Wellness

Is Stress Causing Hair Loss?

Here’s what you should know and how to stop it.
06/15/2018 05:45am ET | Updated June 20, 2018
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The average person loses 50 to 100 hairs a day. Physical and emotional stress can push hair follicles into a resting period, causing more hair to shed.

Everyone experiences intermittent stress in life. Professional and personal demands, illnesses and trauma can wreak havoc on your mental health.

Sometimes that stress can trigger your body to react in ways that can be frustrating and embarrassing. These include issues like brittle nails, acne breakouts and hair loss.

What gives?

The type of hair loss that results from physical and emotional stressors is called telogen effluvium, in which large amounts of stress push hair follicles into a resting period. As a result, the hair begins to shed, causing the appearance of thinning, which can be more prominent in certain areas of the scalp than others.

“The hair follicle has its own life cycle — growth, transition, resting and falling out of hair shaft,” said Dr. Julia Tzu, a double board-certified dermatologist and the founder and medical director of Wall Street Dermatology. Stress alters the percentage of hairs in the growth stage and shifts them to the resting, or telogen, stage.

“No one really understands the complex biology that determines the clockwork behind hair cycling,” she continued. “What is known is that stressors do bend the clock and shift hairs towards the telogen phase.”

But this doesn’t necessarily lead to lasting damage. According to Dr. Lauren Ploch, a board-certified dermatologist at the Georgia Dermatology and Skin Cancer Center, telogen effluvium doesn’t always cause permanent hair loss or baldness.

“Complete baldness does not occur unless there is an underlying inflammatory process” like alopecia areata, an autoimmune disease that causes hair loss in patches and can be triggered by severe stress, she said.

You won’t notice a difference in hair loss immediately after experiencing something particularly stressful.

“Telogen effluvium usually occurs within the first three months after a stressful event,” Ploch said. “Usually, the hair loss is a sign that a new hair is growing again at the base of the lost hair, so new hair growth should be apparent three to six months after the initial shedding.”

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Stress-induced shedding doesn’t always lead to permanent hair loss or baldness, but see a doctor if you notice more strands than usual falling out.

When to worry

The average person loses 50 to 100 hairs a day. This is completely normal, and compared with the total number of hairs on your head (about 150,000), the absence of those strands isn’t even noticeable. However, shedding is considered a problem when it becomes excessive.

If you notice more strands than usual coming out when you comb or wash your hair or if you see reduced thickness in one area or throughout your scalp, you should see a doctor, Tzu advised.

As for why hair loss happens during stress, Ploch said that should not be cause for alarm. Because hair growth is not a vital function, you can lose it when you’re stressed out.

“When our body experiences stress, it essentially goes into survival mode and diverts resources away from functions that are nonessential for life such as hair growth and nail growth,” Ploch said.

There’s little data behind whether there are groups that experience more stress-related hair loss than others, but Tzu and Ploch said that new moms are likely to have hair loss, given the level of physiological stress that comes with childbirth.

Postpartum alopecia, a different type of hair loss, can happen because of a sudden decrease in estrogen levels around childbirth. This drastic hormonal shift shocks the hair follicles to the point that they shut down for roughly four months, but new mothers can expect their hair to return to its normal growth and fullness after a year.

Additionally, trichotillomania, a mental health condition characterized by compulsive urges to pull hair from various parts of the body, is associated with high anxiety levels.

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Preventing hair loss isn’t as important as finding healthy ways to handle the stress that causes it.

Easy ways to stop your shedding strands

Making certain lifestyle changes can help. Along with getting enough sleep and spending time doing hobbies you enjoy to reduce stress, Ploch emphasized the importance of getting adequate nutrients.

“Eat a balanced diet that is rich in vitamins and minerals. Be careful with biotin supplementation,” she warned, referring to a memo the FDA released in 2017 about how biotin supplementation can affect lab values. Ploch suggested keeping biotin intake to 35 micrograms or less daily. Biotin, a B vitamin that is commonly used to combat hair loss, can be found naturally in small amounts in foods such as eggs, milk and bananas.

But most important, remember that it is not as crucial to treat hair loss as it is to find healthy ways to handle the stress that causes it. Regular exercise, adequate sleep and a healthy diet can alleviate anxiety. Eating chocolate, hanging with good friends and listening to music can reduce negative moods. (Dozens of other techniques can help as well.) If you think stress is interfering with your daily life, it might be worth trying something like therapy or discussing your mental health with your doctor.

While self-treatment can be an option in mild cases, you should see a dermatologist as soon as possible if you begin to notice excessive shedding.

“There’s no reason to let hair loss go undiagnosed,” Ploch said. “Even if it’s just telogen effluvium that will likely self-resolve, I would hate for someone to misdiagnose themselves and not seek treatment for what is actually an inflammatory or scarring type of hair loss.”

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