Stress and Hair Loss – how it happens and what to do

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Stressed man with thinning hair
It is not just genetics that makes hair fall out. How you look after yourself, including your stress management, can be just as important to stopping hair thinning or loss. Of course, every case of hair loss is different, but there is a proven link between excessive stress and shedding hair.
Excessive stress can push large numbers of your hair follicles into a “resting phase”, in which they stop producing new hairs. This condition is called telogen effluvium. In some extreme cases, severe stress levels can cause the body’s immune system to attack its own hair follicles, a condition called alopecia areata.

What happens to your body when you are stressed?

Not all stress results in hair shedding. The right sort of stress can even be good for you. Scientists have shown that this sort of stress – known as eustress – can improve your performance, motivate you to achieve, and even improve your physical health and lengthen your life.
On the other hand, negative stress – distress – can have disastrous effects on your health. This might be emotional stress, psychological stress, or long lasting (chronic) stress which either does not get dealt with or which can be overwhelming.
This distress is the problem. When you are stressed, your body releases hormones such as cortisol or adrenaline into your blood, which can be useful in the short term, but long term have damaging effects on your body’s essential systems. If you have too much stress, your body keeps producing the hormones and gets tired, run down and eventually exhausted.

Why does this make your hair fall out?

Most people have roughly 100,000 hair follicles on their scalp. Each follicle alternates between the growth (anagen) phase and the rest (telogen) phase.
If you have a full head of hair, many more of your hair follicles are in the anagen phase than the telogen phase, so it is not noticeable that some of them are taking a break. When a hair follicle switches from growth to rest, from anagen to telogen, the hair falls out. This is a normal part of the hair cycle.

However, what happens if you experience a sudden episode of intense emotional or psychological stress?  The body releases the hormone cortisol, and the hair follicles switch from the growth to the rest phase. The result? Hair thinning.

How long does stress induced hair thinning take, and what does it look like?

The stress that makes your hair fall out can be sudden, or it can be longer-term. However, if you experience a traumatic event, your hair will not thin or fall out straight away. The hair loss will not usually happen until about three months down the line.
Why is this? Hair follicles react slowly, so although they may enter the telogen phase too early, the hair cycle phase change takes about three months. The hair only sheds at the end of the cycle.
Stress-related hair loss is spread out over the scalp. Telogen effluvium can lead to 50% hair loss. The hairs fall out from all over the scalp – complete baldness is not usually a symptom. Hair falling out in patches can be a symptom of a serious attack of alopecia areata, where extreme stress leads to the immune system attacking the hair follicles.

Will hair lost to stress-related conditions grow back?

Usually stress induced hair loss grows back, especially if stress levels return to more manageable levels.  However, this can often be a slow process, as it takes time for the hair follicles to get back into the regular hair cycle and to grow back to usual thickness. Just as it takes time for the follicles to go from the anagen to the telogen stage, the reverse is true.
Unfortunately, the recovery is not always complete. Sometimes the hair never regains its original density. Often, stress related hair thinning reveals other types of hair loss. Older people usually have naturally thinner hair, so this can result in weaker hair growth after hair loss.

What can you do about it?

How people manage stress is extremely individual. Some people find that sport is very effective at improving their wellbeing, while others use meditation.
If you find that you are stressed, try experimenting with activities or mental techniques which help you to relax. There is also no shame in getting professional help, particularly if you are under long-term stress that is not easy to solve.
If hair loss has already happened, and after around six months the hair growth is still not back to normal, one option may be a hair transplant. In this situation, an explanation is needed as to why the hair is not returning.
You should get professional advice. For this, Dr. Acar and his experienced team at Cosmedica clinic stand ready to offer you a wealth of expertise and support with a free consultation.

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