Dr Clare Morrison

Article by Dr Clare Morrison

Stress and Hair Loss

Have you been having a tough time at work recently – or experienced difficulties in your personal life? There’s a well-established link between stress and hair loss, so if you’ve had a nasty shock, or been dealing with long-term pressure, this could be a cause of your hair falling out.

Every day we lose up to 100 hairs from our scalp, yet if you’ve noticed many more hairs falling out than usual, stress could be behind it. Let’s look at how stress and hair loss are linked and what you can do to manage it.

How can stress cause hair loss?

You’ve probably heard of the ‘fight or flight’ response. When humans (and other animals) believe they are in danger, a number of changes happen within the body, including increased heart rate, breathing, alertness and changes in hormones. If you have a particularly unpleasant experience – or are undergoing pressure or worry for a long time – your body will produce adrenaline.

The underlying processes are complex, but essentially stress can lead to your body ‘closing down’ functions that aren’t so critical for survival. One of these functions is the growth of hair. When you are stressed, the body will put your hair follicles into their ‘resting mode’ (telogen effluvium is the scientific name for this).

However, you won’t immediately see hair falling out. Even when the root goes into resting mode, it can take up to three months for hair to fall out of your scalp – so you may not notice a change until quite a while after the stressful or traumatic event has happened.

While telogen effluvium is perhaps the best known type of stress-related hair loss, stress can also cause you to lose hair in other ways:

  • Trichotillomania: This is a condition where you have an irresistible idea to pull hairs from your scalp, eyebrows and elsewhere. When some people are stressed they may find that pulling hairs out can give a release – this is especially the case for people who suffer from severe anxiety.
  • Alopecia areata: Alopecia is the scientific name for all kinds of hair loss. Alopecia areata is a specific kind of auto-immune disorder where the immune system attacks follicles, causing you to shed hair in patches on the scalp and other parts of the body. Stress-related alopecia areata may occur when people undergo traumatic experiences, although there are other factors which cause it too.

How can I tell if my hair loss is caused by stress?

If you have suddenly noticed a large amount of hair falling out it is always best to contact your GP because sudden hair loss can be a sign of serious underlying illnesses. That said, if the hair loss isn’t too severe, stress could certainly be a cause:

  • Did you have a particularly traumatic, scary or difficult experience in the last few months?
  • Have you been under unusual amounts of pressure at work?
  • Have you undergone any difficult events in your personal life – such as housing problems, money worries or a bad breakup?
  • Do you suffer from severe anxiety or depression?

These factors may have caused you to feel particularly stressed and may explain your current hair loss.

On the other hand, if you’ve noticed your hair falling out at a relatively slow rate and haven’t undergone any especially stressful experiences recently, then stress probably isn’t the cause. Almost all men lose hair as they get older, so if the hair loss is gradual, chances are you’re experiencing male pattern baldness instead.

Is stress related alopecia permanent?

The good news about stress and hair loss is that, in most cases, your hair will grow back of its own accord once you return to your normal self. That said, this will normally take a few months and so hair loss treatments can stimulate regrowth.

What can you do about stress and hair loss?

If your hair loss has been caused by stress, there are several actions you can take to tackle the problem. The first, naturally, is to deal with the cause of the stress itself:

  • Specific stressful event (e.g. bad breakup, car accident, grief)

A traumatic experience may be the original cause of a period of hair loss. Some people are able to move on from these experiences over time, others could benefit from additional support. If you’re experiencing flashbacks or struggling to move forward, you’re likely to only experience more stress and hair loss. It’s often best to speak to your GP who might refer your to a counselor.

  • Generalised stress (e.g. work problems, money worries, housing issues)

Generalised, long-term stress can create a vicious cycle whereby your hair follicles are continually going into resting mode due to your stress. If you are dealing with this kind of stress, consider:

  • Lifestyle changes – change jobs or move somewhere new
  • Talk to your manager about your workload
  • Aim to get 7-8 hours’ sleep per night
  • Exercise regularly
  • Eat a balanced diet
  • Take up meditation, yoga, mindfulness and other relaxation techniques
  • Try to avoid smoking and alcohol
  • Talk to a friend or confidant about your stress – an outside opinion might help you find ways to resolve its causes
  • Anxiety and other mental illnesses

If you are suffering from anxiety, depression or other mental illnesses, speak to your GP who may recommend different kinds of therapy or medication.

Treatments for stress-related alopecia

Once you have got to the bottom of your stress-related hair loss and returned to your normal self, your hair will, in most cases, grow back of its own accord. All the same, hair loss in itself can be stressful, especially if it looks unnatural, and it’s understandable to want to get back to your old self.

And this is where hair loss treatments can help. Topical treatments such as Regaine are massaged into the scalp and stimulate hair follicles to start growing hair – and to grow for longer. That may mean your hair returns to normal sooner. If you prefer an oral treatment, Propecia and Finasteride can be taken daily and have been proven to encourage regrowth.

Back to your old self

Stress can be deeply unsettling – and this is made worse through experiences like hair loss. However, the good news is that your body will bounce back and hair loss treatments can help you start feeling like your old self by helping to foster a sense of normalcy and calm.

Dr Clare Morrison
Dr Clare Morrison
Experienced General Practitioner in Hampshire since 1995, with particular interest in Nutrition, Obesity and Smoking Cessation.
Originally published September 06 2019, updated September 06 2019