ll start to notice more hair shedding than normal.
The crucial point here is that the hair follicles themselves aren’t permanently damaged. They’ve just been temporarily paused. Once the stressor begins to recede, or you implement effective stress management techniques, those follicles usually wake up and return to their normal growth cycle. This means new hair will start to emerge, typically within a few months after the shedding peaks. While it takes patience for your hair to regain its full volume and length, the outlook for regrowth is generally very positive.
Trichotillomania
For individuals with Trichotillomania, hair regrowth is highly dependent on whether the hair-pulling behavior is stopped and if the hair follicles have sustained permanent damage. Regrowth is possible with cessation – If the pulling stops, the hair follicles, which are often just temporarily traumatized, can begin to produce hair again. The hair cycle needs time to normalize, so new growth might not be immediately visible, often taking several months or even over a year for significant regrowth.
The challenge with trichotillomania is the repetitive nature of the pulling. Chronic, repeated trauma to the same follicles can lead to inflammation, micro-tears, and eventually, scarring. If a follicle becomes scarred, it may be permanently unable to produce hair. The longer and more severely someone engages in hair pulling, the higher the risk of permanent damage and irreversible hair loss in those areas.
The most crucial step for hair regrowth in trichotillomania is addressing the underlying compulsive behavior. Therapies like Habit Reversal Training (HRT) and other forms of Cognitive Behavioral Therapy (CBT) are designed to help individuals stop pulling. Once the pulling ceases, treatments like minoxidil (topical or oral), low-level laser therapy, or PRP (platelet-rich plasma) injections can be considered to encourage and expedite regrowth. In cases of permanent loss due to scarring, hair transplant surgery might be an option, but it’s vital that the pulling behavior is under control beforehand.
Alopecia Areata
For alopecia areata, the hair follicles are attacked by the body’s own immune system, but they are not typically destroyed.
This means that the hair loss is often temporary and hair can regrow on its own, even without treatment, within several months to a year.
The challenge with alopecia areata is its unpredictable nature. Hair can grow back, but it may fall out again later in the same or different patches. Some people experience multiple episodes of hair loss and regrowth throughout their lives. Regrowth success can vary based on the extent of hair loss. Small, patchy alopecia areata has a higher chance of complete regrowth. More extensive forms, like alopecia totalis (total scalp hair loss) or alopecia universalis (total body hair loss), are less likely to see full regrowth without aggressive treatment, though even in these severe cases, regrowth is possible for some individuals.
Of course, if you’re experiencing hair loss and it’s causing you distress, it’s always a good idea to chat with a healthcare professional. They can help identify the specific cause and offer personalised advice to support your hair’s healthy return.
Stress Related Hair Loss Treatment
When facing hair loss, it’s reassuring to know that various treatments are available, often tailored to the specific type of hair loss. For the three common types linked to stress – Telogen Effluvium, Alopecia Areata, and Trichotillomania – the approaches differ significantly, reflecting their underlying causes.
Telogen Effluvium
Telogen effluvium is largely a self-correcting condition, as it’s triggered by a temporary disruption to the hair growth cycle. The primary “treatment” is to identify and manage the underlying stressor that caused the shedding. This could be anything from a significant illness, surgery, pregnancy, nutritional deficiencies, or chronic emotional stress.
If a specific nutrient deficiency (like iron or vitamin D) is identified through blood tests, supplementing those deficiencies is crucial. If a medication is the culprit, discussing alternatives with your doctor can help. For emotional stress, techniques like mindfulness, meditation, yoga, regular exercise, adequate sleep, and therapy can be highly beneficial.
While not directly “curing” telogen effluvium, some supportive measures can help stimulate hair growth and improve overall hair health.
- Minoxidil (topical or oral): While primarily used for pattern baldness, minoxidil can sometimes be recommended off-label to help shorten the telogen phase and encourage earlier regrowth, especially in chronic telogen effluvium.
- Nutritional Support: Ensuring a well-balanced diet rich in protein, vitamins (especially B vitamins, D, E), and minerals (iron, zinc) is vital for healthy hair. Supplements may be recommended if dietary intake is insufficient.
- Patience and Reassurance: Perhaps the most important aspect of managing telogen effluvium is understanding that it’s usually temporary and hair will regrow once the stressor is gone. This reassurance can significantly reduce the psychological distress associated with the condition.
Trichotillomania
Trichotillomania is a body-focused repetitive behavior (BFRB) driven by irresistible urges to pull hair. Treatment primarily focuses on behavioral and psychological interventions. Habit Reversal Training is the cornerstone of treatment and is a type of Cognitive Behavioral Therapy (CBT). Habit Reversal Training involves:
- Awareness Training: Helping the individual identify and understand the triggers (emotions, situations, thoughts) that lead to hair pulling.
- Competing Response Training: Teaching and practicing an alternative physical action that is incompatible with pulling (e.g., clenching fists, squeezing a stress ball, or engaging hands in another activity) when the urge arises.
- Social Support: Involving family or friends to provide encouragement and positive reinforcement.
- Cognitive Therapy: This helps individuals identify and challenge unhelpful thoughts or beliefs that contribute to the pulling behavior.
- Acceptance and Commitment Therapy (ACT): ACT helps individuals learn to accept uncomfortable thoughts and urges without acting on them, focusing on living in line with their values instead.
- Medication: While no medications are FDA-approved specifically for trichotillomania, certain medications may be used to manage co-occurring conditions like anxiety, depression, or obsessive compulsive disorder (OCD), which can exacerbate the pulling urges.
- Antidepressants (SSRIs): Can sometimes help if anxiety or depression is a significant factor.
- N-acetylcysteine (NAC): An amino acid supplement that has shown some promise in reducing pulling urges in some studies.
- Stress Management: Since stress often acts as a trigger, developing healthy coping mechanisms for stress, anxiety, and boredom is essential. This can include exercise, mindfulness, and relaxation techniques.
- Physical Barriers: Wearing gloves, hats, or bandanas can sometimes serve as a temporary physical barrier to pulling, especially during times of high risk.
Alopecia Areata
Alopecia Areata is an autoimmune condition where the immune system attacks hair follicles. Treatment aims to suppress this immune response and encourage hair regrowth. The approach depends on the severity and extent of hair loss.
- Corticosteroids: These are the most common first-line treatments due to their anti-inflammatory and immune-suppressing properties.
- Intralesional Injections: For small, patchy hair loss, corticosteroids are injected directly into the bald areas. This is highly effective and limits systemic side effects.
- Topical Corticosteroids: Creams, lotions, or foams are applied to the scalp for more diffuse or widespread hair loss, especially in children or those who prefer a non-injection option.
- Oral Corticosteroids: For severe or rapidly progressing cases, oral corticosteroids may be prescribed for a short period to induce widespread regrowth, but long-term use is avoided due to potential side effects.
- Topical Immunotherapy (Contact Sensitisation): This involves applying a chemical (like diphencyprone or squaric acid dibutyl ester) to the scalp to induce an allergic rash. This “distracts” the immune system, diverting its attack from the hair follicles. It’s often used for more extensive alopecia areata.
- Minoxidil (topical): While not directly treating the autoimmune cause, minoxidil can be used to stimulate hair growth once the immune attack is sufficiently suppressed by other treatments, or as a standalone option for mild cases.
- Janus Kinase (JAK) Inhibitors: This is a newer class of oral medications (e.g., baricitinib, ritlecitinib, deuruxolitinib) that have revolutionized treatment for moderate to severe alopecia areata. They work by blocking specific pathways within immune cells that contribute to the autoimmune attack on hair follicles. These are typically prescribed by dermatologists for more extensive cases due to potential side effects and cost.
- Other Treatments: Less commonly used treatments include Dithranol cream (an irritant) and UV light therapy (PUVA). Platelet-Rich Plasma (PRP) injections, while not a first-line treatment for AA, are sometimes explored for their potential to stimulate hair follicles.
It’s important to remember that effective treatment for any of these conditions often involves a holistic approach, potentially combining therapies, medication, and lifestyle adjustments, all under the guidance of a healthcare professional.
Conclusion
The intricate relationship between stress and hair loss is undeniable, manifesting in distinct ways through Telogen Effluvium, Trichotillomania, and Alopecia Areata. While stress can indeed trigger or exacerbate these conditions, understanding their unique mechanisms offers a pathway to effective management. The encouraging news is that in most scenarios, with appropriate intervention and stress reduction, hair regrowth is not only possible but highly probable.
Whether it involves managing underlying stressors for Telogen Effluvium, engaging in behavioral therapies for Trichotillomania, or utilizing targeted medical treatments for Alopecia Areata, personalized approaches are key. If you are experiencing hair loss, remember that seeking professional advice from a dermatologist or healthcare provider is the most crucial step. They can accurately diagnose the cause and guide you towards the most suitable treatments, helping you regain not just your hair, but also peace of mind.
If you still have any questions or are unsure of the procedure, feel free to contact us for unbiased information. We are not associated with any clinics and are here to simplify the information gathering process around hair transplants. We hope you’ve enjoyed this article and feel free to leave a comment below. If the symptoms in this article don’t sound related to the hair loss you’re experiencing or if you’re interested in learning more about hair transplants, check out our blog page.
Frequently Asked Questions (FAQ's)
- Can stress really cause hair loss?
- Yes, absolutely. Prolonged or severe stress can disrupt the normal hair growth cycle and even influence the immune system, leading to various forms of hair loss, including Telogen Effluvium, Trichotillomania, and sometimes triggering Alopecia Areata.
- How quickly does hair loss appear after a stressful event?
- For Telogen Effluvium, the most common type of stress-related hair loss, there’s usually a delay. You might start noticing increased shedding about 2-3 months after the significant stressful event has occurred.
- Will my hair grow back if the hair loss was caused by stress?
- In most cases, yes! For Telogen Effluvium, hair follicles are not permanently damaged, and once the stress is managed, normal hair growth usually resumes within a few months. For Trichotillomania and Alopecia Areata, regrowth is also possible, especially with appropriate treatment and if permanent follicle damage hasn’t occurred.
- What’s the difference between hair loss from stress and genetic hair loss?
- Stress-related hair loss (like Telogen Effluvium) often presents as a more diffuse thinning across the scalp, or sudden patches. Genetic hair loss (androgenetic alopecia or pattern baldness) typically follows a more predictable pattern, such as a receding hairline or thinning at the crown. However, severe stress can sometimes worsen genetic hair loss.
- What should I do if I think my hair loss is stress-related?
- The best first step is to consult a healthcare professional, such as a dermatologist. They can accurately diagnose the type of hair loss, rule out other potential causes, and recommend the most effective treatment plan, which often includes stress management techniques alongside other therapies.