We don’t need to remind you that the last 18 months have been stressful. For some who contract COVID-19, a side effect is hair loss. But even those who haven’t been diagnosed with the virus may have experienced changes to their tresses and scalp. The culprit? Stress. “Stress basically causes a reactionary effect consisting of inflammation, which disrupts the normal functioning of the body,” explains Shab Reslan, a New York City-based trichologist and hair expert. “This disruption interferes with the least important systems in the body, namely the hair growth system.”
Just as the daily stressors of life — pandemic-related or otherwise — can impact your skin, so too can it have unwanted effects on your ’do. If you’ve been noticing otherwise unexplained changes to your locks (think: thinning, oiliness, etc.), stress may be to blame. So, how can you be sure stress is messing with your strands, and, more importantly, what can you do to address it? Below, two trichologists break down everything you need to know about the impact of stress on the hair.
Yes, Stress Can Cause Hair Loss
While we wish it weren’t true, stress can, in fact, cause hair shedding. “Hair loss can be caused by an imbalance of many different kinds of hormone issues, and cortisol — ‘the stress hormone’ — is one of the hormones often identified with hair loss,” says Gretchen Friese, a BosleyMD certified trichologist. “Cortisol is known to affect the hair growth cycle.”
As you may know, extended stress can lead to longer periods of high cortisol levels. “So, while the adrenal glands are busy making extra cortisol, they may make less of the hormones that support healthy hair growth,” Friese shares. Even if it’s not permanent, stress-related hair thinning can be disruptive and, well, stressful. And it doesn’t look the same on everyone. “Hair loss that is caused by stress can show up in different forms,” she notes.
With that in mind, here’s a few of the ways stress can lead to hair loss:
One of the most common signs of stress-induced hair loss is telogen effluvium. As Friese describes, telogen effluvium is “when stress causes the roots of the hairs to be pushed prematurely into the resting state which is followed with the hair falling out.” This can happen in one specific area of the head or all over. “When this happens all over the scalp as opposed to in one area of the head, it is called diffuse hair loss,” she adds.
If the body experiences some sort of trauma or shock, as many as 70 percent of scalp hairs may shed — but the effect isn’t immediate, Friese shares. Instead, the loss usually manifests about two to three months after the ‘trauma’ occurs. “This sudden increase in hair loss, which people usually describe as ‘the hair coming out in clumps or handfuls,’ is acute telogen effluvium,” she explains. While the shedding can be dramatic, the thinning is usually temporary and hair should grow back once stress is under control.
Alopecia areata is an autoimmune disorder that results in unpredictable, patchy hair loss on both the scalp and body. “This is when there are visible spots on the scalp that don’t have hair,” Friese says. “Some describe them as ‘crop circles.’” The hair loss, which is sudden, occurs when the immune system attacks the hair follicles. While research indicates the likelihood of a genetic predisposition for alopecia areata, it is believed that the hair loss can be brought on or worsened by stress.
Mild cases of alopecia areata often resolve without treatment within a few months to a year, though both immune-suppressing and topical hair growth medications may be prescribed.
You may have joked that a difficult situation made you want to figuratively pull your hair out, but such events lead some to literally do so. “Trichotillomania is an irresistible urge to pull hair out from the scalp, eyebrows, or other areas of the body,” Friese says. While stress isn’t the only trigger of trichotillomania, it “can be a way that some people deal with stress, anxiety, tension, loneliness, boredom, frustration, and other negative feelings,” she adds.
Hair follicles damaged during the process of pulling the strands out may never regain full function, but some people experience little to no permanent hair loss or balding after they stop hair pulling.
When you think of psoriasis, you probably think of the skin. Psoriasis is a chronic condition that causes patches of red, dry, flaky skin. So, why are we talking about it here? Psoriasis most commonly appears on the elbows, knees, lower back, and, yes, scalp. The causes and severity of psoriasis varies depending on the patient, but stress is known to trigger flare ups for many with the condition.
Symptoms of psoriasis on the scalp can include itchy patches of fine scaling that looks like dandruff or thick, crusted plaques that cover the entire scalp. It can often be treated with over-the-counter and prescription topicals (think: medicated shampoos), light therapy, and/or oral medication. While scalp psoriasis does not directly cause hair loss, heavy scratching or brushing callously through the scaling can lead to damage and shedding.
Other Ways Stress Impacts Hair
Hair loss isn’t the only side effect of stress. During stressful times, “the body deprives the hair follicle of essential nutrients and hinders both cell production and healthy hair growth,” Reslan notes. As a result, chronic stress “eventually leads to weaker and thinning hair,” she says, and it can also cause other hair and scalp concerns:
- Itchy, Flakey Scalp: Emotional stress can be behind an itchy, flaky scalp. Not to be confused with psoriasis, stress may lead to dandruff due to increased sebum (read: oil) production. “Dandruff, which is caused by an excess amount of oil on the scalp, can be a side effect of stress,” Friese says. An anti-dandruff shampoo should offer relief.
- Greasiness: Speaking of oil production, “stress can cause an overproduction of sebum that may add to the oiliness of the scalp and hair,” Friese says. As a result, your locks may be greasier than normal during emotionally challenging times.
- Gray Hair: A recent study from the National Institutes of Health (NIH) found that stress leads to premature graying in mice, and the same may be true of humans. “It has also been discovered that, when a stressful event is over, the gray hairs may go back to their original color,” Friese adds.
- Texture Changes: While not as common, stress may also impact the texture of your tresses. “High levels of [cortisol] can, in some cases, cause changes in texture and appearance because it does affect follicle function,” Friese notes.
So, How Do You Treat Stressed Hair?
Now that you understand the negative effect stress can have on the hair, it’s time to talk about what you can do to counteract it. Needless to say, reducing stress (we know, easier said than done) is perhaps the most important step you can take to restore your mane, but there are other remedies to help boost your blowout:
1. Determine the Cause
If you’re seeing a prolonged or really drastic change to your hair, don’t rely on Dr. Google — seek professional help. “The most important thing to do when excessive hair loss is present is to determine if an underlying cause for the problem is present,” Friese shares. For some, the shedding may be the result of a medication, illness (hi, COVID), or hormonal change (think: postpartum). In such cases, Friese says, the condition tends to be temporary and does not require treatment.
If the trigger is not clear, a professional will be able to take a closer look. “Blood tests may need to be done if the cause is not obvious,” she notes. It can show things like a mild vitamin or iron deficiency or an underlying condition that was not previously known.
2. Try a Topical
Just as you have curated a meticulous skincare routine, a hair care and scalp care routine that is reflective of the current state of your strands can help undo and prevent damage. “The best protocol to help get your locks back to normal and potentially stronger than before would require the use of a topical that will encourage and stimulate healthy hair growth and circulation,” Reslan shares, adding that she’s a fan of The Inkey List Caffeine Stimulating Scalp Treatment.
Additionally, a medicated topical, like the BosleyMD Women's Extra Strength Minoxidil 5% Topical Foam or Men's Extra Strength Minoxidil 5% Topical Sprayer, is approved by the United States Food and Drug Administration (FDA) to regrow hair and slow down further loss.
3. Pay Attention to Your Diet
You are what you eat — and that extends to your locks. Diet and nutrition plays a very important role in scalp health and hair growth. Eating well all the time is the goal, but it’s especially important when you are stressed. Avoid processed and low-fat foods in favor of meals that are protein packed, vitamin rich (specifically, vitamins A, E, and D), and full of healthy fats (think: avocados, fatty fish, nuts, and yogurt). For some, a hair supplement may also help fortify the diet and, in the process, the hair.
4. Take Sone ‘Me Time’
As we mentioned, developing tools to manage stress is an important part of the treatment protocol. Chronic stress doesn’t go away overnight, but you can and should find time for yourself each day. This could mean going for a walk around the block, journaling, working out, meditating, or even just focusing on your breath for a few minutes. Any little bit helps!
5. Be Patient
The good news about the majority of the hair concerns we discussed here is that they are usually temporary. “So long as you have not been experiencing high levels of stress for an extended period of time, you can reverse the adverse reactions,” Reslan says. Even so, you’ll want to be proactive. “The sooner you act, the better, as hair follicles can become permanently inactive after being dormant for too long due to interruptions of stress in the body,” she adds.
We hate to break it to you, but patience will be required. “Stress-induced hair fall can occur anywhere from three to four months after the onset of a stressful period and can continue for a few months,” Relan noets. Once hair returns to its normal growth phase, you will notice new hair in about six months. All in, you are probably looking at upwards of a year for total restoration. “Shedding usually slowly decreases over several months (three to eight) once the cause for the hair loss is no longer present,” Friese says. “For example, it is believed that, if childbirth is the cause for the rapid hair loss, it usually returns by the child’s first birthday.”
Stress is an inevitable part of life, but it is important to know that there are a number of ways it can manifest on your mane. Though the changes aren’t usually permanent, it’s still important to prioritize your physical and mental well being. Consulting with a professional hair expert can help determine the root cause of your hair concerns and how to nurse it back to health.
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