Hair Loss Caused by Stress

Emotional stress can induce various physical symptoms and is known to be related to three different types of hair loss. Many patients treated for hair loss in Dr. Michele Green’s private dermatology office in Manhattan’s Upper East Side neighborhood present with thinning hair after experiencing stressors or an unexpected stressful event. Different types of stress-related hair loss, however, may present in various ways. Telogen effluvium is one of the most common types of hair loss and is caused by hair follicles undergoing an extended resting phase, resulting in diffuse hair shedding. Alopecia Areata is another type of stress-related hair loss that occurs when the immune system attacks the hair follicles, resulting in patchy hair loss. Trichotillomania, while less common, is a stress-related hair loss disorder characterized by a strong urge to pull out one’s hair. Luckily, board-certified dermatologist Dr. Green is here to help.

Chronic stress or short-term increased stress levels can be a direct cause of hair loss and hair shedding, and the faster the cause of hair loss is addressed, the better the outcome. Though hair loss does not always accompany times of stress in our lives, it is a common occurrence for many patients, and both chronic and emotional stress is linked to hair loss in many cases. Thankfully for many patients, stress-induced hair loss is often temporary, and hair health can often be improved through the use of modern advancements in the world of dermatology, such as the use of Platelet-Rich Plasma injections for hair restoration. If you’re struggling with increased hair shedding due to high-stress levels, board-certified dermatologist Dr. Michele Green is here to help. Dr. Green is an expert in hair loss and can offer you the best treatment options to stop loss and promote regrowth.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing her patients with the most innovative treatment options available, including for hair loss and stress-related hair loss. For her dedication to her patients and expertise, she is consistently identified as one of New York’s best dermatologists by Castle Connolly, New York Magazine, and Super Doctors. When you consult with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, she will work with you to diagnose and treat your hair loss with a customized treatment plan. Dr. Green will provide you with a combination of the best in-office procedures and oral and topical treatment options to achieve thicker, healthier hair that lasts.

2 months, 3 sessions of PRP hair treatment

Will stress cause hair loss?

Although experiencing stress does not guarantee hair loss, studies have shown that chronic and emotional stress is related to hair loss and thinning hair. To understand how stress affects hair growth and hair loss, it can be helpful to think about the process through the context of the natural hair growth cycle. The four essential hair growth phases are anagen, catagen, telogen, and exogen. The anagen phase is also known as the growth phase, and it allows the hairs to develop over two to 6 years, depending on the hair follicle. The next phase, the catagen phase, is a brief transitional phase that typically lasts ten days. The telogen phase is a resting phase that lasts a few months, during which time the strands remain in the hair follicle but are no longer actively growing. Lastly, the exogen phase occurs when the strand is finally released from the follicle and falls out, restarting the hair growth cycle. A disruption in the natural hair growth cycle can cause devastating effects, including significant hair shedding or patchy hair loss.

Typically, when stress leads to thinning hair, this indicates that the hair growth cycle has been disrupted. Cortisol, the stress hormone, has been shown to affect the normal activity of the hair follicles in numerous ways when present in increased levels. One of the effects is an increase in the number of hair follicles entering a dormant stage, which can lead to a large amount of hair shedding all at once. Many different stressors can cause this shift in the body, including hormonal changes such as postpartum shifts or menopause, as well as emotional stress. If you have observed an increased amount of hair shedding, diffuse thinning hair, or patchy hair loss, schedule a consultation with board-certified dermatologist Dr. Michele Green, who can help diagnose and properly treat the type of hair loss you have.

Can stress cause thinning hair? Can stress cause hair loss?

Yes, chronic or emotional stress may cause hair loss or thinning hair, depending on the type of stress-related hair loss one develops. However, this does not mean that everyone who endures stress will necessarily develop hair loss or thinning hair. Although stress will not always cause hair loss, does stress cause hair loss? Is – yes. Stress-induced hair loss commonly occurs in patients who experience a stressful event, such as an injury, a difficult recovery from illness, losing a loved one, divorce, or another form of chronic stress that affects their overall well-being. However, many of those who observe a decrease in the number of hair follicles that are active due to a period of stress experience temporary hair loss that can be successfully revitalized through hair restoration treatments such as PRP for hair loss.

Stress-Related Hair Loss

Stress-related hair loss is typically associated with three major hair loss classifications:

Alopecia Areata

Alopecia Areata is an autoimmune disease during which the immune system starts to attack the hair follicles, leading to increased hair loss. Alopecia areata is often triggered by stress and leads to unpredictable hair loss in circular, non-scarring patches along the scalp. Alopecia areata affects patients from adolescence well into adulthood and typically is indicated through patchy hair loss, with bald patches that are typically about the size of a quarter. It can be triggered by various factors, including genetic predisposition and stress, and sometimes progresses to complete hair loss on the head. The hair may go through phases of regrowth and hair loss over an extended period. In rare cases, alopecia areata can lead to hair loss all over the body, known as alopecia universals. When treating alopecia areata, Dr. Green tailors a treatment plan that combines topical therapies (such as romaine), PRP for hair restoration, and intralesional cortisone treatments.

Alopecia treatment for male patient, 6 months

Telogen Effluvium

Telogen Effluvium is the most common form of stress-related hair loss.  Telogen Effluvium is defined as a shift of many hairs into the telogen phase, leading to a loss in healthy hair growth. During this experience, patients will experience hair loss that is abrupt, diffuse, and temporary. After a stressful event or chronic stress (due to a prolonged event such as a global pandemic), hair shedding typically won’t present until a few months after the onset. However, after around three months, the telogen phase will release the hairs from the hair follicle, and that’s when patients tend to observe hair loss.

Patients often observe diffuse hair loss caused by telogen effluvium as “en-mass” hair shedding, which will lead to an overall sense of hair thinning or hair loss rather than a widening part or gradual thinning caused by other forms of hair loss or baldness. Oftentimes, patients will notice a substantially thinner ponytail, or an increase in the amount of hair in the brush, as an indicator of telogen effluvium. The average person with healthy hair follicles will shed between 100-200 hairs per day, but the increase in hair shedding (sometimes leading to more than 50% of hairs shed on the head) is typically a noticeable increase.

Thankfully, telogen effluvium is a temporary hair loss that does not lead to baldness. Though the initial hair loss can last several months, many patients find that their hair volume and health are about what they were before the hair shedding began after an extended regrowth phase. Nevertheless, this natural regrowth can be arduous, as hair typically grows about a half inch in length per month.

Telogen Effluvium is often caused by stress but can be caused by other factors, such as medication, illness, or postpartum hormonal shifts after a woman gives birth. Additionally, telogen effluvium can expose other subtle hair loss issues, such as female pattern baldness, and can, in rare cases, lead to further hair thinning or chronic hair loss. For this reason, it’s best to treat hair loss due to telogen effluvium when symptoms are visible to restore the health of the hair follicles as they re-stimulate hair growth within the natural hair cycle.

Trichotillomania

Trichotillomania is a behavioral disorder during which a patient will pull out hairs. This hair-pulling disorder can lead to the affected person breaking off, pulling out, or twisting out hairs from the head, eyelashes, or eyebrows, as well as the chin, chest, leg, or underarm regions of the body. It’s classified as a mental disorder along the spectrum of obsessive-compulsive disorder that affects the patient’s daily life and leads to an obvious amount of hair loss. Trichotillomania is thought to be caused by various biological, behavioral, and psychological factors, and there is an increased risk of trichotillomania found in patients with a relative suffering from the condition. It is often linked to other psychiatric conditions, including but not limited to depressive disorders, excoriation, and Tourette’s syndrome.

Though the majority of people who engage in hair-pulling activity as young children tend to stop the habit naturally (akin to sucking one’s thumb), trichotillomania often develops in adolescents. It can continue until adulthood, affecting around 1-2% of the population. As the visible symptoms of trichotillomania often resemble that of alopecia areata or telogen effluvium, a patient must be examined by a psychologist and a veteran dermatologist. Dr. Green can help to work with patients recovering from trichotillomania to restore healthy hair growth on the scalp.

Other types of hair loss

Hair loss is a common condition that affects men and women alike. Different types of hair loss may be caused by a combination of underlying factors such as genetics, hormones, nutritional deficiencies, medical conditions like polycystic ovarian syndrome or thyroid issues (hyperthyroidism and hypothyroidism), taking certain medications, and hair styling practices, among others. Androgenetic alopecia, referred to as male-pattern baldness in men and female-pattern baldness in women, is one of the most common types of hair loss. This form of hair loss leads to thinning hair and receding hairlines due to a lack of new hair growth during the anagen phase of the hair growth cycle. Androgenetic alopecia occurs among more than 30 million women and 50 million men in the U.S. alone. Still, it can often be successfully treated through topical treatments, oral medications, or, most impressively, through the use of Platelet-Rich Plasma treatments for hair loss. Learn more about treatment for androgenetic alopecia here. 

Is hair loss from stress permanent? Will hair loss from stress grow back?

Depending on the type of hair loss you suffer, your hair often can and will grow back to its former level of healthy locks. Most cases of stress-related hair loss are only temporary, although it can take several months for hair shedding to cease. Oftentimes, patients will even be able to restore their hair through simple measures such as stress management and an improved diet. Though not every patient can prevent further hair loss due to stress, many patients can nourish hair follicles and encourage hair regrowth through targeted treatments.

How long does hair loss from stress last?

Stress-related hair loss is usually not a permanent condition for everyone that experiences it—practicing stress management techniques and consulting with a board-certified dermatologist, such as Dr. Michele Green in NYC, can help stop hair loss. Once feelings of stress are under control, it may take up to six months for hair shedding to cease. Dr. Green recommends various treatment options that patients can take advantage of, including PRP injections, topical treatments, oral medications, and supplements that can help promote regrowth.

How to treat hair loss from stress

Dr. Green uses her expert knowledge to cull from various treatment options that stimulate hair growth. These treatment options include topical over-the-counter treatments such as Rogaine (minoxidil), oral medications like spironolactone, oral minoxidil, dutasteride, finasteride, and certain hormonal medications (such as birth control), and Platelet-Rich Plasma injections.

Platelet-Rich Plasma (PRP) is the most popular in-office treatment option for hair restoration. PRP is an innovative, in-office treatment that relies on your body’s growth factors and nutrients to stimulate healthy hair follicles and, thus, produce new hair growth. PRP is derived from a sample of the patient’s blood, which is placed safely in a centrifuge to highly concentrate white blood cells and platelets rich in growth factors such as Platelet-Derived Growth Factor, Transforming Growth-Factor-Beta, and Epidermal Growth Factor, among others. These nourishing growth factors can boost blood vessels, cell, and skin formation and growth, which in turn nourishes and supports the hair follicle. Typically, a treatment session for PRP hair restoration takes around a half hour, and patients can resume normal activity after the procedure. Most patients require an initial short series of four treatment sessions, each spaced approximately one month apart, to achieve optimal results.

When you work with Dr. Green, she’ll be able to accurately assess your current hair loss needs, discuss your medical history, and determine a treatment plan that is best for you. Typically, patients rely on a unique combination of various treatment options that, when combined, prevent or delay hair loss and create healthy new hair growth.

Which Vitamins help hair loss?

Nutrafol is an all-natural supplement clinically proven to restore hair growth. Nutrafol is available as an oral supplement and a topical vitamin-enriched solution to stimulate hair growth. The vitamins and nutrients in Nuutrafol’s proprietary blend combat various causes of hair loss. For example, Nutrafol helps prevent the conversion of the male androgen hormones into DHT (dihydrotestosterone), which is responsible for baldness. Viviscal is a supplement formulated with essential vitamins such as Biotin, Vitamin C, and B Vitamins in addition to other propriety vitamins which have been clinically proven to thicken and help hair growth. Patients with hair loss associated with nutritional deficiencies or anemia may benefit from taking vitamins such as iron or biotin, available over the counter. Before beginning an oral supplement for hair loss, it is recommended to consult with a board-certified dermatologist, such as Dr. Michele Green in NYC.

Are there medications that cause hair loss?

Occasionally, patients worry that certain medications they take may cause hair loss. There are a variety of medications that can cause thinning hair or hair shedding and lead to unwanted hair loss. These medications include acne medications, antacids, antibiotics, antidepressants, birth control pills, blood pressure medications, cholesterol-lowering medications, and weight loss medications, among others. If you are concerned that you may be experiencing an unwanted side effect of hair loss due to your current medications, Dr. Green can work with you to determine your best course of action.

How to regain hair loss from stress with topical treatments and oral medications

Topical treatments for hair loss can be an important element in preventing new loss and stimulating hair regrowth. Minoxidil is the only FDA-approved topical treatment for combating hair loss and can help regenerate new hair. Minoxidil is available over the counter as a solution or foam base, which should be applied to the scalp at bedtime. Minoxidil can be used to complement PRP hair treatments and can be used long-term to sustain the results achieved from PRP. Internationally renowned board-certified dermatologist Dr. Michele Green has a specially formulated minoxidil serum available from her proprietary line of skin care products- MGSKINLABS, Inc. The Revitalizing Hair Serum is a 7% minoxidil compounded with either progesterone or finasteride, depending on the age, sex, and type of hair loss of the patient.

Depending on the underlying factors contributing to your hair loss, Dr. Green may recommend taking an oral medication to cease hair shedding and promote new hair growth. Some of the most commonly prescribed oral medications for hair loss include:

• Finasteride (Propecia) is an oral medication that is FDA-approved for treating androgenetic alopecia (male patterned baldness). DHT (dihydrotestosterone) is a male androgenic hormone shown to impact hair follicles negatively. This effect on the hair follicles ultimately leads to baldness. Finasteride is a 5-alpha-reductase inhibitor, which helps reduce hair loss by blocking the action of converting testosterone into dihydrotestosterone (DHT), which results in lowering the DHT levels in the body, slowing hair loss, and promoting new hair growth. Propecia effectively treats both men and post-menopausal women with hair loss and thinning hair.
• Spironolactone is an FDA-approved anti-androgen medication that treats female hair loss by regulating androgen hormones. Fluctuations of androgen hormones in the body can trigger hair loss and thinning hair, and keeping levels regulated can combat this condition. Spironolactone is an oral treatment option reserved for female patients, as it may cause unwanted side effects in male patients. A board-certified dermatologist must monitor treatment with spironolactone so that adjustments can be made as necessary since some of the potential side effects include depression, fatigue, weight gain, and sexual dysfunction.
• Oral Minoxidil is a medication that was initially prescribed for hypertension until researchers discovered that one of the side effects of taking low-dose oral minoxidil was new hair growth. Oral minoxidil is a relatively new treatment option for hair loss, and its mechanism of action against hair loss is still not entirely understood. Some research has indicated that oral minoxidil promotes increased blood circulation to the scalp, providing more oxygen and nutrients to the area, which increases the health of hair follicles. Oral minoxidil may also promote an extended growth phase during the natural hair growth cycle. Other studies have indicated that oral minoxidil regulates components of the immune system that may be associated with autoimmune-related hair loss. Patients that can not tolerate the topical version of minoxidil due to skin irritation can take advantage of the convenient oral form.
• Dutasteride, like finasteride, treats hair thinning and loss by inhibiting the conversion of testosterone to dihydrotestosterone (DHT). DHT is an androgen hormone that plays a role in developing male sex characteristics such as facial and body hair. DHT can also potentially bind to androgen receptors in the scalp, which causes the hair follicles to cease the production of new hair. Although dutasteride has yet to be approved by the FDA, recent clinical studies demonstrate the benefits of the medication as a hair loss treatment.

Why does stress cause hair loss? Does stress stop hair growth?

There are four distinct phases in the natural hair growth cycle: anagen, catagen, telogen, and exogen. During the anagen phase, the hair is actively growing. The anagen phase can last between 2 to 6 years, and most of the hair on the scalp is in the anagen phase. The catagen phase, which lasts about 10 days, is the transition phase. During the catagen phase, hair stops growing and detaches from the hair follicle. The telogen phase is the third phase, during which the hair follicle rests, and during the final phase, the exogen phase, the hair falls out. The telogen phase typically lasts between 2-3 months, and after, the hair growth cycle is repeated. Changes or disruptions in this hair growth cycle, or damage to the hair follicle, is what causes alopecia or observed hair thinning and loss. Chronic stress or a major stressful event, such as divorce, the loss of a loved one, or another traumatic event, can result in increased systemic levels of stress hormones, which can force the anagen phase (growth phase) of hair growth to finish prematurely.

Before and after 3 and 5 sessions of PRP, 6 months then 14 months

What does hair loss from stress look like?

Stress-related hair loss may present as telogen effluvium, alopecia areata, or trichotillomania. The presentation of hair loss varies depending on the specific type of stress-induced hair loss. Telogen effluvium is characterized by increased hair shedding. Most people lose an average of 50-100 strands of hair daily. However, an individual with telogen effluvium may observe more strands of hair falling out each day when combing, washing, or touching their hair. Alopecia areata is a type of stress-related hair loss that presents as patchy hair loss. In alopecia areata, baldness occurs in discrete patches on the scalp as hair falls out at an unusually high rate. Trichotillomania is a hair-pulling disorder that is caused by emotional stress. Trichotillomania often looks like an observable amount of hair loss, thinning hair, or baldness on the scalp, eyebrows, or eyelashes. Patients with trichotillomania may experience relief from emotional stress following an episode of hair pulling and have difficulty ceasing the behavior. An experienced medical professional, such as board-certified dermatologist Dr. Michele Green, can physically assess the scalp and hair to help diagnose the type of hair loss and best treat it.

Can trauma cause hair loss?

Yes, chronic stress, emotional stress, and physical trauma may result in hair loss. For most men and women, hair loss associated with trauma or stress is a temporary condition that resolves within several months. If an unexpected traumatic event has resulted in thinning hair or hair loss, schedule a consultation with board-certified dermatologist Dr. Michele Green. Dr. Green has over 25 years of experience treating stress-related hair loss and can provide the treatment options best suited to your needs.

What is telogen effluvium hair loss?

Telogen effluvium is a condition in which stress can cause temporary hair loss, often due to extreme shock or stress to the body. The hairs are pushed into the resting phase, the telogen phase, for two to four months before the hair falls out. At the same time, the next growth, or anagen phase, does not begin. A few months later, these hairs fall out several months after the stressful event, and new hair growth is delayed. Clinically, there will not be bald patches, but you will see a general thinning of the hair, particularly noticeable after washing your hair. Telogen Effluvium does not lead to complete baldness, but you can lose between 300 to 500 hairs per day, which can cause a profound cosmetically appearing hair loss problem. Although a significant amount of hair can be shed from Telogen Effluvium, it does not generally result in complete baldness. The hair loss, or Telogen Effluvium, typically begins three months after the precipitating event.

Causes of Telogen Effluvium include serious illnesses, childbirth, extreme dieting or weight loss, nutritional deficiencies, withdrawal of hormonal therapy, or surgery. Telogen Effluvium also can occur due to a mineral or vitamin deficiency. Iron deficiency is a common cause of hair loss in women. Medications, such as warfarin, birth control pills, and Accutane (Isotretinoin), can cause this type of hair loss. Telogen Effluvium usually lasts no more than six months and often grows back on its own when the stress is removed. However, in some patients, this type of hair loss can last for a few years without explanation.

Does high cortisol cause hair loss?

Cortisol is a stress hormone that plays a large role in the body’s natural “fight or flight” response and, in increased levels, has been shown to cause hair loss. Cortisol has other important bodily functions, such as regulating metabolism and managing the use of different carbs, proteins, and fats in the body. Chronic stress and episodes of short-term stress can both increase the body’s levels of cortisol. Increased cortisol levels can affect various aspects of normal activity in the hair follicles, resulting in hair loss. High levels of cortisol can also cause other serious health effects, such as depression, anxiety, cardiovascular issues, gastrointestinal issues, fatigue, headache, hypertension, weight gain, irregular menstrual cycles, erectile dysfunction, and osteoporosis, among others. It is incredibly important to find healthy ways to manage stress to prevent health deterioration and stay healthy. If emotional or chronic stress is affecting your hair or other aspects of your health, schedule a consultation with an experienced medical professional, such as board-certified dermatologist Dr. Michele Green in NYC.

Is hair loss a sign of stress?

Hair loss and thinning hair can absolutely be stress-related. There are, however, many other underlying conditions or external factors which may be associated with hair loss. Autoimmune conditions, thyroid disorders (overactive and underactive thyroid), pregnancy, certain hair styling practices, inflammatory skin conditions (seborrheic dermatitis and psoriasis), anemia, and polycystic ovarian syndrome may also cause thinning hair or hair loss. If you have observed patchy hair loss, diffuse thinning hair, or an increased number of strands of hair fall per day, schedule a consultation with an expert, such as board-certified dermatologist Dr. Michele Green. Dr. Green is an expert in hair loss and an internationally recognized leader in dermatology, with over 25 years of experience. Dr. Green will help you diagnose your type of hair loss and effectively treat it.

How to reduce stress-related hair loss

In addition to finding preferred practices for stress management and engaging in proper hair care, the best way to reduce stress-related hair loss is by consulting with an expert, such as board-certified dermatologist Dr. Michele Green. Dr. Green has over two and a half decades of experience diagnosing and treating various types of hair loss and incorporates the most cutting-edge treatment options into the customized treatment plans of her patients. During your initial hair loss consultation with Dr. Green at her private dermatology office in Manhattan’s Upper East Side neighborhood, you will have the opportunity to discuss with her in-depth your medical history, family history of hair loss, and factors such as stress levels, hair styling practices, diet, and more. Dr. Green may order certain blood tests to determine if hormonal changes are impacting your hair loss or, in some cases, send a scalp biopsy to the laboratory for microscopic evaluation of the hair follicles. You will then work with Dr. Green to develop a personalized treatment plan for your hair loss that caters to your specific needs and the type of hair loss you have for healthier, thicker, and fuller hair.

How to stop hair loss from stress

Stress-related hair loss, while temporary for most, can take several months to resolve and exacerbate feelings of emotional stress. Though there is no one-stop solution to hair loss or thinning hair, strategies can make a world of difference when it comes to reducing stress-related hair loss. Dr. Green always recommends that her patients examine their lifestyles to reduce stressors and develop stress management solutions that work for their lifestyles. Eating a balanced diet, getting enough sleep each night, and avoiding damaging hair styling tools are all important components in restoring healthy hair and maintaining new hair growth. In addition, there are restoration treatment options, such as PRP injections, that are always helpful in returning your hair to its natural, beautiful volume. If you’re frustrated by stress-related hair loss, there are treatment options available at Dr. Green’s that can help.

Dr. Michele Green is an internationally renowned board-certified dermatologist with over two and a half decades of experience providing her patients from around the world with the best treatment options available, including for stress-related hair loss. Super Doctors, Castle Connolly, New York Magazine, and the New York Times consistently identify Dr. Green as one of NYC’s best dermatologists for her holistic approach and dedication to her patients and expertise. When you consult with Dr. Green regarding your hair loss, she will work with you to determine the underlying causes and develop a personalized treatment plan to stop loss and promote regrowth for thicker, healthier, fuller hair. To schedule a consultation with Dr. Green, call the NYC-based office at 212-535-3088 or contact us online today.