High levels of stress can lead to different types of hair loss. It may inhibit hair regrowth, cause the body’s immune system to attack the hair follicles, or cause an irresistible urge to pull one’s hair.

Humans typically lose between 50 to 100 hairs a day.

Not all hair loss is because of stress, but a person may shed significantly more when they experience extreme stress.

This article answers the question of whether stress can cause hair loss, the different types of stress-related hair loss, and what a person can do to manage stress-related hair loss.

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There is a well-established association between stress and hair loss. Hair loss results from multiple factors, including environmental and genetic factors.

While acute stress boosts the immune system, chronic stress suppresses and over-activatesTrusted Source the immune system, leading to inflammation.

Sustained and chronic stress can cause inflammation in or around the follicle, which can disrupt its mechanisms through endocrine and neuroimmune mediators like cortisol and corticotropin-releasing hormones.

Hair growth involves three stages:

  • Anagen: the active phase where hair grows from the follicles
  • Catagen: phase involving the death or shrinkage (apoptosis) of the follicle at the base of the hair strand
  • Telogen: resting phase in which the hair follicle is dormant and has no hair shaft growth. In this phase, the stem cells are quiescent, and hairs shed more easily

Stem cells found in hair follicles drive this hair cycle.

A 2021 rat studyTrusted Source found that removing adrenal glands, which produce essential stress hormones in rats and humans, resulted in rapid hair regrowth cycles. Subjecting the rats to mild stress for weeks resulted in increased stress hormone (corticosterone) levels and reduced hair growth.

The hair follicles were also in an extended resting phase (telogen). To add, corticosterone also prevents the cluster of cells (dermal papilla) beneath the stem cells from secreting a molecule that activates the hair follicle stem cells.

Three types of stress-related hair loss are associated with extreme stress levels.

Telogen effluvium

Telogen effluvium is the excessive hair shedding of resting (telogen) hair. In a typical person’s scalp, 85% of hairTrusted Source is anagen, while 15% is telogen. Some stressors induce 70% of anagen hair into telogen, leading to hair loss.

According to the American Academy of Dermatology (AAD), telogen effluvium or excessive hair shedding is common among people who experience extreme stress. Common stressors include:

  • excessive weight loss
  • giving birth
  • major life stressors, such as job loss, divorce, death
  • high fever
  • recovering from an illness
  • stopping taking birth control pills

Other inducing factors include:

  • systemic diseases
  • major surgeries
  • drugs
  • nutritional deficiencies

This shedding usually occurs 3 monthsTrusted Source after the stressor. It is usually self-limiting and lasts for about 6 months. Chronic telogen effluvium exceeds 6 months.

Alopecia areata

Alopecia areata involves the body’s immune system attacking the hair follicles in the anagen phase, which forces them to the catagen phase. Because the stem cells in the follicles are not destroyed, the hair follicles continue to regenerate and continue cycling.

Clinically, it presents as small bald patches on the scalp or around the body and may lead to total loss of scalp or body hair.

Environmental triggers play a significant role in its development. Some also consider stressful life events as significant factors that trigger the condition. There is evidence to show that genetic factors may also play a role in the development of alopecia areata.

Trichotillomania

Trichotillomania, or hair-pulling disorder, involves repeatedly pulling hair anywhere on the body. It is part of obsessive-compulsive disorder (OCD). A person with trichotillomania uses their hands, tweezers, or other devices to pull their hair.

The exact cause of trichotillomania remains unknown, but many people report the occurrenceTrusted Source of a stressful event before the hair-pulling behavior. It may act as a person’s coping mechanism to stress and anxiety.

Treatment for stress-related hair loss depends on the type of hair loss a person experiences.

Telogen effluvium

Acute telogen effluvium is self-limitingTrusted Source and will typically resolve once the underlying cause is treated. Some research showsTrusted Source that the medication minoxidil can help people with chronic telogen effluvium. However, further research is needed to confirm the full effects it can have on hair shedding.

There is limited evidence on the effectiveness of treatments for alopecia areata, but dermatologists prescribe topical corticosteroids as the first-line treatment for the condition.

Dermatologists may give topical corticosteroids to children 10 years old or younger and corticosteroid injections to individuals older than 10 years with patchy alopecia.

A dermatologist may prescribe topical immunotherapy in people with extensive alopecia (greater than 50% scalp hair loss). With this treatment, 74.6% of peopleTrusted Source with patchy alopecia experienced hair regrowth, and 54.4% of people with alopecia totalis showed hair regrowth. However, 38.2% of people also experienced recurrence of their alopecia.

Trichotillomania

A healthcare team may use several treatment strategies to help manage trichotillomania. In children, conservative methods like using gloves or socks to cover the hands and cutting the hair short can help.

Habit reversal training, grounded in cognitive behavioral therapy (CBT), helps a person identify the cognitive distortions and the maladaptive behavior paired with them (hair-pulling) to changeTrusted Source them.

A number of stress management techniquesTrusted Source can help a person cope with stress, including:

Below are other stress management tips that can help reduce stress and reduce the likelihood of hair loss due to stressTrusted Source:

  • eating nutritious, balanced meals
  • getting enough quality sleep
  • avoiding tobacco, alcohol, and substance use
  • taking time to do enjoyable activities
  • expressing worries and concerns to others
  • connecting with communities or faith-based organizations
  • trying meditating or spending timeTrusted Source in nature
  • asking for professional help when necessary

There are many other potential causes of hair loss. These include:

The following are some questions that people frequently ask about hair loss.

Will stress-related hair loss grow back?

Acute stress-related hair loss, called telogen effluvium, tends to be self-limiting and resolves when the trigger is treated or removed.

What does hormonal hair loss look like?

The hair may look finer or thinner. It may also fall easily and grow slower than before.

What does stress hair loss look like?

Stress hair loss, or telogen effluvium, looks like hair falling out quickly from combing, washing, or even just touching the hair. The hair on the scalp may be thinning, but the scalp looks healthy and does not have scales or rashes.

Hair loss can happen due to a variety of factors, including stress. There are several types of stress-related hair loss. Their results may range from short-term, self-limiting hair loss to permanent, irreversible hair loss. Identifying the cause of the hair loss and seeking appropriate treatment is essential.

Treatment depends on the underlying cause and may include lifestyle changes, medications, topical treatments, and immunotherapy. Stress management techniques, such as deep breathing, can also help manage stress and decrease the risk of hair loss.