Hair loss can be caused by lots of different underlying causes, from genetics to health conditions. Stress is commonly discussed as a potential trigger, as many people notice more hair shedding after going through a difficult or anxious period.
In this blog, we’ll cover why stress can cause hair loss, how to distinguish stress-related shedding from other forms of hair loss, and what you can expect if stress is the underlying cause.
What is telogen effluvium?
Yes, stress can cause hair loss in some cases.
The kind of stress matters. There’s a form of hair loss called telogen effluvium that can be triggered by an event that causes significant stress on the body, either physical or mental. Examples include surgery, illness, childbirth, or a stressful life event. A few months after the stressful event begins or occurs, it can trigger excessive hair shedding all over the scalp.
Some studies have also linked chronic stress to potential hair loss. Researchers at Harvard University found that removing the adrenal glands (which produce stress hormones) from mice led to rapid cycles of hair regrowth, while feeding them corticosterone (the equivalent stress hormone of cortisol in humans) restored the normal hair cycle. The also found exposing mice to mild levels of corticosterone over many weeks reduced hair growth, as hair follicles stayed in an extended resting phase.
The scientists also found out how corticosterone affected hair follicle cells. By deleting the receptor for corticosterone from different cells, they were able to pinpoint that it prevented hair follicle stem cells, the dermal papillae, from secreting GAS6, which activates hair follicle stem cells and prompts them to start growing new hair. By delivering GAS6 to the mice being fed corticosterone, normal hair growth was restored.
So, in a similar way to telogen effluvium, chronic stress is believed to affect hair growth by causing more hairs to remain in the telogen (resting) phase for longer.
Why does telogen effluvium happen?
A stressful event can disrupt the normal functioning of the hair growth cycle.
Usually hairs cycle through growth, resting and shedding phases, with about 85% of your follicles in anagen (growth) phase at any one time, while about 15% are resting and getting ready to be shed (telogen). In a healthy hair cycle, the resting hair is pushed out by a new hair growing from beneath it.
With telogen effluvium, more hairs than normal are pushed into the telogen phase. This proportion can increase to roughly 30%, causing hairs to stop growing prematurely and shed several months later.
Is your hair loss stress related?
Telogen effluvium causes diffuse shedding, which means hair is usually lost from all over the scalp, rather than any particular spots.
This differs from other common types of hair loss. For example, male pattern baldness is a genetic condition which causes hair to be lost from the hairline and crown but does not typically affect hair at the back and sides of the head, even in advanced stages. Female pattern baldness also has a distinctive pattern of hair loss, usually affecting the parting in a ‘christmas tree’ pattern.
Less common types of hair loss include alopecia areata, which is an autoimmune disease caused by the body attacking its own hair follicle cells. This usually causes patchy hair loss, and sometimes affects hair on other parts of the body – not just the scalp.
So, if you’re noticing an increase in hair shedding, thinking about where you’re losing the hair from can give an indication of the underlying cause.
Is it permanent?
In 95% of cases, telogen effluvium is temporary and doesn’t need any treatment to get better. Once the underlying trigger is resolved, it can take up to 6 months for hair growth to go back to normal, but it can be even longer before usual density and thickness is restored.
In rare cases, hair loss can continue for longer than 6 months, or even long-term. This is called chronic telogen effluvium. It is most common in women aged 30-60, and does not cause complete baldness, just persistent shedding. Finding the underlying trigger can help identify the best treatment. Blood tests can be used to identify health conditions such as nutritional deficiencies or thyroid function which could be driving the long-term hair loss.
Minoxidil Spray may be used to help manage telogen effluvium, as minoxidil is known to encourage hair follicles to re-enter the anagen (growth) phase. In a small study, researchers found that 5% minoxidil improved hair growth in people with telogen effluvium. However, as the researchers themselves pointed out, telogen effluvium is typically a self-healing condition that often gets better on its own. This means it's difficult to determine how much of the improvement was due to minoxidil and how much was the result of the hair naturally returning to its normal growth cycle. Another study found that oral minoxidil improved hair growth in 33 out of 36 women with chronic telogen effluvium after 12 months of treatment.
So, if you suspect your hair loss has not improved after about 6 months, we recommend speaking to your GP about investigating possible causes and treatments.
All of our blog articles are reviewed by our Medical Director before publication.
