Does stress cause hair loss?

20th March 2024

Posted by Dr Michelle Wright

Does stress cause hair loss or is it an urban myth? Dr Michelle unravels the science in this week’s Health Matters.

Stress and hair loss: An urban myth?

Someone asked me recently if stress causes hair loss, or whether it’s one of those urban myths.

The short answer is yes, stress can lead to hair loss. And there are three main ways.

But before I dive into these, just a little bit about hair growth and physiology.

Hair growth and physiology

Hair growth is actually a continuous process and has four main phases:

  • The anagen – or growth – phase when cells in the root of the hair are rapidly dividing and new hair is formed. This phase usually lasts for between 3 and 5 years.
  • Then hair follicles enter the catagen – or regression/sometimes called transition – phase. Hair stops growing and the blood supply to cells producing new hair is cut off. Around 3% of hairs are in this phase at any one time and it lasts for around 10 days.
  • The telogen – or resting – phase is up next. During this phase, hairs remain in their follicles but they’re not actively growing, usually lasting for about 3 months.
  • And finally, hairs enter the exogen – or shedding – phase. This is when hairs fall out from their follicles. Most of us naturally, and normally, lose between 50-100 hairs a day because they’re in this phase.
Does stress cause hair loss?

Being under significant levels of stress can lead to raised levels of the hormone cortisol. It’s thought that this can push larger numbers of hair follicles than usual into the telogen, or resting, phase.

This most common type of stress-related hair loss is called telogen effluvium and within a few months, affected hairs will move into the exogen phase and can fall out.

You might notice this when washing or combing your hair, or perhaps you might notice a lot of hair on your pillow when waking up in the morning. And you might notice thinning of the hair on your scalp, typically the top of your head, rather than the back and sides.

Another way that stress can lead to hair loss is by leading to what we call trichotillomania. This is essentially when you have the urge to pull out hair from anywhere on your body, including your scalp.

People suffering from trichotillomania are using the hair pulling as a coping mechanism to manage stress, anxiety, frustration, or perhaps loneliness.

And then the third way that stress can lead to hair loss is through being a potential risk factor for alopecia areata. This is a condition that leads to patchy hair loss and again, this can be hair loss on the scalp, but also the eyebrows and eye lashes and hair on other parts of the body.

Alopecia areata is what we call an autoimmune condition. That’s where the body’s immune system attacks its own cells – here the cells of the hair follicles leading to hair loss.

Stress-related hair loss isn’t permanent

Now, the good news is that stress-related hair loss isn’t usually permanent. Hair is one of the few tissues that can regenerate. So, if you can find ways to manage your stress, or your stress resolves, it’s possible for your hair to grow back after around 3-6 months

But please do talk to your doctor if you’re worried.

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