The majority of hair loss in men is caused by male pattern baldness, but in women it is more often caused by the physical or hormonal changes that result from stress. Men can also suffer from stress-related hair loss, either in place of or in addition to hormonally-driven hair thinning.
What is stress?
Stress can take two forms: physical stress, and emotional stress. Physical stress can take the form of a major illness, an accident, an injury, childbirth, or a miscarriage, while emotional stress may be the death of a close friend or family member, divorce, money worries, or work-related stress. All can induce hair loss.
In many cases, because of the way that stress affects hair growth, stress-related hair loss may not be seen for several months after the stressful event, and the problem that caused it has often been resolved before the symptoms occur.
How does stress cause hair loss?
High levels of stress can change the functioning of the hair follicles, the physiology of the body and your own psychological behaviour, causing hair loss in one of three ways. These are now recognised stress-related hair loss syndromes:
Telogen effluvium as a cause of hair loss
Each hair root has a lifecycle comprising a growth stage, called anagen, which lasts for three to seven years, and a resting stage, called telogen, which lasts for around three months. Once the telogen stage begins, the old hair stops growing and sits in the follicle until it is pushed out by new hair growth as anagen resumes.
Under normal circumstances, around 15% of your hair is at some point of the telogen stage at any one time. This explains the loss of around 100 hairs a day as these follicles switch back to the anagen state.
During times of extreme stress, chemical changes within the body cause many follicles to move into the telogen stage simultaneously. This means that there is no new hair growth from these follicles and when they all move back into anagen at the same time there is a significant increase in hair loss due to old hair falling out. There is very little new growth to replace it, so the hair appears noticeably thinner. This also explains why there is typically a delay of about three months between the stressful event and the subsequent hair loss.
Alopecia areata as a cause of hair loss
Stress is also thought to be one of the trigger factors for alopecia areata. In this condition, the body’s immune system malfunctions and white blood cells and anti-bodies, which normally provide the body’s defences, begin to attack the body instead. When the body’s own immune system attacks the hair follicles, hair growth slows or even stops, causing widespread hair loss and sometimes complete baldness.
Trichotillomania as a cause of hair loss
For some people, stress causes compulsive behaviour such as trichotillomania whereby people twist and pull at their own hair. This can range from mild twisting or ‘playing’ with their hair in stressful moments, to compulsively pulling out individual hairs or clumps of hair without being able to stop.
The phrase ‘tearing your hair out’ to denote a high stress situation suggests this behaviour has been around for a long time. Trichotillomania not only results in significant hair loss, but it can also cause lasting damage to the hair follicles and may kill them completely.
Is stress-related hair loss permanent?
The most common stress-related hair loss problem, telogen effluvium, has no lasting effect, and will generally right itself once the stress is dealt with. As discussed above, the hair loss from stress may not manifest itself until around three months after the stressful event, but as long as the issue has been resolved, normal hair growth will begin again at this point and the hair will grow back more or less normally.
In cases of alopecia areata and trichotillomania, the stress may cause longer lasting damage to the hair follicles, resulting in permanent hair loss and bald patches, or complete hair loss in very severe cases.
Due to the nature of stress-related hair loss, it is unlikely that hair transplant therapies or hair restoration medication will have any beneficial effect, but your GP or hair specialist will be able to give you a clearer idea as to whether any hair restoration treatment may help.
How to avoid stress-related hair loss
There is little that can be done to avoid the acute stress of a traumatic event, such as a bereavement, accident, or illness. However, the nature of these events means that the associated high stress levels will generally be short-lived and will not have a lasting effect on hair loss.
Chronic stress, such as financial problems, work issues, or relationship issues, can have a much longer effect and so it is important to take steps to reduce your stress levels whenever possible. This will not only reduce hair loss, but it will also benefit your general health.
There are many ways you can reduce stress in your daily life, including:
Take time out – try to put your problems aside for a while and focus on something else, such as going to the cinema or chatting with friends
Do some exercise – the natural endorphins released during exercise can be hugely beneficial in reducing stress levels
Relax a little – put your feet up and switch off whenever you can. Just half an hour a day of relaxation can have significant benefits.
Have some fun – laughter is a great remedy and can help you put things in perspective
Seek professional help – there are lots of ways that you can get help, from practical advice, such as sorting out your finances, to counselling and therapy to help you cope with stress more effectively
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