Why Stress Causes Hair Loss and How To Prevent It
If you’ve recently been shedding hair left and right and pulling huge wads of it out of your hairbrush, you may be feeling a little freaked out. And if you’re already stressed about other things that are going on in your life, you probably now are feeling even more stressed. We all know stress can wreak havoc on our bodies and our minds. But can it cause your hair to fall out? Good question. Let’s take a look at the science!
According to Dr. Paradi Mirmirani at Permanente Medical Group in Vallejo, California, stress can cause hair loss. But whether or not it does depends on the type of stress you have. Short-term stress like you get from being stuck in a traffic jam one day or late for work the next is not going to make your hair fall out.
Chronic stress on the other hand, or intense acute stress from extreme circumstances, can. As Dr. Mirmirani describes it, “Something that causes you to lose sleep, or changes your appetite and raises the level of stress hormones.”
Types of Hair Loss Associated With Stress
There are three main types of hair loss which are associated with heightened stress levels:
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- Telogen Effluvium
- Alopecia Areata
Let’s talk about each one in turn so you understand exactly how and why stress can cause your hair to fall out.
Telogen Effluvium: When Hairs Go Out of Phase
This is probably the most common type of hair loss which is associated with stress. Basically, you are always losing hair (usually around 100 strands a day), even when everything is totally normal in your life. This has to do with the phases of hair growth.
Around 90% of your hairs are in a growing phase at any one time, which lasts two to three years.
The rest of your hairs are in a “resting” phase. This phase lasts three to four months. When the resting phase concludes, your hair falls out.
Sometimes, though, when your body is subjected to extreme stress, your hair follicles can go out of phase. Instead of the usual ratio of 90/10, you end up with a disproportionate ratio where a far greater percentage of your hairs enter into the resting phase simultaneously. For a few months, you may hardly notice, but then, all at once, you will shed a shocking quantity of hairs. This will often happen when you are combing your hair or while you are washing it.
The good news is that assuming the stressor has been removed from your life (for example, if you have recovered from an acute illness), your hair should go back to normal quite quickly. How long it takes to get a full head of hair again is going to depend on how long your hair is. Healthy hair will grow at roughly half an inch per month, so if you have short hair, you could be looking at a full head of hair again in just a couple months. If you have longer hair, it will take time for those patches to grow back to match the length of the rest of your hair.
Alopecia Areata: When Your Immune System Attacks Your Hair Follicles
This is a much less common type of hair loss. If you have alopecia areata, your hair will typically fall out in round, clearly-identifiable patches. You may not only lose hair on your scalp, but elsewhere on your body as well. You may even lose all the hair on your scalp. Thankfully losing all of the hair on your scalp and body is pretty rare, and only affects around five percent of those with alopecia areata.
Alopecia is non-contagious and is the result of your immune system turning against your hair follicles. This results in your hair falling out. You can get alopecia at any age, but it typically begins when you are a child. While alopecia seems to be genetic, attacks of hair loss may have secondary triggers such as allergies, asthma, or stress.
If you have alopecia, it does not necessarily mean you have a horrible underlying health condition. While alopecia sometimes occurs in conjunction with other diseases, it is quite common in people who otherwise are healthy. Hair typically grows back with alopecia, though it can take years to do so sometimes. Repeat attacks are common, so you could grow your hair back, lose it again, and grow it back again.
Trichotillomania: When You Attack Your Own Hair
Trichotillomania is not actually a health condition. It isn’t a physical thing at all; it’s a psychological malady. All of us have nervous tics. For some people, a nervous tic can take the form of hair-pulling. People with Trichotillomania may experience it as an urge they can barely control. If you pull your own hair, you may do it on an everyday basis, or you may only do it when you are undergoing some kind of stress.
Trichotillomania is a common reaction to feelings of boredom, frustration, anxiety, depression, and loneliness. Many people who do it are not even aware of what they are doing unless someone points it out to them or they put conscious thought into staying aware of their habits.
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If you are a chronic hair-puller and want to stop, the best thing to do is to look into something like cognitive-behavioral therapy, which helps you to focus on what you are doing and modify and replace bad habits with good ones. Some people also say that speaking to a psychologist is helpful. Biofeedback and hypnosis may also reduce pulling.
What Types of Stress Can Cause Hair Loss?
What types of stress can cause hair loss depends on the type of hair loss you have. If for example you are losing hair because you are the one pulling it out, in theory any stressor could lead to hair loss. That includes emotional stress and acute stressors. Getting stuck in a traffic jam or arguing with a collections agent on the phone won’t cause Telogen Effluvium or alopecia, but it may be enough to cause you to attack your own hair.
For Telogen Effluvium to happen, you need to be dealing with either intense acute stress or chronic, ongoing stress. Generally speaking, we are talking about stress associated with physical conditions and changes.
Common culprits include:
- A high fever: Even if the fever only lasts for a short span of time, it can result in a significant amount of hair loss. I have personally experienced this, and it can be quite unsettling. When it happened, I had no idea initially what was going on. Since it happened right after a high fever, I worried it could be a sign of some terrible underlying condition. Thankfully it was just a result of the fever, which had passed!
- Any severe or long-term illness: When your body is subjected to severe stress from illness or disease, you can lose hair through Telogen Effluvium. That means there are a wide variety of conditions which may contribute. Serious infections are particularly notorious for causing hair to fall out (again something I have personal experience with).
- Surgery: If you have recently had a major operation, do not be too surprised if it is followed up with hair loss. Surgery is an extremely invasive and stressful experience for your body, which is why you can feel extremely tired afterward. This kind of major stress can take a toll on your hair follicles as well.
- A drop in estrogen levels: Anything that causes a sudden sharp or unusual drop in estrogen levels can lead to hair loss. Childbirth is one example. Another is going on and off oral contraceptives.
- Shedding a lot of weight quickly on a low-calorie diet: If you have been crash dieting, do not be shocked if there are some unwanted side-effects. Crash dieting is extremely stressful for your body and can be very unhealthy. One sign you are taking your dieting too far is when your hair starts falling out. Stick with a more moderate diet and you can avoid this.
- Emotional stress can lead to lifestyle decisions that can cause hair loss: You are not going to watch your hair fall out because of a divorce or a death in your family or a lost job. But if severe emotional stress causes you to do something like eat a lot less or compromise your immune system, you could end up losing hair. The real reason you lost hair is because you lost weight or got an infection, not because of the lost job, the death in the family, or the divorce.
You can see why there is a lot of confusion surrounding the link between emotional stress and hair loss. Firstly, when we hear the word stress, a lot of us immediately think of psychological stress, and forget that doctors are referring to physical stress. Secondly, nobody lives in a vacuum, and our bodies and minds are intimately interlinked. What impacts our bodies changes our thoughts, and the thoughts we have likewise impact our bodies. When you are under emotional stress, you can quickly convert it into physical stress through the choices you make (often unconsciously).
Everyone is Different
Another reason that hair loss is hard to predict and understand is because the same factor that causes hair loss for one person may have zero effect on someone else. You might be using the same oral contraceptive as someone else you know. Maybe your friend went on and off her oral contraceptive without shedding a single unexpected hair, but you did the same thing and shed like crazy.
Or maybe you both went on the same crash diet for the same period of time, subjecting yourself to the same low-calorie constraints. You got through it without a problem, losing ten pounds. Your friend lost around the same amount, but also lost a lot of hair to boot, and now she’s panicking.
Situations like these are not unusual. It does not mean anything is “wrong” with either of you. Sometimes there are differences in our physiology which result in our bodies processing stress differently.
What Should You Do About Hair Loss?
There are around 30 different diseases which are associated with hair loss, but that is not a cause for you to panic if you start losing hair. As you can hopefully see from reading this article, hair loss due to stress is extremely common. The simplest explanation is usually the right one. If you are losing hair in a diffuse pattern across your scalp, you probably have Telogen Effluvium, and it may very well be the result of stress.
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Think back to events in your life three months or more before you started noticing the hair falling out. Remember that when hair enters a resting phase, it generally stays there for three to four months before falling out, so there is usually going to be a delay of around that length of time between the stressful event and observable hair loss.
If you can think back several months and pinpoint a likely stressor, then chances are that is the cause of your hair loss. Maybe several months ago you had a bad fever one night, or you had a severe flu. Or maybe you were dieting or you changed contraceptives. Or maybe you went through a serious emotional stress which caused you to stop eating like you should.
When Should You See a Doctor?
If you are losing hair in round patches, you probably have alopecia. Since alopecia is usually not linked to any serious health conditions, you don’t have any cause for alarm, but a diagnosis may make you feel better. If you have diffuse hair loss and you cannot pinpoint the cause, you also should see a doctor. And even if you do think you know a cause, if your hair loss continues, you should talk to a doctor about what might be causing it so you can rule out underlying conditions.
If you are in any doubt, it is always best to consult with a medical professional. Even if you are not suffering from any dangerous health condition (which you probably are not), it should give you peace of mind.
If you are pulling out your own hair and you want to stop, it may help you out to seek the advice of a psychologist. You may also have luck on your own trying out cognitive behavioral therapy (CBT) techniques. The more conscious you can become of the relationship between stress and hair-pulling, the more empowered you’ll be to knock it off and leave your locks alone.
How Can You Get Your Hair to Grow Back?
The good news about hair loss and stress is that once the stressor has been removed from your life, your hair should start growing back on its own. In fact, usually by the time you have started noticing your hair falling out, new hairs are already starting to grow! Just waiting is enough to get back to a full head of hair.
If you want to accelerate the process, however, there are a few things you can do to help your hair along:
- Be careful with the hair you do have (i.e. do not sit on it or lie on it or pull too hard with your comb when you are detangling it): This won’t stop the hairs that are in a resting phase from falling out, but it will prevent you from inadvertently pulling out growing hairs and thinning things out even further.
- Wash your hair only when it needs it: The less you wash your hair and (especially) the less you shampoo it with chemical products, the less you will dry it out. This will keep your hair from being prone to breakage. Again, this may not make your hair grow faster, but it will help you keep what you do have in good condition.
- Massage your scalp: This will boost blood flow. The increased circulation increases cell turnover and also draws nutrients to your hair follicles. Your hair needs nutrition to grow, so this is one of the few things you can do that will actually speed up your hair growth. You can do this when your hair is dry, or you can do it in the shower while you are shampooing your hair.
- Take a multivitamin for hair growth: While massaging your scalp will help to draw nutrients to your hair follicles, it won’t do a lot of good if you are not getting enough of the nutrients you need to stimulate hair growth! The right multivitamin for hair can accelerate the re-growth process after you lose hair from stress, getting you back on track to a full head of hair.
Now you hopefully are feeling better about your hair loss. Yes, intense or prolonged stress can take a toll on our bodies, and can cause our hair to fall out. The good news is that hair loss is commonly innocuous, especially if you can quickly spot a readily identifiable stress-related cause. Your hair is probably already starting to grow back, and you should soon be feeling a lot happier when you look in the mirror! Don’t forget to talk to a doctor if you still have concerns.