There are many people who experience stress at some point in their life. It’s not problematic if it’s only short-lived; some people even find it motivating. However, it can also be debilitating if it’s chronic. It has both physical and psychological manifestations. Stress hair loss is one of its physical manifestations, and there are several ways it can occur.
What Is Stress?
According to Yale Medicine, chronic stress is “feeling pressurized and overwhelmed” for a long time (several weeks). A 2018 YouGov poll found the following causes of stress among Brits:
- Health (their own or that of a loved one)
- Comparing themselves to others
- Pressure to succeed
- Housing concerns
- Body image
- Replying to messages immediately
Stress has physical, psychological, and behavioural effects on the individual suffering from it. Experienced for a very long time, it can cause exhaustion, resulting in burnout. It can also cause depression and anxiety. The following may be the symptoms of chronic stress:
- Aches and pains
- Heart palpitations
- Difficulty sleeping
- Upset stomach
- Difficulty concentrating
- Teeth grinding/jaw clenching
- Low libido
- Changes in appetite (eating more or less)
- More drinking alcohol and smoking
- Feeling lonely and sad
Stress results in the activation of the sympathetic nervous system in the body, which is responsible for the “fight or flight” response. It causes internal changes through the release of hormones from the adrenal glands.
How Does Stress Cause Hair Loss?
Although the link between stress and hair loss had long been speculated, it was only confirmed by researchers at Harvard University in their study “Corticosterone inhibits GAS6 to govern hair follicle stem-cell quiescence,” published in the journal Nature in 2021.
In it, the researchers began by removing adrenal glands from the bodies of mice. These glands are responsible for the production of stress hormones: corticosterone in mice and cortisol in humans. Their removal resulted in an accelerated hair growth rate, even as the mice aged.
Normally with ageing, the duration of the resting phase increases and the growing (anagen) phase decreases. However, the opposite of it happened after the glands were removed. That led to the conclusion that the mere presence of stress hormones, even at normal levels, affects hair growth. However, when hormonal imbalance occurs because of stress, the follicles find it difficult to enter the anagen phase.
What happens is that stress hormones prevent the release of a molecule – GAS6 – from the dermal papilla. This molecule is responsible for activating hair follicle stem cells, allowing growth to take place. Because it’s not released when a person is stressed, hair loss occurs.
Can Stress Cause Grey Hair?
Researchers at Harvard also confirmed that stress could cause grey hair in a study published in Nature journal in 2020. They found that the neurotransmitter noradrenaline, also known as norepinephrine, was mainly responsible for this.
The nerves from the sympathetic nervous system extend to hair follicles. Stress results in the activation and depletion of melanocyte stem cells (producing melanin, the pigment that gives colour to hair). This is what results in premature greying, and according to the researchers, this kind of damage is permanent. That means you cannot reverse greying hair.
Which Types of Hair Loss Does Stress Cause?
Stress hair loss can occur in one or more of the following ways:
Normally most of our hair is in the anagen phase of growth, while only 6-8% of them are in the resting phase. However, in the event of chronic stress, most of the hair shifts from the anagen to the resting phase, which lasts for 3 months. For this reason, this kind of hair loss occurs months after the stressful event that triggered it. After these 3 months have passed, most people notice sudden, diffuse, and excessive hair loss.
The American Academy of Dermatology considers the loss of 50-100 hair normal. In telogen effluvium, you can end up losing as many as 300 hair strands in one day. This kind of hair loss can occur due to the following emotional stressors:
- Death of a loved one
- Family problems
- Workplace (heavy workload, job insecurity, long hours, etc.)
More recently, many people experienced telogen effluvium because of COVID-19. Having the virus, fear of contracting one, or the effect it could have on their job caused quite a lot of anxiety, resulting in COVID hair loss.
Extreme stress can trigger a hair-plucking disorder known as trichotillomania. The person may have an irresistible urge to puck the hair from different parts of their body, including the scalp, face and body. While pulling their hair out, the person may not even realise that they’re at it. For them, it’s a way of dealing with stress itself. Other factors can trigger trichotillomania as well.
Although it isn’t exactly understood what causes alopecia areata, it is widely said to be an autoimmune disorder. The immune cells start attacking the healthy hair follicles, and it is thought that extreme stress can trigger this.
According to Alopecia UK, stress hormones can activate some dormant immune cells that target the hair follicles. Stress can set them up as a target for the immune cells. In addition, the inflammation from alopecia areata can result in an increase in the production of stress hormones, which can further exacerbate hair loss. People with alopecia areata report experiencing a very stressful event just before developing the condition, while others report experiencing chronic stress.
Is Hair Loss Due to Stress Permanent?
Fortunately, stress hair loss is not permanent. In the case of telogen effluvium, your hair should start to grow back after 3-6 months. During this time, you have to remain patient as the hair will follow the natural growth cycle.
Trichotillomania should also not cause permanent hair loss. However, if it’s done for a very long time, you can expect irreversible damage to occur. Alopecia areata also usually results in temporary loss of hair.
How to Regain Hair Loss From Stress?
There are different ways to cope with stress-related hair loss. These are as follows:
Have A Balanced Diet
It’s important that you have a wholesome diet. That means you need to consume whole grains, lean proteins, fruits and vegetables. According to one study published in Psychosomatic Medicine, dieting can increase the level of stress hormones in the body. Additionally, the act of monitoring calories also made the participants feel stressed.
You can end up experiencing telogen effluvium if you’re not dieting in a healthy way. Crash diets are especially more dangerous and can cause stress hair loss.
There are different ways in which exercise can help you in managing stress. Not only can it increase your resilience to it but also improve your mood, release “feel–good” hormones and keep you healthy. Therefore, it’s a good idea to exercise in order to counter stress hair loss.
Get A Good Night’s Rest
According to the American Psychological Association (APA), those sleeping fewer than 8 hours per night are more likely to experience stress. It should also be noted that sleeplessness can be a result of stress. Therefore, the person can get stuck in a vicious cycle.
Different strategies are recommended for dealing with sleep difficulties due to stress. It’s best not to use phones and tablets when lying down to sleep because the blue light can affect the internal clock. You can also consider taking a warm, relaxing bath. In addition, you should avoid caffeinated beverages; you should drink herbal tea instead.
A study published in the Journal of Physical Therapy and Science found that 15-20 minutes of scalp massage improved female office workers’ blood pressure, heart rate, and stress levels. Scalp massages are very relaxing and can help with stress hair loss.
Medication & Therapy
To stimulate hair growth, your doctor may recommend the use of minoxidil. You will have to apply it 2-3 times a day. It has some side effects, though. In the case of alopecia areata, the treatment may include this along with the use of corticosteroid (cream to the bald spots or injection).
Other than that, you can also consider getting PRP injections to stimulate growth. They can help promote healing through growth factors. In addition, they can increase density by improving blood supply to the scalp.
There are different ways in which you can try managing stress. For instance, you can do:
- Deep breathing
- Tai Chi
- Art Therapy
You are also recommended to talk to a professional. In the case of trichotillomania, cognitive behavioural therapy (CBT) is considered quite effective. Other than that, if you feel like you’re losing control over a situation, you can try breaking down bigger tasks into smaller ones and planning ahead.
Almost everyone experiences stress. It can cause physical, mental and behavioural changes in the person if it’s chronic. One consequence of it is stress hair loss, which can occur due to different reasons.
Stress can impact the immune system resulting in alopecia areata, or it can make the hair enter the resting phase prematurely, resulting in telogen effluvium. Stress can also lead to behaviours such as plucking one’s hair out. Fortunately, this kind of hair loss is rarely permanent. Depending on the kind of stress hair loss you’re experiencing, you may need a different intervention.
Reviewed and Approved by Dr. Hassan Soueid.