Is hair loss a symptom of stress and anxiety?

Reviewed by our clinical team

The short answer is yes, stress can cause hair loss, or contribute to it. There are three types of hair loss that can be triggered (or made worse) by stress - telogen effluvium, alopecia areata and trichotillomania. Stress-related hair loss is often temporary, so it's unlikely your hair will be lost forever. But it's still important to speak to a doctor about it, especially if it's bothering you. 

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.

In this article we’re going to look at the types of hair loss including the most common - telogen effluvium, why stress can cause hair loss, symptoms and potential treatments.  

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, 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 such as cortisol 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.

Stress pushes a large number of hair follicles into the resting phase where they stop growing. Then within a few months these hairs might suddenly fall out. You may notice this when brushing or washing your hair.   

Stress-related hair loss types

The symptoms of hair loss caused by stress can vary on the person and the type of hair loss you’re experiencing. The different types of hair loss that can be caused by stress are telogen effluvium, alopecia areata and trichotillomania. 

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. You may notice:

• Increased hair shedding
• Thinning hair
• Scalp sensitivity
• Slower hair growth 

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. 

If you're worried about your hair loss but think it might be telogen effluvium, you should still speak to your GP. 

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. 

Stress is thought to be a trigger that can set off the symptoms of alopecia areata. 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.

If you think you have alopecia areata, you should book an appointment to see your GP. 

Trichotillomania

Trichotillomania is the compulsive urge to pull out your own hair. People may pull out their eyebrows, eyelashes and hair on other parts of their body. While we don’t know exactly what causes trichotillomania, it’s thought that for some people stress can be a factor.

Symptoms of trichotillomania can include:

• Repeatedly pulling out your hair
• Feeling growing tension before pulling your hair or if you try to stop
• Feeling pleasure or relief after pulling
• Unusual shaped bald patches on your head
• Bald patches are on one side of the head  

If you notice you're pulling your hair out in this way, you should book an appointment to speak to your GP. 

Does stress-related hair loss grow back?

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 stress-related hair loss

In instances where there is no regrowth, or hair doesn’t grow back fully, a few different treatments are available. The type of treatment that’s best for you depends on the type of hair loss you’re experiencing.  

Treatment for telogen effluvium

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

Men can order a hair loss bundle, from our site which contains minoxidil, shampoo and vitamins which can help hair health and hair loss. You can find out more about hair loss vitamins in our article. 

Treatment for alopecia areata

For alopecia areata, there are a range of treatments available. Some of these treatments might be prescribed 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.

Treatment for trichotillomania

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.

Tips for managing stress 

If you think stress might be causing your hair loss, you might be advised on some things you can do to destress. This might include things like: 

• Identify what situations are causing you stress – might it be a stressful work situation that’s triggered your stress? A relationship? A loved one being ill? 
• Tring to take control of the situation – prioritise your workload, speak to someone about getting some support, etc.  
• Getting active and exercising more 
• Connecting with friends, family and colleagues  
• Cut down on alcohol, smoking and caffeine 
• Try and eat a healthy balanced diet 

You can find out more about stress busters, in this article from the NHS. 

Androgenic alopecia

The most common cause of hair loss amongst men and women is androgenetic alopecia. Androgenetic alopecia is mainly caused by genetics. However extreme stress, hormone imbalances and illness.

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. You can find out more about male pattern baldness here. 

Treatment for male pattern baldness

There are two main treatments for male pattern baldness: 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. We offer Finasteride, Propecia and also Regaine foam for men - which contains minoxidil. 

We also have advice on how to stop hair loss such as: 

• Eat a healthy balanced diet
• Be kind to your hair
• Avoid tight hairstyles 

Read our guide on hair loss in young people for more tips.   

Treatment for female pattern baldness 

The main over the counter treatment for female pattern baldness is minoxidil (Regaine). You can find out more about Regaine for women here.

You can also help to keep your hair healthy by:

• Eating a varied balanced diet
• Avoiding tight hair styles
• Not using harsh chemicals on your hair
• Use heat protectors 
• Use gentle shampoos 

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/
https://www.nhs.uk/mental-health/self-help/guides-tools-and-activities/tips-to-reduce-stress/