Some trichologists estimate that up to two-thirds of hair-loss cases are related to stress. Photo / 123RF
Best known for his dryly amusing comments on Clarkson’s Farm, 25-year-old farmhand Kaleb Cooper has made a career from his exasperation at working for Britain’s most bolshy and least experienced farmer, Jeremy Clarkson.
“I have lost about 30.4 per cent of my hair from working with him,” Cooper quipped in a recent interview.
Although outside observers might not be able to track Cooper’s hairline (he usually wears his messy blond curls over his forehead), the young farmer wouldn’t be the first to experience stress-related hair loss. Known by trichologists (hair experts) as ‘telogen effluvium’, it is far from a joke. Some trichologists estimate that up to two-thirds of hair-loss cases are related to stress.
Does stress really cause baldness?
Indeed it does, although it’s usually a bit more complicated than having a few stressful weeks at work. “It has to be a protracted period of stress over at least a few weeks,” explains leading trichologist Eva Proudman. “A bad day at work isn’t going to cause hair shedding, but a prolonged episode following a bereavement or a sudden break-up, for instance, might cause a problem – although it takes around two to three months before you start losing hair.”
During a sustained period of stress, the body produces more of the stress hormone cortisol. “That puts your body into ‘survival mode’, where it starts to focus only on the essential cells – and hair is deemed non-essential,” explains Proudman. Although hair cells are the second-fastest dividing cells in the body, they stop being prioritised for nutrition including protein and minerals. As prolonged stress causes inflammation in the body, follicles can become inflamed and the hair sheds.
“Ordinarily, 85 per cent of hair is in a growing phase and 15 per cent is in the resting-to-shedding phase,” says Proudman. “Stress changes that balance. You’ll see more coming out when you wash or brush it and it’ll feel thinner overall, especially if you have longer hair.”
Thankfully, unlike pattern hair loss (androgenetic alopecia), telogen effluvium isn’t permanent. “It can be acute telogen, then within six to nine months it stops and it goes back to normal,” says Proudman. “If it lasts longer than nine months, it becomes chronic telogen effluvium – and that’s when the body needs some help. It could be due to depleted stores of vitamins or minerals, or because the inflammation isn’t resolving. It could be a number of things.
“Sometimes stress can trigger autoimmune conditions such as alopecia areata – patchy hair loss – which is where the immune system is tripped into seeing the hair as the problem and taking it out,” says Proudman. “Both things can be resolved; it just takes time and care to find all the problems and fix them.”
How can you prevent and repair stress-related hair loss?
Depending on the individual’s reaction to stress – whether they’ve stopped eating or are overeating, whether it affects their sleep, whether they’re drinking excessively – the time it takes to resolve their hair loss can vary.
“It is about getting stress levels down,” says Proudman. “But it’s important with any hair growth to make sure you’re eating protein, ideally animal protein, because that will give you the vitamins and minerals that your hair needs. Sugary and highly processed foods can exacerbate inflammation of the follicle, so those are to be avoided.”
Stress can also cause flare-ups of other conditions, such as IBS, which can lead to problems with absorption of minerals, “so it’s important to get that under control”, she adds.
Beyond that, Proudman says that proper hydration and good sleep are highly recommended; if you can avoid alcohol, then do. “I might also suggest a general multi-vitamin, if a patient’s blood test comes back and shows they’re deficient in vitamins or minerals.”
Once those elements are under control, it’s getting stress levels under control. Whether that’s with mindfulness, meditation, journaling, knitting, gardening or just spending time with friends, whatever you can do to reduce your stress will be helpful.
Treatments for genetic hair loss, including minoxidil and finasteride, will also work on stress-related hair loss, although given their expense and the possible side effects of the latter, Proudman says she wouldn’t recommend them as a first-line treatment – except in cases where the patient’s hair loss is exacerbating their stress.
Does stress-induced hair loss differ from genetic hair loss?
Telogen effluvium is different from androgenetic alopecia, but to the casual observer, it can look the same. According to Proudman, the people it affects are different, too. Although pattern baldness affects the vast majority of men at some stage in their lives, the trichologist says she sees far more cases of stress-related hair loss in women. “I suspect it might be because men are better at compartmentalising their stress and not letting it spiral,” she says.
While genetic hair loss is characterised by miniaturised hair follicles that start producing thinner hair, this is not the case when hair is being lost through stress; hair can also thin due to lack of nutrients.
“If I speak to the patient and it sounds like telogen effluvium, I’ll start by treating that, then see them again in another three or four months,” says Proudman. “If the hair is still thin and it’s got worse, we might be on our way to a diagnosis of pattern loss. But it can go both ways: some come back and their hair is fine after they’ve taken steps to fix their diet or get better sleep; others come back with more miniaturisation.”
If you’re genetically predisposed to male or female pattern hair loss, stress-related hair loss can accelerate it, but it is “very, very unusual” to see the latter become the former.