If you’re finding more strands of hair than usual on your pillowcase and in the shower drain, you may be wondering if stress is to blame.
You’ve probably heard about a possible link between stress and hair loss, but is there any truth to that claim?
Whether you’re feeling frazzled at work or overwhelmed by emotional events such as divorce or a death in the family, it’s natural to feel concerned about how stress can affect your body.
Here’s what you should know about chronic stress and hair loss.
Long-term, or chronic, stress puts people at risk for a variety of health problems, including depression and anxiety. It can also lead to problems with your cardiovascular system and sleep health, according to the National Institutes of Health.
Chronic stress also has been linked to hair loss, and recent research has helped confirm why this may happen.
In 2021, a study of mice published in the journal Nature revealed that a major stress hormone equivalent to cortisol in humans impairs hair follicle stem cells — putting them into an extended “resting phase,” without regrowth.
Luckily, stress-induced hair loss is usually temporary, and a variety of effective treatments are available to help slow hair loss or help hair regrow. (More on that soon.)_
Can Anxiety Cause Hair Loss?
Not only do stress and anxiety play a role in hair loss, they also are linked to three conditions that can cause you to lose hair.
Telogen effluvium
This condition is a common cause of temporary hair loss. Stress can push hair follicles into a “resting” phase so that they don’t produce new hair strands. Over time, hair can fall out more easily, even if you’re just washing, combing, or touching it.
Telogen effluvium can also be caused by poor nutrition, severe infections, major surgery, changes in hormone levels, and certain medications. Acute telogen effluvium lasts fewer than six months, while chronic telogen effluvium lasts longer than six months.
Symptoms of telogen effluvium include:
- Noticeable hair loss — You may find evidence of increased hair loss in your shower drain, hairbrush, or even when you use your fingers to comb through your hair.
- Thinning or dry hair without any other symptoms, such as a rash, flaking, or itching.
Trichotillomania
If you’ve ever found yourself literally pulling out your hair when you’re stressed or tense, it could be a sign of trichotillomania, also known as hair-pulling disorder.
Trichotillomania is classified as an obsessive-compulsive disorder. Often, people with the condition deal with negative emotions, like stress and anxiety, by pulling hair from the scalp, face, and other parts of the body. Others may pull out of habit or when they’re bored without realizing it.
It’s still unknown exactly what causes trichotillomania, but experts suspect genetics, changes in brain structure, and extreme stress may play a role. Trichotillomania is treatable in many cases with medication and therapy.
Currently, the Diagnostic and Statistical Manual of Mental Disorders lists certain criteria necessary for a diagnosis of trichotillomania:
- Bald spots or thinning of hair.
- Can include removing hair from anywhere on the body.
- Hair pulling or loss not caused by another medical or mental health condition.
- Hair removal causes significant distress or impairment.
- Unsuccessful efforts to stop or decrease Hair removal.
Alopecia areata
Alopecia areata is an autoimmune disease that causes sudden hair loss on the scalp, face, and sometimes other areas of the body, according to the National Alopecia Areata Foundation.
In this condition, your body’s immune system attacks your hair follicles, causing your hair to fall out. In some cases, alopecia areata can just cause hair to be thin, while in other cases, people may develop bald spots.
Hair can regrow over time, then fall out again. Doctors aren’t sure exactly what causes alopecia areata, though genetics may play a role.
There are different levels of alopecia areata in terms of severity, and people with certain autoimmune diseases are more likely to develop the condition.
While it’s possible that emotional stress or illness can trigger alopecia areata in those who are at risk, there is no obvious trigger in most cases.
Symptoms of alopecia areata include:
- A sudden hair loss — which often begins as a round or oval balding patch that develops on the scalp, beard, or anywhere else on the body. Some people lose eyebrows, eyelashes, nostril hairs, or hair on their legs.
- Brittle and crumbling nails.
- Itching, tingling, or burning sensations related to hair loss.
- Irritated eyes if eyelashes or eyebrows are lost.
Treatments for Hair Loss from Stress
Stress-related hair loss is usually temporary, but it’s still critical to talk to your doctor about it — especially if it’s uncomfortable or otherwise disrupting your life.
Treatments for hair loss due to stress include over-the-counter topical solutions and medications.
Your health care provider can help you decide the treatment that’s right for you. They may even advise you to combine certain treatments to help with regrowth.
Here are some potential treatment options for stress-related hair loss.
Minoxidil
The U.S. Food and Drug Administration has approved minoxidil, commonly known as Rogaine, for pattern baldness. It’s an over-the-counter topical solution that you rub into your scalp, often twice daily, to stimulate new hair growth.
Finasteride
The main ingredient in FDA-approved prescription hair loss treatment Propecia, finasteride is approved for men and people assigned male at birth to treat pattern baldness. This daily oral medication lowers dihydrotestosterone, or DHT, a hormone in men that shrinks hair follicles to help stimulate hair regrowth. Results can take up to six months.
Corticosteroids
This prescription medication can help treat hair loss by slowing the speed of the loss and facilitating regrowth. Usually offered via injection, it’s most often used to treat alopecia areata.
Vitamins
Nutritional deficiencies may affect hair growth. A doctor can recommend supplements that support healthy hair, such as biotin, zinc, collagen, iron, and vitamin D.
Tips for Managing Stress
Any number of stressful situations can trigger hair loss, including pregnancy, chronic illness, injury, relationship issues, financial concerns, poor nutrition, surgery, medications such as antidepressants, and even jet lag.
To counteract stress and protect your hair, try these tips:
- Avoid drugs and alcohol.
- Eat a healthy diet and take a multivitamin if your doctor recommends it.
- Get regular exercise, which helps manage stress and its effects.
- Learn and regularly practice relaxation techniques, such as deep breathing, meditation, or yoga.
- Seek professional help from a therapist.
- Set aside “me” time each week to check in with yourself and do something you enjoy.
- Spend time with positive people and connect with others — isolating yourself can make stress worse.
Hair loss from stress doesn’t have to be permanent. If it continues, talk to a doctor about a prescription or over-the-counter remedy to spark hair regrowth.
Editor's Note: This article was originally published on December 27, 2018, and was last reviewed on August 1, 2024.
