- Stress-related hair loss
- When to See a Doctor
What is stress-related hair loss?
Everyone undergoes stress at some point in their life. Sometimes, that stress causes a physical reaction or physical symptoms. You might experience flare-ups of eczema, dandruff, or acne. Hair loss is another common side effect of stress.
The human head loses around 50 to 100 hair follicles each day. This isn’t much, considering we have approximately 100,000 hair follicles on the scalp. This is why average hair loss isn’t noticeable. Hair loss caused by stress or another medical condition is a noticeable loss.
Stress-related hair loss happens when your body is experiencing such high stress levels that your hair falls out faster than it otherwise would. In some cases, you’re so stressed that you actually pull your own hair out. This is called trichotillomania, or hair-pulling.
Signs of hair loss
The first sign you’ll notice if you’re experiencing stress-related hair loss is more hair coming off on your comb or collecting by the shower drain.
Some other signs of stress-related hair loss include:
- A receding hairline that becomes more visible
- A bald spot that grows slowly
- Thinner-than-normal ponytail
- Broken hairs around your forehead
- Widening hair parting
- Thinning or patchy eyebrows, eyelashes, beard, nose hairs, or pubic hairs
Types of stress-related hair loss
Particularly high levels of stress, is associated with three different types of hair loss.
Hair follicles undergo three stages of growth. Hair grows in the anagen phase. The catagen phase is transitional. And the telogen stage is when the hair rests. Most hair follicles are in the anagen phase. However, a severe shock or stress can move a big number of hair follicles into the telogen stage of hair growth. This is called telogen effluvium.
Within 3 months of the stressful event, affected hair follicles will fall out as you comb, style, and wash your hair.
Trichotillomania is an impulse control disorder where you have an urge to pull the hair out from your head, eyebrows, eyelashes, and other body areas.
A number of factors may trigger it, like boredom, frustration, loneliness, or stress. In this case, you don’t just feel stressed, but you feel an irresistible urge to pull out your own hair because of your stress.
Alopecia areata is an autoimmune condition where your body attacks its own hair follicles. With autoimmune disorders, your body’s immune system doesn’t work as it should. Instead, the body attacks its own tissue, causing varying symptoms and diseases.
People with alopecia areata lose quarter-sized patches of hair, leaving that area on their scalp smooth and bald. These patches grow back in 3 to 6 months without any treatment. Sometimes the hair grows back white.
Stress can cause an autoimmune disease like alopecia areata. Stress can also cause flare-ups of an autoimmune disease that you already have.
Causes of stress-related hair loss
Significant emotional stress causes stress-related hair loss. However, just because you are stressed or experiencing a stressful situation doesn’t mean that your hair will fall out.
Some events that can cause significant emotional stress and corresponding hair loss include:
- Losing a loved one
- A break-up
- Individual health crisis
- Global pandemic
- Ongoing financial insecurity
- Added pressure at work or school
When to see a doctor for stress-related hair loss
Stress does cause hair loss, but it isn’t the only cause. If you’re experiencing sudden and ongoing hair loss, visiting your family doctor is a good first step. Your doctor can evaluate the hair loss, review your medical history, and refer you to a dermatologist if necessary.
You might think of a dermatologist as just a skin doctor, but this doctor also specializes in problems of hair and nails. Visiting a doctor sooner, rather than later, can improve your outcome.
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Diagnosis for stress-related hair loss
A primary care doctor or dermatologist can run tests to confirm that you’re experiencing hair loss. Your doctor may also want to rule out other causes before determining that your excessive hair loss is due to stress . Some tests your doctor may do include:
A doctor can lightly tug on about 40 strands of your hair to test for excessive loss. It’s likely that you have excess hair loss if more than 6 strands come out during the test.
Your doctor will hold sections of your hair with two hands. One hand will be at the root and the other near the tip. Then, they will tug with the top hand to see if any strands break in the middle. This lets your doctor know if your hair is brittle.
A biopsy is the removal of a tissue sample to inspect it under the microscope. Getting a closer look at the scalp can help a doctor to diagnose the type of hair loss you have.
For this test, the doctor uses a handheld magnification device called a densitometer to look at your hair. They look for miniaturization of the hair shaft.
Checking labs can help a doctor to determine if an underlying medical condition is causing your hair loss. Hair loss can indicate a medical condition like a thyroid issue or anemia.
Some lab tests a doctor might order include:
Treatment for stress-related hair loss
How to treat hair loss depends on the cause of the hair loss. Excessive hair loss from stress typically stops when the stress stops.
Some ways to reduce stress include:
- Removing the stressor from your life
- Sleeping regularly
- Eating healthier
- Seeing a counselor or therapist
Your hair will likely regrow to its normal fullness in 6 to 9 months without any treatment.
A dermatologist can also provide hair loss treatment options to individuals who do not want to wait 6 to 9 months for their hair to grow back. These might include:
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American Academy of Dermatology Association: "Hair Loss: Overview."
American Academy of Dermatology Association: "Hair Loss: Signs and Symptoms."
American Academy of Dermatology Association: "Hair Loss: Who Gets and Causes."
American Osteopathic College of Dermatology: "Telogen Effluvium Hair Loss."
American Osteopathic College of Dermatology: "Trichotillomania."
Autoimmunity Reviews: "Stress as a trigger of autoimmune disease."
Cedars Sinai: "Pandemic Stress Triggers Skin, Hair Problems."
Clinical and Experimental Dermatology: "Normal body hair—a review."
Hair Transplant Forum International: "Densitometry and Video-microscopy."
Mental Health Connecticut: "The Negative Effect of Anxiety and Stress on Your Hair."
NYU Langone Health: "Diagnosing Hair Loss."
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