The relationship between stress and hair loss

Published on February 19, 2021
Updated on February 19, 2021
An electronic device next to a man, who is holding the bridge of his nose with one hand and looking stressed out.
Both emotional and physical stressors can cause telogen effluvium.

2020 was a stressful year. Whether it was the endless Zoom calls, the stress of working from home with kids running around, or just standard pandemic fatigue, you weren’t alone. 

And of course, there was quarantine. Some people took up marathon running, while others binge-watched Netflix. Regardless of how you personally dealt with the stress of 2020, you might have noticed its effects on your body – particularly on your skin, hair, and mental health.

One unfortunate side effect of long-term or extreme stress is hair loss. The good news is that this type of hair loss, telogen effluvium, is usually temporary.

What is telogen effluvium?

Telogen effluvium is a common type of diffuse hair loss. It can be caused by stress, but has also been associated with various other issues. According to the journal Clinical, Cosmetic, and Investigational Dermatology and the Indian Journal of Dermatology, Venereology, and Leprology, telogen effluvium can occur because of:

  • Chronic illnesses
  • Fevers
  • Medications
  • Nutritional deficiencies
  • Seasonal changes
  • Sunlight exposure
  • Surgery and other major medical procedures
  • Use of certain hair products or dyes

How to tell if you have telogen effluvium

According to the study in the journal Clinical, Cosmetic, and Investigational Dermatology, the average adult with a healthy scalp can expect to lose about 100 hairs each day. Given that you have thousands of hairs on your head, losing this amount is perfectly normal. It’s all part of the hair growth cycle.  

In contrast, the average person with telogen effluvium loses about 300 hairs each day, but might lose up to 1,000 hairs in a single day. In these cases, the hair growth cycle has been disrupted in some way, causing you to shed more hairs than normal. People with this condition also tend to experience a specific symptom, trichodynia, which is when your hair hurts.

Understanding stress and hair loss

Essentially, telogen effluvium is almost always caused by stress. It doesn’t have to just be emotional stress, though. It can be a physical stressor, like recovering from a long bout of being sick, forcing yourself to follow a strict fad diet, or using a hair product that causes an allergic response and results in skin inflammation.

If you’re worried you might be losing your hair, try to think about different potential emotional or physical stressors in your life. You might be able to tie a specific event, like dyeing your hair or starting a new medication, to your hair loss. 

However, keep in mind that stress-induced hair loss doesn’t have to be instantaneous. Telogen effluvium may only become noticeable a few months after the incident that affected your hair follicles

Managing telogen effluvium

If you’re able to determine an external stressor that’s causing telogen effluvium, you also have the potential to stop it. You may need to talk to your doctor about switching to a new medication, change your diet, or use a different type of shampoo. The solution will be specific to what’s affected you.

It’s also completely possible for multiple stressors to affect you, causing your hair loss. For example, you could have been stressed about work and might have also ended up skipping meals because of your busy schedule. 

A study in the Journal of Drugs in Dermatology reported that many people with telogen effluvium have iron, vitamin D, and zinc deficiencies. If you think a nutrient deficiency might be related to your hair loss, you may want to consider taking a supplement. It’s always sensible to consume a balanced diet, but nutrient supplements are helpful as it can take a while to get levels of certain essential nutrients back to normal once you have a deficiency.

Telogen effluvium vs. other types of hair loss

Stress can contribute to other types of alopecia. For instance, a study in The Journal of Medicine and Life says that both environmental and emotional stress contribute to alopecia areata, an autoimmune condition. However, unlike the diffuse hair loss caused by telogen effluvium, alopecia areata usually causes round patches of hair loss. It might also lead to hair loss all over the scalp or on your entire body. 

Telogen effluvium shouldn’t be confused with trichotillomania. This is another type of stress-related hair loss. However, unlike alopecia areata or telogen effluvium, where your hair falls out on its own, the Mayo Clinic defines trichotillomania as an irresistible urge to pull hair out.

Androgenic alopecia and telogen effluvium

Androgenic alopecia, also known as male pattern baldness, is another common type of hair loss. When you think of this condition, you might think of older men with completely bald heads, or middle-aged guys with the typical pattern hair loss symptoms, like a receding hairline or balding crown. However, according to the study in the journal Clinical, Cosmetic, and Investigational Dermatology, it’s actually possible to have both androgenic alopecia and telogen effluvium. 

Differentiating between these two types of hair loss can be challenging if your androgenic alopecia symptoms are minimal. However, people with androgenic alopecia will typically lose a larger amount of vellus hairs than people with telogen effluvium.

Vellus hairs are shorter, thinner hairs that often lack pigment unlike the typical terminal hairs on your head, underarms, or genitals. In general, you can consider vellus hairs to be those that are 3 centimeters or shorter. 

If you’re losing a substantial amount of hair, and more than 10 percent of your hair loss is made up of vellus hairs, you may actually be experiencing both androgenic alopecia and telogen effluvium. In this case, you’ll want to consider starting an FDA-approved hair loss treatment like minoxidil, finasteride, or low-level laser therapy. Without one of these treatments, you’ll continue to lose hair.

Takeaway

Telogen effluvium occurs when stress causes hair loss. The source of stress can be emotional, physiological, or some combination of both. Fortunately, this condition is usually completely reversible and your hair should grow back over time.

However, it’s also possible to have telogen effluvium in combination with other types of hair loss, like androgenic alopecia. Since androgenic alopecia is a progressive type of hair loss, you’ll need to start a hair loss treatment to get your hair back and stop losing hair. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

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