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By Dr. Afton (Chavez) Cobb M.D., F.A.A.D.
Got hair loss? Don’t stress. As a dermatologist, I often see patients in my office who are worried about alopecia, which is the general medical term for hair loss.
First off, it is normal for people to lose between 50 to 100 hairs daily. If you’re losing more strands than that and the hair seems to be thinning, there could be several potential underlying causes.
Interestingly, one of the most common causes of hair loss is stress! It’s important to correctly identify the underlying cause of hair loss so you can tackle it appropriately.
Stress-related hair loss occurs when the body is under significant physical or emotional stress, which can cause the hair to fall out in large amounts. In this blog post, I'll go over what stress-related hair loss is, how common it is, and offer some solutions to help combat it. Keep in mind, if you’re dealing with hair loss, you might want to consult your dermatologist to help identify the true cause.
First, let's dive into what stress-related hair loss is. When dermatologists talk about stress-related hair loss, we are often referring to a condition called telogen effluvium. Telogen effluvium is a term describing hair loss caused by a traumatic “event” that causes a shock to the system and resulting disruption in the normal hair cycle.
With telogen effluvium, more hair follicles than usual shift into the resting (telogen) phase of the hair growth cycle. This shift into the resting phase can cause hair to fall out diffusely in large clumps, typically about two to four months after the inciting event. Luckily, most cases of telogen effluvium are temporary, and the hair grows back normally after about six months. However, there are some rare cases of chronic telogen effluvium.
Telogen effluvium can be caused by a severe illness or injury, such as a surgery, hospitalization, pregnancy, menopause, or even a viral illness. It can also be caused by severe emotional distress, such as losing a loved one, a stressful job, or any other major lifestyle transition that causes grief, depression, or anxiety. This is because the body is focused on healing and may divert resources away from hair growth.
When dermatologists are determining whether hair loss may be caused by telogen effluvium, we often check labs first to ensure there isn’t anything else wrong organically within the body. We use labs to rule out causes such as iron, vitamin D, or zinc deficiency, or thyroid or autoimmune issues.
Chronic stress from daily life may also affect hair loss in ways other than what is traditionally thought of as telogen effluvium. The complete explanation for how ongoing stress from a busy lifestyle affects hair loss isn’t entirely understood, but there is definitely a link. Stress can cause elevated levels of the hormone cortisol in the body. This can inhibit hair growth and damage the sugar-proteins in and around hair follicles, leading to hair loss.
It’s difficult to say with certainty how common stress-related hair loss is because it isn’t always reported. The prevalence of telogen effluvium varies depending on the population being studied and the definition used to diagnose the condition. Some estimates suggest that up to 30% of women experience telogen effluvium at some point in their lives, while the condition is less common in men.
Now, let's move on to the good news. There are a number of solutions to help combat stress-related hair loss. Let’s go through them one by one.
First and foremost, it's important to address the source of your stress. If the stressor is an ongoing situational factor, what steps could you take to avoid the stress-inducing trigger? If you’re unable to remove yourself from the stressful situation, you could try practicing relaxation techniques to manage your stress, such as deep breathing, meditation, yoga, getting enough sleep, exercising, and maintaining a healthy diet. Also, never underestimate the calming power of aromatherapy, a soothing bath, or a piping hot cup of tea.
In addition to addressing the source of your stress, several natural remedies may help promote hair growth. For example, massaging your scalp with essential oils like rosemary, thyme, and peppermint oil may help improve blood flow to the scalp and promote hair growth.
If you’re going to try essential oils for the scalp, do a patch test on a small area of skin first to see how you react. I also recommend mixing the essential oil with a bland oil like coconut oil or jojoba oil so it isn’t too strong. The main downside of applying essential oils on the scalp is that they could cause irritation or worsen dandruff.
Some research also suggests drinking peppermint tea may help support hair growth!
Although the cause of the hair loss may not be specifically related to the shampoo or conditioner you’re using, choosing the right products will help support the hair follicles and minimize hair shaft breakage. This can minimize the appearance of thin, dull-appearing, unhealthy hair. Look for gentle products with minimal preservatives and fragrances.
Haircare products that target dandruff (seborrheic dermatitis) can also benefit people suffering from hair loss because they help make the scalp skin healthier. Look for ingredients like selenium sulfide and zinc pyrithione in hair care products to help treat flaky dandruff scale.
In terms of caring for your hair, everyone is different in how often they need to wash. At minimum, I generally recommend washing the scalp and hair about three times a week. However, you may need more or less depending on your specific skin and hair type.
If you’ve had your labs checked and you know you have a vitamin deficiency, your doctor may recommend taking supplemental iron, vitamin D, or zinc. In general, it’s a good idea to officially check your labs so you know if you truly have a vitamin deficiency. It’s also essential to take the correct amount, as it is possible to develop adverse side effects from taking too much of a vitamin or mineral.
Many people think biotin is something they should take for hair loss. However, there is no good evidence that it actually improves hair growth. In addition, taking biotin supplements can interfere with laboratory blood work results by causing falsely low troponins (a marker of heart disease) and altered thyroid markers. Therefore, biotin supplements are not something I generally recommend for hair loss.
Stress is a common part of everyday life. But when it is excessive or chronic, stress can have significant negative impacts on the body, including on our hair. Chronic stress can lead to health issues in a wide range of systems and organs in the body, including the cardiovascular, immune, digestive, nervous, and integumentary (aka the skin and hair) systems. Several skin conditions are exacerbated by stress, including psoriasis, eczema, acne, and even autoimmune conditions.
Stress-related hair loss is a common condition that can be especially frustrating to deal with. The first step is to figure out what the underlying stressor is. If the reason for hair loss (specifically telogen effluvium) was a major stressful physical or mental health event that occurred several months ago, don’t sweat it—the hair loss will slow down, and the hair will eventually regrow.
If the source of stress is ongoing, try to address solutions for changing the situation or implement stress-relieving techniques like yoga, meditation, exercise, and healthy lifestyle behaviors. Be sure to use a good shampoo and conditioner to support your hair follicles, and look for the ingredients I mentioned above, such as peppermint and rosemary. Remember to always consult with a dermatologist before trying any new treatments to ensure they are safe and effective for you.
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