Medically reviewed by Vicky Davis, FNP
Written by Our Editorial Team
Last updated 4/10/2021
If you’ve begun losing your hair, seeing more hair at the bottom of the shower each morning can cause plenty of anxiety, but can anxiety make the hair loss worse?
Believe it or not, there’s reason to believe that your anxiety problems (whether in the form of stress induced anxiety attacks or generalized anxiety disorder) may be playing a role in some additional hair loss.
But the idea that worrying will worsen male pattern baldness is a bit extreme. To understand what’s going on, we need to explain what’s going on in your average hair follicle.
Most people assume that hair is either always growing or permanently dead, but hair follicles each have independent life cycles consisting of three phases. And each follicle can be on a totally different schedule than the one right next to it.
Hair follicles — the living, working ones — exist in one of three phases at any given time: anagen, catagen, or telogen.
90 percent of a healthy person’s hair is in the anagen phase at any one time. The anagen phase is the growth part of the cycle; this is where your follicle keeps producing hair (and causing you to need a new cut).
This phase only concludes when the catagen phase begins. The catagen phase is a sort of retirement period, where the follicle isn’t making more hair, but the hair itself is still technically alive. It lasts just a few weeks, and only a couple percentage points of your mane are ever in this phase normally at one time.
What comes next is the telogen phase, which is essentially dead hair walking time. At this point the follicle is considered dormant, and you’re just waiting on the hair to fall out. The follicle will rest briefly before the whole cycle starts over. Surprisingly, you’ll have around nine percent of your hair in this phase at any one time, unless something’s going wrong.
What does this look like practically? Well, the American Academy of Dermatology (AAD) says that you have about 100,000 hairs on your head, and on average, you can shed as much of 100 of these a day and be functioning normally. Most of the hair in the drain or on your pillow accounts for this number, and when you run your fingers through your hair, what comes away from your scalp is part of this number (unless you’re pulling with a pair of pliers or something).
There are a couple of ways you might lose hair from your anxiety, and its effects on your body. They mostly consist of the stress of anxiety literally pushing your follicles into later phases manually. Yes, this can 100 percent happen.
Though studies have mostly been conducted in mice, there is mounting evidence to show that stress can cause hair follicles to transition from one lifecycle phase to another, in some cases inducing “premature hair follicle anagen-catagen transition.” In other words, yes, there’s evidence to show stress can cause hair to prematurely stop growing.
Hair loss has a lot of different names and categories, but the two where stress can be a primary factor are telogen effluvium and traction or traumatic alopecia.
Telogen effluvium is simply a term for when some external factor puts more than 10 percent of your follicles abruptly into the telogen phase of their cycles. This can be caused by a wide variety of external factors. Serious injuries, surgeries, or accidents can do it. Women can experience telogen effluvium after giving birth. You might experience it after a sudden and significant weight loss.
But telogen effluvium can also be caused by stress and anxiety, including anxiety and panic attacks. When you have it, it has particular visual traits, like that the hair loss is all-over and generally makes it look like you’re thinning, rather than balding in the traditional ways men do.
While literally losing your hair over a particular episode or period of sustained stress and anxiety sounds scary, the good news is that this condition is typically self correcting, as long as the underlying cause is addressed.
So when the body recovers from the illness or surgery, or when your sources of stress and anxiety are addressed, your hair will begin to grow back, typically within a few months.
Traction alopecia is a little different—it’s trauma or stress to the literal hair follicle itself.
Most commonly, traction alopecia presents as a result of hair styling: excessive use of chemicals or straighteners, or tight buns that literally cause traction on the follicle until it’s damaged.
But traction alopecia (which also goes by the name traumatic alopecia) can also be caused by psychological issues. Have you ever heard someone say they’re so anxious that they’re pulling their own hair out? Well, if they’re literally doing that, it’s actually as a result of a condition called trichotillomania — literally defined as “pulling your own hair out.”
Trichotillomania is a psychological condition and as such it’s best addressed by therapy. A healthcare professional might give you a referral, where some form of therapy like cognitive behavioral therapy will help you build awareness of (and control over) habits like grabbing handfuls and yanking them when you feel anxious.
Unlike other sources of hair loss, anxiety-induced hair loss is a mostly psychological issue, even though the symptoms are clearly physical.
Because of the root cause here, talking to a therapist is going to be your end solution to the problem. If you’re not sure where to go, a healthcare professional can provide you with guidance, and potentially even a referral for the kind of treatment you’ll want to track down.
Lifestyle changes will also help immediately: reduce the amount of stress you deal with on a daily basis, and how you process it. We realize reducing stress is easier said than done, but these problems won’t go away on their own.
And a final note? Just because you’ve checked a lot of boxes for these types of hair loss, doesn’t mean they’re necessarily the culprits.
This is why it’s best to start with a visit to a healthcare professional, who can assess your diet, lifestyle, genetic predisposition and other factors and help you understand why the hair is disappearing.
No matter what kind of hair loss you have, it’s best to address the problem and not just ignore it hoping it will go away. And same goes for your anxiety—the symptoms may appear minor, but they’ll only get worse if left unaddressed. Getting treatment is nothing to be afraid of—and certainly nothing to lose your hair over.