August 30, 2013
Dear Mayo Clinic:
Is it true that chronic stress can cause hair loss, and if so, is the hair loss reversed once the stress is lessened?
There isn't an easy yes or no answer to this question. Some hair loss may be related to stress, and, in some cases, it is possible that hair loss could be reversed. But it depends on the type of hair loss you have and other triggers for the hair loss that could be at work.
It is generally accepted that some connection between high levels of stress and hair loss is likely in certain situations. But that connection has not been proven in clinical research trials in people. Research on mice and human hair that has been grown in laboratories seems to show that stress may play a role in two specific kinds of hair loss: telogen effluvium and alopecia areata.
The first, telogen effluvium, is the more common of the two. This type of hair loss involves shedding hair faster than normal from all over your head. It typically does not lead to baldness, but your hair does become thinner than usual. Telogen effluvium has been linked to a range of triggers, and some of them do involve stress.
One trigger that is frequently noticed by women with infants is the hair loss that often starts about three to five months after the birth of a child. While you are pregnant, you lose less hair than normal. Several months after delivery, the body then sheds hair down to its typical level. That hair loss may be concerning, especially if you did not notice the buildup of hair during pregnancy. But for most women, the loss tapers off once the hair has returned to its usual thickness.
Other triggers that can cause telogen effluvium include thyroid problems, massive weight loss, significant medical illness and general anesthesia. If you have recently stopped using a method of birth control that contains hormones, that also could lead to this kind of hair loss. A few specific medications may trigger telogen effluvium, too, although that is rare.
The other type of hair loss that may be linked to stress is alopecia areata. It usually involves patchy hair loss, with bald patches about the size of a quarter or half-dollar. In extreme cases, alopecia areata may affect all the hair on a person's head, including eyebrows and eyelashes.
In most people with alopecia areata, the hair grows back in one to two years. Treatment with steroid injections into the affected areas can often prompt the hair to regrow faster. The larger the area of hair loss, though, the less effective treatment tends to be.
If you are dealing with hair loss, whether you think it is related to stress or not, keep in mind that there are many variations of hair loss, and many medical diagnoses that can lead to hair loss. Some kinds of hair loss may be reversible, while others are not. In some cases, treatment may be able to reverse hair loss. But that is not always the case.
Be very cautious of products and services that claim to restore hair in all cases. Many products related to hair loss available in the marketplace today are expensive but do little, if anything, to effectively treat hair loss. If you are concerned about hair loss, see a dermatologist who specializes in hair issues. He or she can help you investigate the cause of hair loss and decide on possible treatment options.
— Rochelle Torgerson, M.D., Ph.D., Dermatology, Mayo Clinic, Rochester, Minn.