Stress & Hair Loss

Times are tough, and people invariably are under a lot of stress. Sometimes, hair loss can be a physical manifestation of this stress. Several studies have established a direct link between stress and hair loss. So, does stress cause hair loss? It absolutely does. However, the good news is that stress-related hair loss issues aren’t permanent and can be resolved. 

In this post, I’ll address the A to Z of hair loss caused by stress and suggest the best possible solutions to manage stress and hair loss.

Signs of stress-related hair loss

Some reasons may lead to thinning hair on your scalp. But how do you suspect that stress is causing your hair to fall out? You look for signs, and here are some of them:

• You will see more hair collecting by the shower drain or gathering in your comb- that’s the first sign 
• Bald spots that gradually grows
• Widening hair parting
• Broken or split hairs around your forehead
• A ponytail that is thinner than normal

What does Stress-related hair loss look like?

While breaking down the kinds of stress-induced hair loss, we can also get a clear picture of what sets off each condition. Now, let me clarify- intermittent feelings of worry or stress won’t lead to a rapidly receding hairline. Stress causing hair loss is only a result of high-stress levels, whether sudden or long-term. 

When we talk about stress and hair loss, there are three major types of hair loss.

1. Telogen Effluvium

According to the American Hair Loss Association, TE, as seen by dermatologists, is one of the most common and sudden hair fall disorders caused by stress. 

Our scalp hair grows in a cycle. The growth stage can last up to two years, followed by regressing into a resting stage for a month or two before again starting the growth cycle of the new hair fiber. Approximately 80 to 90 percent of the hair follicles on a healthy scalp grow hair (anagen phase), leaving 10 to 15 percent follicles in the resting stage, called Telogen. This is when new hair strands are not produced. 

Telogen Effluvium means that there are more dormant hair follicles in the resting phase than usual. TE can cause hair loss in both males and females and is a reversible condition. Telogen effluvium is commonly limited to the scalp, but in severe cases, can spread to the eyebrows or even the pubic area. 

As per physicians, TE can present itself in 3 possible scenarios:

• Hair follicles enter the telogen stage normally but don’t regenerate as they should, causing gradual hair loss. In this scenario, the follicles lie dormant in the resting phase for longer periods of time rather than returning to the anagen phase. Thus, fewer active hair follicles remain. This prolonged scenario is more common in patients with chronic anxiety issues. Because it is prolonged, immediate thinning is less likely. 
• The second scenario is that of environmental shock. This TE situation is usually the result of a significant life event. The effects of such environmental shock can last up to 3 months. Patients, in this case, will usually see full hair regrowth in less than six months without any surgical intervention.
• In the third scenario, TE presents in the form of persistent thinning and shedding. This happens when your hair follicles undergo truncated cycles meaning their growth phase is cut short. 

Other than dietary problems, TE is hugely triggered by emotional stress. Physical trauma or even surgery can act as a shock causing a large amount of hair to shift to the telogen stage all at once. People experiencing an episode of Telogen Effluvium generally encounter diffused hair thinning patterns. 

These episodes should typically resolve on their own. Even though the hair regrowth process is sluggish, your hair will get back to the pre-effluvium density in about six months post shedding. 

2. Alopecia Areata

Stress or chronic tension can either cause alopecia areata or be a trigger that flares up the pre-existing condition in patients. Alopecia Areata is an autoimmune disease. Autoimmune disorders cause the body’s immune system to go haywire, which is what happens to patients with this condition. The body attacks its own hair follicles leading to shedding. 

In this type of stress-induced hair loss, hair first starts to thin & falls out in patches in some cases, leaving bald spots all over the scalp. The patches tend to get filled within six months. However, if it doesn’t, it may require treatment. Apart from the scalp, this autoimmune condition can also impact body hair. 

3. Trichotillomania

It literally translates to “hair-pulling disorder”. Trichotillomania is a psychological condition in which patients have an uncontrollable urge to pull out their hair. They can pull it from the scalp, eyelashes, eyebrows, or other body parts to cope with extreme stress. 

Does hair loss caused by stress grow back?

So, we know how stress and hair loss are related, but the worry about whether or not the lost hair will grow back is inevitable and constant. You can relax because stress hair loss grows back once your stress levels are under control. It usually happens on its own, even though it is a delayed process. However, you need to look into treatment options to reduce stress if it doesn’t.

How to prevent stress hair loss?

Want to break the chain between stress and hair loss? Well, you need to curb your stress levels. Clinical assessments have linked increased DHT (Dihydrotestosterone) secretion with high-stress levels & DHT is believed to induce hair loss. 

Here are some potential ways to help you counter stress and build resilience against it:

• Get physically active. Regular exercise helps tackle stress and its adverse effects.
• Practice relaxation techniques like yoga, meditation, or deep breathing regularly.
• Break out from isolation and find a positive social company
• Reduce work stress, find a work-life balance 
• Make sure you have a healthy and balanced diet
• Consult a therapist, if needed
• Be careful and more aware while treating your hair- washing, drying, or even styling it.

Treatment for Stress-induced hair loss

What if hair loss from stress continues? In that case, you can consult a doctor who can either prescribe medication or over-the-counter remedies. However, beware because hair loss from stress treatment itself is also not uncommon. 

A dermatologist might want to rule out possible causes before concluding that stress is why you lose excessive hair. So, they might prescribe tests like the following:

• A pull test involves the doctor tugging on approximately 40 strands of hair. If six or more hair comes out during the process, it would indicate excessive hair loss. 
• In a tug test, the doctor uses both his hands to hold sections of your hair. While one hand grips the root of your hair, the other grips the tip. Doctors tug the tip to check if strands break from the middle. Thus, letting them know that your hair is brittle. 
• Densitometry involves a professional inspecting your hair with a densitometer to miniaturize hair shafts. 
• Your doctor may prescribe Scalp Biopsy to diagnose what type of hair loss you have. The process involves removing a small scalp tissue sample to check under a microscope.

FDA-approved drugs & topical solutions like Finasteride and Minoxidil are known to promote hair growth after hair loss due to stress. While Finasteride prevents the conversion of testosterone into DHT (the hormone that causes hair loss in men), Minoxidil nourishes the hair follicles by boosting the oxygen and blood flow to the scalp. However, each of these medications has its set of side effects. 

Using essential oils or homemade oils to massage the scalp can also promote hair growth. Similarly, minerals and vitamin supplements like biotin are also prescribed to people who are unwilling to wait for six months for their hair to grow back. 

Luckily, today, there are certain alternative treatments to regrow hair safely (without unwanted side effects). You can now grow hair with laser devices. Low-level laser therapy is proven to be effective on patients suffering from Alopecia areata as well as those suffering from lingering Telogen Effluvium. 

LLLT has become highly popular among users for its effectiveness and convenience of use. This treatment doesn’t require you to make time for clinic visits. Instead, you get your daily hair regrowth therapy at home. These hair regrowth devices come in the forms of Laser caps, Laser helmets, laser bands & laser combs. Some of these laser devices, like Theradome helmets, are recommended even by renowned hair professionals. 

The laser light in these devices stimulates the dormant hair follicles on the scalp, thus setting hair regrowth in motion. Before choosing a laser hair growth device, check whether they are FDA-approved. The best laser devices are slightly expensive, but they are definitely worth it, considering their effectiveness. Most of the popular devices come with a return policy (minimum 6-month money-back guarantee). So, if you feel you are not getting the results, you can always return these products.  

Final Thoughts

Severe stress indeed affects us mentally, but it also has physical implications, as you’ve seen. So, taking care of our emotional health is just as important. Keeping stress levels in check by practicing needed coping strategies can prevent stress and hair loss. 

However, it would be best if you didn’t forget that a correct diagnosis leads to correct treatment. So, if you are continuously waking up to a pillowcase full of hair strands, consult a doctor to know why you are losing excessive hair and choose a treatment accordingly.