Hair loss is caused by different factors, such as genetic and environmental. One of the significant contributors to hair loss is stress, which has been shown to increase the risk of developing several health issues,
Stress increases a person’s risk of developing several health issues, hair loss is one of them. Numerous forms of hair loss can result from high amounts of stress. It may result in preventing hair regeneration or trigger an immune system attack on the hair follicles.
There are three stages of hair growth. Hair strands push through the skin during growth (anagen). Hair stops growing and the follicle at the base of the strand decreases in degeneration (catagen). Hair falls out while at rest (telogen), and the cycle might start over. Hughes and colleagues1 stated in a healthy scalp, approximately 85% of the hair is in the anagen (growth) phase, while around 15% is in the telogen (resting) phase. During the anagen phase, hair actively grows for about 4 years before transitioning into the telogen phase, which lasts around 4 months. As a new anagen hair begins to grow, it pushes out the resting telogen hair. Asghar and colleagues1 found that when the body experiences prolonged stress, about 70% of anagen hairs prematurely shift into the telogen phase, leading to increased hair shedding.
Forms of Stress-Related Hair Loss:
i) Telegon Effluvium: Telogen effluvium is a condition characterized by excessive shedding of hair in the resting (telogen) phase, often triggered by metabolic stress, hormonal fluctuations, or certain medications. Common triggers of telogen effluvium include severe infections, major surgery, significant trauma, postpartum hormonal shifts (especially a drop in estrogen), abrupt discontinuation of estrogen-containing medications, unhealthy diet, inadequate protein intake, heavy metal exposure, and iron deficiency. Common triggers of telogen effluvium include acute febrile illness, severe infections, major surgery, significant trauma, postpartum hormonal shifts (especially a drop in estrogen), hypothyroidism, abrupt discontinuation of estrogen-containing medications, crash dieting, inadequate protein intake, heavy metal exposure, and iron deficiency. [2] While telogen effluvium can affect both men and women, women are more prone to it due to hormonal fluctuations, particularly postpartum phase.
Khattab and colleagues3 indicated that both botulinum toxin A and multivitamin mesotherapy are effective treatments for telogen effluvium, showing improvements in terminal hair growth and the presence of multiple follicular units.
ii) Alopecia Areata: Alopecia areata (AA) is a prevalent form of hair loss that occurs due to an autoimmune response. [4] Characterized by a variable course, the condition is often relapsing or remitting, with the potential for persistence, particularly when hair loss is widespread. Alopecia areata has been strongly linked to psychological stress, including conditions like anxiety and depression. Although its exact cause remains unclear, stress has been identified as a significant factor in triggering or exacerbating this condition.
ii) Trichotillmania: Trichotillomania is an impulse control disorder characterized by compulsive hair-pulling, leading to irregular pattern of hair loss. [4] This condition often results in broken hairs that remain firmly attached to the scalp. It is often triggered by stress, anxiety, or emotional tension, and the repetitive nature of hair-pulling can lead to long-term damage to the hair follicles.
Permanent Solution: Hair Transplant
While stress-related hair loss can be distressing, it is important to note that there are effective treatments available to manage and even reverse the effects. However, for those who experience permanent hair loss or significant thinning due to stress or other causes, a hair transplant offers a permanent solution. Hair transplants involve the relocation of healthy hair follicles from one area of the scalp to areas experiencing thinning or balding. This procedure not only provides a natural and permanent result but also helps restore confidence and improve the quality of life for individuals affected by hair loss. Consulting with a qualified medical doctor that specialized in hair transplant can help determine the most suitable treatment plan to address both the cause and the symptoms of stress-induced hair loss.
References
Asghar F, Shamim N, Farooque U, Sheikh H, Aqeel R. Telogen Effluvium: A Review of the Literature. Cureus. 2020;12(5):e8320. Published 2020 May 27. doi:10.7759/cureus.8320
Hughes EC, Syed HA, Saleh D. Telogen Effluvium. In: StatPearls. Treasure Island (FL): StatPearls Publishing; May 1, 2024.
Khattab FM, Rady A, Khashaba SA. Recent modalities in treatment of telogen effluvium: Comparative study. Dermatol Ther. 2022;35(10):e15720. doi:10.1111/dth.15720
Pratt CH, King LE Jr, Messenger AG, Christiano AM, Sundberg JP. Alopecia areata. Nat Rev Dis Primers. 2017;3:17011. Published 2017 Mar 16. doi:10.1038/nrdp.2017.11
