The vast majority of us are really stressed out these days. In fact, it could be said that many of us are so stressed, we feel like tearing our hair out. For some folks, that’s more than just a saying. Hair loss and stress do very much go hand-in-hand.
For most healthy adults, it’s normal to lose on average 50 to 100 strands of hair from your head every day. We’re constantly shedding old hairs and growing new ones. But if you’re losing a lot more or the amount of hair you’re losing seems to suddenly increase around the time that you’re dealing with a stressful situation, the two could well be connected.
Types of Stress-Related Hair Loss
There are generally three types of hair-loss related to stress:
Chronic Stress-Related Hair Loss
“Long-term chronic stress can affect hormone levels in the body, especially cortisol and other stress hormones,” says Dr. Patrick C. Angelos, a facial plastic and reconstructive surgeon and author of “The Science and Art of Hair Restoration: A Patient’s Guide.” In turn, “hair loss is affected by those fluctuations in hormone levels,” he adds.
This “chronic, unmitigated stress can potentially lead to more hair loss than you might get with just your genetics and aging alone,” he adds.
Telogen effluvium is a more acute and dramatic type of stress-related hair loss. Indeed, it really is possible to get so stressed that your hair falls out.
“There’s an extreme stress response that can cause you to lose most of your hair all at once in a very rapid fashion,” Angelos says. “That tends to come with a kind of life threatening (stress) or a big psychological insult,” such as a near-death experience, a job loss, the death of a child or other major stress event.
In this process, “basically your body is diverting its energy away from non-essential functions like hair growth to more essential things as a survival mechanism,” Angelos explains.
As scary as telogen effluvium might be, the good news is that it’s usually temporary. Angelos says that within about three months, the hair should start growing back in, and “it’s usually resolved by about six months.”
Beyond hormones causing hair to fall out on its own, some people actively contribute to their stress-related hair loss if they have a condition called trichotillomania, which affects about 1 in 50 people.
“What happens with these patients is they’re chronically stressed and anxious, and they tend to scratch and pick and pluck their hairs out as a nervous habit,” Angelos explains. Many people pull the hair at the crown of the head, making for an obvious bald spot that can develop over time.
This condition can lead to permanent hair loss because by constantly pulling on the hair, they’re causing “physical trauma to the follicles. They’re breaking the hairs and digging up the follicles and depending on how bad the scarring is, that can vary how much hair loss is related to that,” Angelos says.
Other Causes of Hair Loss
While stress can be one cause of hair loss, it’s not the only reason some of us lose some of those luscious locks. There’s a long list of medical conditions that can cause hair loss, including:
- Hormonal conditions. Conditions that change the balance of hormones in the body, such as thyroid disease and polycystic ovarian disease may cause some hair loss or excessive hair growth, depending on how the hormones are disrupted.
- Autoimmune diseases. Alopecia areata is one autoimmune condition that can cause people to lose their hair. Alopecia is the clinical term for hair loss, but the term alopecia areata refers to an autoimmune disease in which the immune system attacks the hair follicles, causing “patchy, circular patterns of hair loss,” Angelos explains. It can escalate to a condition called alopecia universalis that causes the person to lose all their hair over their entire body. Other autoimmune diseases that can lead to hair loss include lupus, Crohn’s disease and rheumatoid arthritis.
- Infections. Angelos explains that fungal infections of the skin or scalp can sometimes occur in people who have psoriasis and eczema, two autoimmune conditions that affect the skin. These infections can trigger hair loss in some people. Angelos also notes that some people who’ve been infected with the SARS-CoV-2 virus that causes COVID-19, such as actress Alyssa Milano, have also reported excessive hair loss.
- Medications. Certain drugs, such as those used for cancer, arthritis, depression, heart problems, gout and high blood pressure can all have hair loss or thinning hair as a side effect, says Dr. Annie Gonzalez, a board-certified dermatologist with Riverchase Dermatology in Miami. Chemotherapy drugs, for example, are well known for causing widespread hair loss, because the medications target fast-growing cells, such as cancer cells. Hair cells, however, are also fast-growing, and this is what causes so many cancer patients to lose all their hair soon after they begin treatment.
- Nutritional deficiencies. Not getting enough of some vitamins and minerals can also lead to hair loss. For example, anemia, a condition caused by a deficiency of the essential nutrient iron, can cause hair loss in some people.
- Diabetes. People with diabetes may see their hair thin because diabetes affects hormone levels and chronically high blood sugar levels can trigger hair loss. Those with type 1 diabetes, which is an autoimmune disorder, are also more likely to have additional autoimmune conditions, including alopecia areata.
- Childbirth. After giving birth, some women will experience hair loss as their hormones shift. Angelos says this type of postpartum hair loss is very common and should correct itself once your hormones stabilize.
- Genetics. Male pattern baldness, also called androgenic alopecia, is a common condition that causes some men to lose some or all of the hair on their heads, often in a recognizable pattern. For most men, it tends to develop in their 30s and increases as they age, but it can start any time after puberty. Angelos notes that while this condition is generally associated with men, “it does affect women as well,” and many women experience hair thinning after menopause.
10 Ways to Address Stress-Related Hair Loss
The good news with stress-related hair loss is that it’s often reversible. “Stress and hair loss don’t have to be permanent,” Gonzalez says. “If you get your stress under control, your hair might grow back. Cases related to trichotillomania usually need psychological intervention. However, the vast majority of cases of telogen effluvium recover spontaneously about six months later after onset.”
If you’re dealing with stress-related hair loss, try the following ten strategies to help speed regrowth and conceal thin spots:
1. Eat Right
Eating a healthy, balanced diet can help mitigate stress and support proper hair growth. Foods rich in biotin and protein, such as eggs and milk, can support healthy hair and nail growth. Bananas also contain biotin. Angelos also says that he recommends some patients try vitamin nutritional supplements that contain antioxidants, such as vitamins C and E and omega-3 fatty acids. Talk to your doctor before adding a supplement to make sure there are no potential negative interactions with other medications you may be taking.
2. Get Plenty of Sleep
Stress and anxiety can greatly disrupt sleep, causing insomnia and other sleep disorders that may further shift the hormonal balance in the body. Strive to get a solid 7 to 9 hours of sleep each night and engage in good sleep hygiene practices, such as going to bed and waking at the same time each day, sleeping in a cool, dark room, and blocking noise and keeping electronics out of the bedroom.
4. Engage in Relaxation Techniques
Practicing yoga, meditation or mindfulness can help restore calm and soothe a stressed out mind. Even just a few minutes of meditation each day have been found to be very helpful in reducing stress and could help you get out of the stress cycle that’s causing hair loss. And make time for hobbies and other activities you enjoy that can help you decompress from life’s stressors.
5. Seek Professional Help
“With major stressor events that are causing things like telogen effluvium, it may be helpful to seek professional help from a therapist,” Angelos says. A counselor, psychologist or psychiatrist may all be able to assist in helping you finding better ways of coping with severe stressors.
“Sometimes we need to take a break and that’s OK. In cases where this isn’t sufficient, don’t feel ashamed to seek psychiatric and psychological intervention,” Gonzales adds.
6. Be Gentle
Tugging or pulling on the hair or wearing it in a tight ponytail or bun every day can cause breakage and hair loss. Use care when detangling wet hair, such as after a shower or after swimming. Wet hair is more likely to break than dry hair, so brush your hair after it’s dry and again, be gentle. If your hair is very tangled, start at the bottom – gently free the ends and work your way up the length of your hair, untangling as you go a little at a time.
7. Avoid Heat and Chemicals
As much as possible, try to give your hair a break from chemical dyes or heat-based treatments such as blow drying, curling or flatironing. These styling treatments can all be hard on the hair and lead to breakage and excess hair shedding. And on the subject of heat, avoid washing your hair in super-hot water. Though hot water doesn’t directly cause hair loss, very hot water can dehydrate the scalp and could cause temporary inflammation of the scalp that in turn could make hair strands weaker and more likely to break.
8. Switch Shampoos
Many shampoos contain chemicals that can damage hair and lead to breakage and excess shedding. Try to avoid sulfates, polyethylene glycol and parabens to reduce those issues. Opt instead for shampoos that contain agents that can help plump each strand to make the hair appear thicker. While not all products that claim to thicken the hair work, some do. Do some research or ask your hairdresser for recommendations. Generally speaking, shampoos that contain keratin, a type of protein that makes up the hair can be helpful. In addition, products that contain biotin, panthenol (a type of vitamin B5) and amino acids, may also help your hair look thicker and more lustrous.
9. Be Patient
Angelos adds that for many people, the problem will resolve on its own and being patient and just trying to relax is often the best way to speed that process. “Unfortunately, there’s no magic cure,” he says. But time can be a great healer for many things.
10. See a Doctor
“If you notice sudden or patchy hair loss or more than usual hair loss when combing or washing your hair, talk to your doctor,” Gonzalez says. You can start with your primary care doctor, or you can connect with a dermatologist, a plastic surgeon or a hair restoration specialist. There may be certain hair restoration techniques they can deploy, depending on your individual situation.
“I usually recommend my patients keep a healthy diet and try hair supplements like Nutrafol or Viviscal to aid in the recovery. Platelet-rich plasma can expedite the recovery in select cases,” Gonzales notes. Talk to your health care provider to get an accurate diagnosis and treatment plan that’s tailored for your specific situation.
Lastly, Angelos encourages you to not add to your stress levels by worrying so much about your hair. “Don’t panic, don’t panic, don’t panic. That just creates more stress and bad feedback. That’s easy to say, I know,” he says, but the fact is, the more you can reduce your stress levels and just be patient, the faster the regrowth process is likely to be.