Everyone experiences stress at different times, but it’s a very subjective thing; what is stressful to one person may not be stressful to another. For example, for some people flying is extremely stressful, while others might find it relaxing and enjoyable.

What is universal, however, is the effect of stress on the body.

Stress stimulates the release of specific hormones, such as cortisone and adrenaline (epinephrine) from the adrenal glands, to help the body cope. Levels of these hormones can be measured in the blood to determine a person’s stress response. The body doesn’t distinguish between physical and psychological stress, and responds to both in the same way.

The effects of stress can be seen throughout the body, including in hair follicles, which themselves produce stress hormones. In times of stress, hair follicles are negatively affected by a variety of mechanisms: some hairs in the growing ‘anagen’ phase can be triggered to pass prematurely into the transitional ‘catagen’ and then resting ‘telogen’ phase, which can lead to general excessive (diffuse) hair loss when they fall out three months later; growing hairs can fall out prematurely as a result of inflammation of the nerves around the hair follicles; and the release of noradrenaline during sympathetic nerve activation can affect hair follicles and lead to loss of hair pigment, as has been shown in studies using mice.

The connection between stress and diffuse hair loss has been seen by many particularly during the past year, with the anxiety and financial stress brought on by the pandemic. Suddenly losing your job and income puts the body under enormous strain, and many people experienced diffuse hair loss after around three months. The body registered the psychological stress and then manifested it in a physiological way. If it’s any comfort, diffuse hair loss is reversible and the hair regrows, so once the rate of hair loss normalizes, the hair will be replaced and thicken up again.

Patchy hair loss, known as alopecia areata (AA), can also result from stress. It indicates an autoimmune problem, where white blood cells attack the cells in the hair bulb, leading to hair loss. There are some crucial differences between AA and diffuse hair loss: with AA the hair loss can occur within a couple of weeks of the stress, and the hair is not replaced immediately – it may take three months or so. AA can also occur diffusely rather than in patches, and stress is not the only cause. I have seen cases of AA triggered by an allergic reaction to chemicals used in hair dye.

Given the connection between stress and hair loss, it is crucial to manage and minimize the stress in your life. Therapy for stress-related problems can be hugely beneficial, helping you to reduce or eliminate the cause of the stress (often easier said than done) and, most importantly, helping you to cope with the stress. For the latter, I often recommend L-tyrosine, N-acetylcysteine and/or vitamin D, which can all be helpful in modulating the stress response.

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