Categorized | Causes

Stress and Hair Loss – Are They Connected?

Hair loss is a traumatic experience for people suffering from the condition. A gloriously thick mane of hair plays a crucial role in defining the personality of an individual. Persistent hair loss can rob them of their self-confidence, mental equilibrium and poise. More so, when the hair loss is sudden and effusive.

Major Causes of Hair Loss

Dermatologists have long suspected stress to be one of the major causes of hair loss. However, is there really a connection between stress and hair loss? Or is it just a figment of one’s imagination? The debate has been raging since decades. The issue is enigmatic and exasperating, hanging in limbo due to lack of in-depth understanding of the subject.

Most of the causes of hair loss have been studied extensively and the underlying science behind them has been well documented since long. However, the role stress plays in hair loss has been ambiguous and confusing to scientists. There was no specific scientific explanation for how stress caused hair fall until now.

Recent studies have uncovered an avalanche of information, effectively connecting hair loss to psycho-emotional stress. Researchers have solved the intriguing puzzle of how stress actually causes hair to shed. Studies performed on laboratory mice have provided solid scientific evidence that explains the biochemistry behind stress related hair loss.

Stress and Hair Loss

Stress and hairloss

Stress and hairloss

The hair follicle shows a distinctive cyclic pattern of growth, shedding and regeneration. The hair cycle exhibits the growth stage called anagen when a new hair shaft grows from the hair follicle, the intermediate stage called catagen, when the follicle prepares to shed the hair, the last stage called telogen, when the hair strand sheds on its own, and then anagen again. To understand how stress causes hair loss, it is important to understand the effects of stress on the hair cycle and the hair follicle.

In a 2003 study jointly conducted by the Department of Dermatology at the University of Hamburg in Hamburg, Germany and the Humboldt University in Berlin, the researchers Petra Clara Ark, Ralf Paus and colleagues exposed one group of laboratory mice to extreme ultrasonic sound- a known stressor in mice. The hair follicles of the stressed mice were examined for physiological changes. It was discovered that the stress related neuropeptide called Substance P inhibited hair growth in mice by prematurely terminating the normal duration of anagen and inducing premature catagen in the hair follicles of the stressed mice.1

Around the same time in 2003, E Aoki and colleagues at the Nippon Medical School in Tokyo, Japan conducted a study on the effects of stress on hair follicles of lab mice by exposing the mice to intermittent foot shock stress. The researchers found that foot shock stress “prolonged the telogen stage and delayed the subsequent anagen induction in the hair cycle of the stressed mice”.2

In both the studies, the hair follicles in the mice were also deliberately injected with the neuropeptide Substance P. The results were strikingly similar to when the mice were exposed to actual stressors.

Both the studies successfully proved that stress profoundly affected hair follicle growth and the normal hair cycle in mice.

The results of a study conducted by Ralf Paus and colleagues in 2005 at the University of Hamburg in Germany were even more astonishing. They studied human hair follicles for the effects of stress on the physiological functions of the hair follicles.

The human body has a complex and well-developed stress-response mechanism. On exposure to severe stress, the hypothalamus and pituitary gland secrete neurohormones, which in turn stimulate the adrenal cortex to secrete the stress hormone cortisol. This is called the HPA axis. The HPA axis controls and co-ordinates responses to different kinds of stress. The researchers discovered that “human hair follicles display a functional equivalent of the HPA axis and synthesize cortisol.”3

This effectively means that in response to stress, our hair follicles secrete the stress hormone cortisol.

The researchers also studied the effects of cortisol on the hair follicles. It was revealed that cortisol induced cell death and premature catagen in the hair follicles. It also inhibited anagen and the formation of new hair cells.

Thus, this study proved conclusively that human hair follicles secrete cortisol when an individual is under extreme stress. The cortisol in turn wreaks havoc on important hair biology parameters and triggers profound hair loss.

Telogen Effluvium and Alopecia Areata are types of hair loss associated with stress.

Do all kinds of stress cause hair loss?

An important point to be noted is that not all kinds of stress will trigger hair to shed. Excessive work load, cranky kids and a looming deadline at work will not cause your hair to fall out. These are temporary, everyday stress factors, which are part of our daily lives.

No, it has to be something much more intense and life-altering than that. Something which causes you to lose your appetite and your sleep over an extended period of time is likelier to be the cause.

Child-birth, miscarriage, surgery or a severe illness could be possible triggers. Likewise, powerful emotional stressors like the death of a loved one, a painful divorce or separation, chronic depression could all lead to hair loss.

Bottling up stress over a long period of time will cause stress hormones to build up in the system which could prove to be devastating for the health of the hair.

Is stress related hair loss curable?

The same studies that proved the relation between stress and hair loss, threw up fascinating conclusions with regard to treatment of stress related hair loss. The studies found that stimulation of the hair follicles with the stress-hormone receptor antagonists– substances that counter the effects of the stress hormones- normalized most of the stress induced changes in the hair follicles. These findings open up interesting possibilities to develop topical and systemic hormone therapy.

A few reports suggest that topical application of capsaicin may relieve symptoms of hair loss in patients.4 However, extensive studies need to be undertaken to prove its efficacy.

Focused scientific research is required in the field of endochrine therapy to find a lasting solution to stress related hair loss. Until then, managing stress is the only way out.


  1. Stress Inhibits Hair Growth in Mice by Induction of Premature Catagen Development and Deleterious Perifollicular Inflammatory Events via Neuropeptide Substance P-Dependent Pathways
    (Petra Clara Arck, Bori Handjiski, Eva Milena J. Peters, Anita S. Peter, Evelin Hagen, Axel Fischer, Burghard F. Klapp,* and Ralf Paus)
  2. Intermittent foot shock stress prolongs the telogen stage in the hair cycle of mice.
    (Aoki E, Shibasaki T, Kawana S.)
  3. Human hair follicles display a functional equivalent of the hypothalamic-pituitary-adrenal axis and synthesize cortisol.
    (Ito N, Ito T, Kromminga A, Bettermann A, Takigawa M, Kees F, Straub RH, Paus R.)
  4. Alopecia Hair Loss Linked to Stress