Stress and Hair Loss

Low energy, insomnia, difficulty in concentrating and loss of appetite are common symptoms of stress, however we don’t often think that hair loss is a consequence of stress. In fact, hair loss can be a result of single stressful event or an extended stressful period in your life.

Three types of hair loss are attributed to stress and anxiety – Telogen Effluvium, Alopecia Areata and Trichotillomania.

A sudden large dose of physical or emotional stress can drastically fluctuate the hormone in body, which in turn affect the health of hair follicles. Life events such as giving birth to a child, loss of family member, vaccinations, crash dieting, physical trauma can sometimes be a shock to the system and a proportion of scalp hair follicles go into hibernation.

Telogen Effluvium

Telogen Effluvium happens when there is a reduction in the number of hair follicles growing hair. If the number of hair follicles producing hair drops significantly for any reason during the resting, or telogen phase, there will be a significant increase in stagnant, telogen stage hair follicles. The result is Telogen Effluvium hair loss.

There are three types of Telogen Effluvium (TE):

1. Rapid hair loss in a short period of time due to a large number of follicles go into a resting state.
2. Slow progression of hair loss as gradual thinning of the scalp hair. This results in a gradual accumulation of hair follicles in a telogen state and progressively fewer and fewer anagen hair follicles are left growing hair
3. The hair follicles do not stay in a resting state but rather cycle through shortened growth cycles. When this happens, the individual experiences thin scalp hair and persistent shedding of short, thin hair fibers.

What are triggers for TE?

A sudden large dose of physical or emotional stress can drastically fluctuate the hormone in body, which in turn affect the health of hair follicles. Life events such as giving birth to a child, loss of family member, vaccinations, crash dieting, physical trauma can sometimes be a shock to the system and a proportion of scalp hair follicles go into hibernation.

Research has shown that chronic stress can gradually exert a negative effect on hair growth and lead to persistent TE on animals. Many individuals under stress suffer from nutritional deficiencies. Lack of vitamins (particularly if they are prone to not eating during periods of anxiety and stress) will develop problems with growing back hair that naturally falls out daily. 

Trichotillomania

Trichotillomania also called hair-pulling disorder that involves recurrent, irresistible urges to pull out hair from scalp, eyebrows or other areas of your body. Severely stressful situations or events may trigger trichotillomania in some people. There is a very strong correlation between trichotillomania and stress. Stress can lead to hair pulling because people who battle trichotillomania use hair pulling as a coping mechanism for the anxiety that stress causes.

Stress and hair loss impact each other. In a way, hair loss is their anxiety trigger, and they experience greater levels of anxiety because they are so worried about losing their hair. In addition, sometimes those with anxiety simply see more hair loss where it doesn’t exist, because of their fears. It’s not uncommon for hair to look exactly the same (or have slightly more fall out due to natural aging) but anxiety plays tricks with the mind to make it seem or feel like more fell out than usual.

Alopecia Areata

Alopecia areata (AA) is probably the third most common form of hair loss dermatologists see, after androgenetic alopecia and telogen effluvium. Researchers believe AA is an autoimmune disease such as rheumatoid arthritis, but in this case the individual’s own immune system attacks hair follicles instead of bone joints. AA can affect men, women, and children. It often appears as well-defined circular bald patches on the scalp. Many people will get just one or two patches, but for some the hair loss can be extensive. Extreme stress might trigger AA in some people, but recent research shows that genes can also be involved.