Stress can cause your hair to break, to fallout, to shed, to stop growing. Your hair listens and reacts to what is going on inside of your body and will respond to stress by falling out. The Webster Dictionary definition of stress, the state or condition of strain and especially of intense strain. Not all stress is negative, however in our daily usage of the word stress, we tend to think of the negative aspects of the word and that is what we are going to discuss as it relates to hair.
There are three stages of hair growth, the acronym ACT:
A-nagen (growth stage)- a single hair follicle grows its hair strand over a period of four to six years
C-atagen (transitional phase)- growth stops and the outer layer of the hair root withers or shrinks, wrapping around the root to form a bulb.
T-elogen (rest stage)- It then rests for two to four months, after which it loses the “old” hair as a new hair shaft grows and pushes out its predecessor.
See the article Understanding Hair for a more rounded explanation. If the normal hair cycle changes in any way then there is usually trouble. Stress is one of the culprits that can cause an unbalance in your hair cycle, when the body undergoes more stress than it can handle it shortens the anagen or growth phase of your hair cycle and sends it directly to the telogen or rest stage.
In this stage the hair starts to fall and up to 70% of the hair can be lost if there is a massive fall out. Ironically, the body does not react immediately to what causes the stress, in some cases, the hair falls out up to two to three months after the stressor. For some persons that are undergoing chronic stress the hair cycle is so messed up that hair loss continues steadily for as long as the stressful situation is at intensity. This type of hair loss is called telogen effluvium or stress alopecia. We discussed this and other types in Types of Hair Loss.
There are several stressors that can cause hair loss, the general rule is to watch for those that cause a shock to the bodies system or which stresses the hair follicles. Here are some of the stressors to look for that can cause hair loss:
Acute Trauma (surgery, physical injury or psychological trauma)
Severe emotional stress can be caused from the death of a loved one, an accident, abuse, termination of relationships- basically anything that is severely traumatic. During your stressful event or trauma, the hair follicles enter the resting phase prematurely and you will notice a shedding of the hair about three months after the event. The irony of the situation is that you maybe fully recovered from the stress when your hair actually starts to shed.
Many woman notice that their hair is thicker and healthier during pregnancy, this is due to the increased levels of hormones oestrogen and progesterone, which cause more hairs than normal to remain in the growth phase. When the child is born however, many of the hair follicles that had delayed entering the resting phase, suddenly enter the resting phase due to the rapid drop in hormone levels. As a result of this, these hairs are then shed about 3 months after the birth. Fortunately in most cases the hair will return to normal 9-12 month after the child’s birth.
Similarly, miscarriages or abortions can trigger hair loss by the sudden changes in hormone levels in the body.
The Birth Control Pill
Birth control pills affect the hormone levels within the body and these hormone levels can affect hair growth. In some cases hair thinning may occur due to the male hormones present is some types of contraceptive pills, this type of hair loss is similar to pattern baldness or Androgenetic Alopecia. However discontinuation of The Pill can result in hair loss similar to that which occurs after childbirth due to the drop in hormone levels.
Crash diets which prohibit the intake of key nutrients like vitamins, protein and iron can cause a disruption in the hair cycle.
Under-active Or Overactive Thyroid
One of the first things a dermatologist will check if you have persistent hair loss are your thyroid glands. An overactive or under-active thyroid gland can account for hair loss.
Diseases Such As Diabetes And Lupus
There are some diseases, which will cause the hair to fall in their initial stages, diabetes and lupus are two such diseases, and additionally if there is nothing done about the conditions or they go unchecked, there will be hair loss on a consistent basis until the condition is rightly diagnosed.
Chemotherapy is hard on the body and on the hair; the hair is usually one of the first visible things on the body to go after undergoing chemotherapy. Usually, it grows back after chemotherapy sessions.
These include retinoids, blood pressure medication, anti-depressants, certain birth control pills and NSAID’s (Nonsteroidal anti-inflammatory drug). NSAIDs are commonly prescribed for the inflammation of arthritis and other body tissues, such as in tendinitis and bursitis. Examples of NSAIDs include aspirin, indomethacin (Indocin), ibuprofen (Motrin), naproxen (Naprosyn), piroxicam (Feldene), and nabumetone (Relafen).
Your Stress History
The history of stress in your life is a good indication of whether your hair is undergoing stress alopecia. Even before you see a dermatologist for your condition, you may want to sit down and document what were the stressors that you have undergone in a six to one year period. Your doctor will ask you these questions anyway. If your stress related hair loss is caused by a disease or diet your doctor will check your iron and thyroid levels. This they will do anyway to see if these contribute to your hair loss. If your dermatologist does not ask for a full work up of your history and even further tests if you are experiencing hair loss find a dermatologist who does before you take any medications. Too many times, the underlying causes of hair loss are left undetected because the necessary checks were not done.
If you are not sure whether your hair loss is caused by stress or not, there is a single test that you can do, you can simply run your hand through your hair and see if the hairs that are shed have clubbed shafts or the ‘little bulb thingy’ at the end of your hair shaft. Club hairs are hairs that have a bulge at the end that comes out of the hair follicle. It is wider size than the rest of the normal hair fiber and so it acts as a wedge to hold the hair in place in the hair follicle canal. Although the fiber is no longer growing and the hair follicle below it resting, the club hair does not immediately fall out of the follicle. It can be pulled out during washing, combing, brushing, styling or any other form of physical hair manipulation, but often the club hair stays in place until the hair follicle below it returns to an active state and starts making a new hair fiber. The new fiber eventually pushes the old club fiber out of the hair follicle. In stress slopecia the more hair follicles enter a resting state than would normally be expected. This leads to more club hairs as hair fiber production stops in affected follicles. These club hairs are more likely to be pulled out.
Therapy For Stress Hair Loss
Usually, stress related hair loss clears up on its own, if hair continues to shed there is an underlying issue that needs to be cleared up. If the loss of hair is due to a birth, illness, or a self-limited problem, it will stop and will not progress to baldness. If the hair loss is due to medication, the drug should be stopped or ask your doctor for another option that does not cause hair loss. For continued stress, see a therapist or a close friend you can trust to help to ventilate the issues.