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    Can stress cause hair loss?

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      Man with ginger hair touching his forehead

      No matter what your age or gender, hair loss can be upsetting and worrying – particularly if you don’t know what’s causing it.

      While it’s natural for the hair to thin as we get older, sudden or patchy hair loss can sometimes be a sign of an underlying condition or a reaction to medical treatment. Stress can also be a reason for hair loss.

      Why does stress cause hair loss?

      Though we tend to think of stress as a psychological issue, it can affect your body. If you’ve ever experienced a period of significant stress you’ll know it can cause a long list of symptoms, including problems sleeping, muscle tension, headaches, and heartburn.

      Stress symptoms are linked to the body’s “fight, flight or freeze” response. This is a survival response to stressful or potentially dangerous situations. Our body releases stress hormones which help us through this particular situation. 

      But if the stress is ongoing (also known as "chronic"), we might have an excess of stress hormones circulating through our body. This can have a negative effect on your body - and it can also cause hair loss.

      What types of hair loss can be caused by stress

      Telogen effluvium

      The type of hair loss most commonly caused by stress is telogen effluvium.

      We have hundreds of thousands of hairs on our head and not all of them are actively growing all of the time. Hairs that are growing are in the “anagen” phase. Hairs that are resting are in the “telogen” phase – this means they have stopped growing, but will stay on the head for a few more months before falling out.

      In people with telogen effluvium, more hairs move from the anagen phase into the telogen phase. This means that you end up losing more hair than is normal. On average, a person with this condition might lose up to 300 hairs each day – the average for healthy hair is around 100.

      It isn’t clear why, but studies have shown that stressful experiences can cut short the anagen phase, and push more hairs into the telogen phase. This is why stress is known to be a trigger for this type of hair loss.

      One thing to bear in mind is that it can take a few months for hair to shed, so hair loss may not begin until several weeks after a stressful event or period. 

      Telogen effluvium has been linked to people who've had COVID-19. Find out more about a potential link between COVID-19 and hair loss

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      Alopecia areata

      Alopecia areata is another type of hair loss that can be triggered by stress. This type of alopecia is believed to be related to the immune system. It usually causes a very distinctive type of hair loss, where small coin-sized bald patches appear across the scalp, face, and body.

      For some people these patches progress into total hair loss across the head – and occasionally the body too. For others, the patchy hair loss never progresses and is only temporary, with hair returning after a few months.

      Stress is thought to be a trigger that can set off the symptoms of alopecia areata. As explained in this blog from Alopecia UK, people who experience patchy hair loss can often recall a stressful event a few weeks before they  first started noticing the hair loss.

      It’s not clear why this happens but one theory is that stress hormones affect the immune system, causing the immune cells to target hair follicles.

      Trichotillomania

      Trichotillomania is the compulsive urge to pull out your own hair. While we don’t know exactly what causes trichotillomania, it’s thought that for some people stress can be a factor.

      How to regain hair after stress

      For most people, stress-related hair loss will be temporary, and it’s simply a case of “waiting it out”. This is particularly the case with telogen effluvium, which normally resolves within six to nine months.

      It’s also fairly common for people with mild alopecia areata to experience regrowth.

      Treatment for hair loss

      In instances where there is no regrowth, or hair doesn’t grow back fully, a few different treatments are available.

      Thinning caused by telogen effluvium may be treated with a medication called minoxidil (Regaine) – this is a topical treatment applied directly to the scalp.

      For alopecia areata, there are a range of treatments available. Some of these treatments might be prescibed by your GP but most are only prescribed by dermatologists including: 

      • Steroid creams, lotions, tablets or injections 
      • Dithranol 
      • Immunotherapy

      For a detailed guide to treatments for alopecia areata, consult this page on the Alopecia UK website.

      Because trichotillomania is often related to anxiety or OCD (obsessive compulsive behaviour), the most effective treatment is thought to be psychological therapy, for example CBT (cognitive behavioural therapy).  If you  think you might have trichotillomania, please discuss this with your GP.

      Other causes of hair loss in men and women

      The most common cause of hair loss amongst men and women is androgenetic alopecia. In men, this is known as male pattern baldness; in women, female pattern baldness.

      This type of hair loss is really common, probably affecting 50% of men over 50, and 40% of women over 50.

      In men, androgenetic alopecia causes a distinctive pattern of hair loss: the hairline recedes and hair is lost from the top of the head. In women, the hairline doesn’t recede, but the hair thins on the crown of the head.

      Unfortunately, this type of hair loss is permanent. However, there are treatments that can delay the hair loss, and in some cases temporarily reverse it.

      Treatment for androgenetic alopecia

      There are two main treatments for this type of hair loss: finasteride and minoxidil. Finasteride (Propecia) is a tablet taken daily and it’s only suitable for men.

      If you’re a man living with male pattern baldness, visit our online hair loss clinic to learn about how finasteride works. If you’re a woman experiencing hair loss, you may benefit from minoxidil, which is available from LloydsPharmacy.

      VideoGP by LloydsPharmacy

      References

      https://www.mind.org.uk/information-support/types-of-mental-health-problems/anxiety-and-panic-attacks/
      https://www.alopecia.org.uk/telogen-effluvium
      https://www.alopecia.org.uk/alopecia-areata
      https://www.alopecia.org.uk/Blog/what-causes-alopecia-areata
      https://www.alopecia.org.uk/trichotillomania-hair-pulling
      https://dermnetnz.org/topics/female-pattern-hair-loss/
      https://dermnetnz.org/topics/male-pattern-hair-loss/

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