Medically reviewed by Kristin Hall, FNP
Written by Our Editorial Team
Last updated 8/24/2020
Noticed more hairs on your brush, pillow or around the shower drain than normal? Dealing with hair loss is never fun, especially when you’re not sure what’s causing it.
Most male hair loss is the result of androgenic alopecia, or male pattern baldness — a form of hair loss that’s triggered by a genetic sensitivity to DHT. However, it’s also possible for a range of other factors to cause and contribute to hair loss.
One of these factors is stress. If you’re feeling overly stressed due to work, your personal life or anything else, it’s possible that this stress could contribute either to mild thinning of your hair, or significant hair loss.
Below, we’ve explained how and why stress can cause you to lose hair. We’ve also looked at a range of treatment options that can help you regrow any hair you lose due to stress.
Contrary to popular belief, stress is not linked to male pattern baldness — the form of hair loss that causes you to permanently lose hair around your hairline, temples and the crown of your scalp.
However, stress can trigger and potentially worsen a form of temporary hair loss called telogen effluvium.
Telogen effluvium affects your hair by interrupting the natural hair growth cycle. Normally, your hair goes through four different growth phases as it grows from below the skin to its full length, then falls out to be replaced by a new hair:
The first phase is the anagen phase, during which the hair grows to its full length.
The second phase is the catagen phase, during which the old, fully grown hair follicle detaches from the skin.
The third phase is the telogen phase, during which a new hair starts to grow from the follicle to replace the old one.
The fourth phase is the exogen phase, during which the old hair falls out, with the new hair growing in its place.
Just like your skin and nails, your hair is constantly undergoing this growth cycle. We’ve covered each phase of the hair growth cycle in more detail in our guide to the hair growth process.
Each phase of the hair growth cycle varies in length. Hairs usually stay in the anagen phase for up to six years during which they grow to their full length. About 90 percent of your hairs are in the anagen phase at any time, meaning that most of your hair is constantly growing.
Telogen effluvium affects your hair follicles in the telogen phase. Normally, about five percent to 10 percent of your hairs are in the telogen phase at any one time. With telogen effluvium, as much as 30 percent of your hair can suddenly enter the telogen phase, resulting in hair shedding.
Telogen effluvium can potentially be caused by physiological and psychological stress. Some of the common causes of telogen effluvium include:
Severe psychological stress, such as stress caused by an overly demanding job, family difficulties, the loss of a loved one of other stressful, traumatic events.
Physical trauma, such as injuries from an accident, sports injuries, concussions, deep cuts or broken bones. Telogen effluvium can also occur after surgery.
Infections, fever, illnesses and nutritional deficiencies such as iron deficiency.
Sudden changes in hormone production and hormone levels.
Sudden changes in diet and/or extreme caloric restriction caused by crash dieting, as well as extreme weight loss.
Thyroid conditions, including hypothyroidism and hyperthyroidism, as well as certain autoimmune diseases.
Medications, including certain anticoagulants and anti-hypertensive drugs.
Hair loss from telogen effluvium isn’t immediate, meaning you usually won’t start to lose hair right after a traumatic or stressful event.
Instead, it’s common for your hair to gradually fall out in the months following the event that triggered the physiological or psychological stress. Hair loss from telogen effluvium can last for several months.
There are several major differences between telogen effluvium (hair loss potentially triggered by stress) and hair loss from male pattern baldness:
First, hair loss from male pattern baldness is typically permanent. In contrast, almost all of the hair you lose from telogen effluvium will grow back, provided the primary cause of the telogen effluvium is treated.
Second, hair loss from male pattern baldness looks different from hair loss that’s triggered by stress. Male pattern baldness typically causes a receding hairline, balding on the crown or other baldness patterns. Telogen effluvium causes diffuse thinning on the entire scalp.
Third, telogen effluvium is not related to androgen hormones such as DHT. This means that some treatments for male pattern baldness, such as finasteride, aren’t effective as treatments for stress-related hair loss.
If you’re starting to lose your hair and aren’t sure whether it’s caused by stress or male pattern baldness, it’s best to talk to a healthcare professional. Most dermatologists can diagnose telogen effluvium using one or several tests, including a hair pull test.
Because telogen effluvium has a variety of potential causes, there’s no one treatment that works for everyone.
If your hair loss is caused by a one-off stressful or traumatic event, such as a physical accident, surgery or psychologically stressful event, your hair will typically grow back on its own over the course of several months.
It can often take several months before you notice significant hair regrowth. Medications such as minoxidil, which increase blood flow to the scalp and promote hair growth, may be effective at helping you regrow hair after chronic telogen effluvium hair loss, but are likely ineffective at helping treat cases of acute telogen effluvium.
Drugs like finasteride, which are designed to treat male pattern baldness, will not prevent hair loss from telogen effluvium and do not appear to speed up regrowth.
If your hair loss is caused by chronic stress, understanding and coping with the stress in healthier ways may help you to regrow some or all of the hair that you’ve lost. This is something that you’ll need to discuss with your healthcare provider.
It’s normal to experience some level of stress in life. An occasional stressful day or a bad week might make you feel unhappy, but it generally won’t have any effect on your hairline.
However, chronic stress or severe stress caused by physiological or psychological trauma may cause you to temporarily lose some or all of your hair. If this happens to you, the best approach is to talk to your healthcare provider and treat the underlying cause of the stress.
Over time, it’s normal for hair loss from stress to grow back naturally. If you’re experiencing chronic telogen effluvium, hair growth medications such as minoxidil may be helpful.
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