By Alan J. Bauman, M.D.
For most of us, the many joys of the holidays are usually accompanied by extra stress, and in some cases, lots of it. From long lines and shopping trips, family dinners and busy travel schedules, it is easy to forget to take care of yourself. We all know that stress can take its toll on our physical health, but did you know it can also affect your hair?
Believe it or not, hair can be a very sensitive barometer of someone’s health. Even small changes in different lifestyle factors, including nutrition, hormone levels, sleep cycles, medications, and of course stress, can wreak havoc on your hair. The old saying has always been that stress will “make you go gray,” but can stress also make your hair fall out? The short answer is “yes,” but thankfully, there is more to it than that, or else—let’s face it— no one would have any hair!
Stress alone doesn’t cause permanent hair loss, but it can lead to a temporary hair loss situation called telogen effluvium or excessive shedding, leading to thinning in both men and women. People who are most susceptible to this type of stress-induced fallout likely have other contributing factors as well, such as a genetic predisposition to male- or female-pattern baldness, or certain health factors that are already influencing the hair follicles (e.g., illness, hormonal imbalance, lack of sleep, medications, poor nutrition, smoking, etc.). Additionally, when stress does play a key role in hair loss, it’s usually a more extreme circumstance or severe chronic stress—for instance, a serious illness, death of a loved one, or divorce. In the latter case, recent studies have found a correlation between divorce cases and a loss of hair volume.
It’s not entirely clear yet why a higher level of stress impacts the hair follicles, but some studies have suggested it could be due to above average cortisol levels. When a person is “stressed out” their body tends to experience elevated levels of cortisol, which is a type of steroid hormone produced by the adrenal gland. It has been documented in a number of medical studies that cortisol has a number of adverse effects on the body, including suppression of the immune system, decreased bone density, weight gain, increase in blood pressure and cholesterol, heart disease and lower rates of learning and memory. Recent studies on mice have also indicated that stress hormone levels have a direct impact on impairing hair follicle function, shutting down the hair follicle and causing hair loss. This effect was confirmed by adding a stress hormone blocking molecule in one group of mice, prompting hair regrowth in that cohort.
The normal cycle of the hair is to grow, rest, shed and regrow. However, spiking cortisol levels appear to interrupt this cycle by forcing the hair follicles to go into a resting state prematurely and remain in it longer – most often until the cortisol levels decline. This is what leads to shedding without regrowth. (But keep in mind – some shedding is normal. The average person sheds 100 to 200 strands per day. It is only when the shedding exceeds that level that it is considered problematic.)
For consumers, it is important to realize that the health of your hair is directly linked to the body’s overall health; any changes to the latter will impact your follicles in one way or another.
No one will ever be able to eliminate every bit of stress from their lives, and certainly not during the holidays, but it’s important for patients to pay close attention to their overall health and the health of their hair. If you notice excessive shedding during periods of stress, it may be time to meet with a board-certified hair restoration physician or a qualified trichologist. These hair science professionals can examine your hair line, scalp and medical background to determine the exact cause of the hair loss and whether or not it will worsen over time. At Bauman Medical Group’s state-of-the-art salonB Trichology Center, aside from measuring your hair density over time with HairCheck trichometry and HairCam photography, we can also test the scalp for key factors influencing hair growth and performance, such as blood cortisol levels as well as scalp sebum, pH and hydration. For some patients, reversing problematic hair may simply come down to adding a hair-specific nutritional supplement like Viviscal Pro or mega-dose Biotin to your diet; or it may include a “scalp makeover” by our salonB trichologists, which utilizes scalp massage, scalp steaming and highly advanced topical products to boost the health of the scalp and follicles. For other patients, this occasional shedding may be a sign of a more serious problem that requires more advanced therapies, such as low-level laser therapy, platelet-rich plasma (PRP) therapy, Formula 82M minoxidil and FinPlus finasteride.
If you notice sudden, unusual, or excessive shedding, don’t ignore it. Hair loss caused by stress, whether emotional or physical, is particularly difficult to self-diagnose because it doesn’t happen immediately following the stressful period or triggering event – it often happens weeks, or even months afterwards. To properly diagnose the cause of your hair loss, it is important to be evaluated by a board-certified hair restoration physician, who can help determine if your hair loss is in fact due to stress, or if it is a symptom of a more serious underlying health condition.
Stress and Hair Loss
Stress is often cited as a key factor influencing the health and quality of the hair, with recent medical studies finding direct causal links between the two. Here are three ways stress may induce or support hair loss in both men and women:
1) Telogen Effluvium: This type of sudden, excessive hair fallout or shedding is not permanent, and often resolves on its own after a few weeks or months. Repeated cases of TE, however, could result in lasting damage to the follicles and hair strands, as the hair may regrow thinner or weaker each time. TE occurs when the hair follicles’ normal growth cycle is disrupted, forcing more follicles into a longer resting phase when no new hairs are produced. TE may be caused by stress (which raises the cortisol level in the blood), changes in estrogen/progesterone levels, serious illness, blood-flow restriction, medications and other health factors.
2) Trichotillomania: A hair-pulling disorder due to stress, anxiety or obsessive-compulsive disorder, this condition can result in permanent hair loss in the affected areas due to physical damage of the follicles.
3) Alopecia Areata: A rare auto-immune disease that attacks the hair follicles, resulting in bald “patches” within the scalp. Recent medical research suggests that extreme stress may also play a contributing role in this condition.
Hair Restoration for Men and Women