Stress and Hair Loss

Most people’s lives are very stressful at one time or another, but not everybody loses hair during these stressful episodes. This is because people’s bodies react in different ways to stress. It seems that people who are more susceptible to stress-induced hair loss are the ones who are more susceptible to hair loss in the first place. This means that stress is often only one of many factors influencing the hair cycle, rather than the only influence.

Stress can affect your hair cycle, and losing your hair can cause a lot of stress! However, which one triggers the other? Did the stress of meeting that deadline last month cause you to lose some hair, or was it the hair you noticed on your pillow last week that triggered the stress?

The exact role of stress as it relates to different types of hair loss is difficult to assess accurately. Under most circumstances, as with many other hair-loss causes, increased hair shedding occurs between four and sixteen weeks after the trigger has occurred. Yet most people attribute an increase in hair shedding to what happened yesterday or last week, not a couple of months ago. If your stress levels are normal at the time you see your hair thinning, you are unlikely to associate your problem with a stressful situation that occurred, say, three months before. Although it is difficult to pinpoint a specific stress episode as the cause of hair loss, there is evidence that acute and chronic stress may precipitate hair-loss conditions, such as genetic hair loss, telogen effluvium (hair shedding), and alopecia areata (patchy hair loss)–see below.

When asked, most people say they are under a “normal” amount of stress, so it can be difficult to assess whether this is affecting the hair. To help assess people’s stress levels, I usually ask them to rate their stress levels one to three months before they started noticing their hair fall on a scale of 1 to 10 with 10 being the most stress. If the hair loss occurred periodically over a long span of time, then I would ask if and when there had been greater stressful episodes, and then try to correlate these with the hair loss.

In addition to stress causing hair loss, hair loss undoubtably causes stress for the sufferer. It affects one’s self esteem and quality of life, which in turn can cause more hair loss.

Hair Loss conditions influenced by stress.

Genetic Hair Loss

Since male hormones trigger genetic hair loss, many researchers believe that stress can aggravate the condition because, during stressful episodes, the adrenal glands increase their output of certain hormones that can lead to the production of more testosterone, thus increasing dihydrotestosterone levels and potentially accelerating hair loss. Some researchers also believe that the skin becomes more sensitive to the effects of testosterone during stress, thus increasing the chances of hair loss.

Telogen Effluvium

Severe stress can also influence diffuse shedding of hair (telogen effluvium), though this condition tends to be reversible. One possible explanation for stress-induced telogen effluvium could be that the body’s uptake of glucose is increased during a stress episode, leaving less available for non-essential tissues, such as the hair, causing it to be shed prematurely. Also, stress can reduce the uptake of certain vitamins which can be important for hair growth.

Alopecia Areata

Alopecia areata, or “patchy” hair loss, has also been connected to stress episodes. One study showed that over 90% of patients with alopecia areata were under high levels of stress, though an additional study found that the stress was actually a result of the condition itself. As alopecia areata is believed to be partly a product of an auto-immune response, the stress influence on reducing the immune system is thought to be a factor in the condition.

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