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Stress, Cortisol, and Hair Shedding: What's the Link?

By Fifty 410 Medical Team|January 10, 2025|11 min read

> Quick Answer: Stress triggers cortisol release, which can push hair follicles from the growth phase into the resting (telogen) phase prematurely. This causes increased shedding 2-3 months after a stressful event—a condition called telogen effluvium. Chronic stress compounds the problem by keeping cortisol elevated, disrupting the hair cycle long-term, and depleting nutrients needed for hair growth.

The Biology of Stress and Hair

When you're stressed, your body doesn't distinguish between a deadline at work and a predator chasing you. The physiological response is the same: a cascade of stress hormones designed to help you survive.

While this response is life-saving in acute situations, chronic activation takes a toll on many body systems—including your hair.

Understanding the Stress Response

The HPA Axis

Your body's stress response operates through the hypothalamic-pituitary-adrenal (HPA) axis:

  • Hypothalamus detects stress and releases CRH (corticotropin-releasing hormone)
  • Pituitary gland responds by releasing ACTH (adrenocorticotropic hormone)
  • Adrenal glands produce cortisol and other stress hormones
  • Hair follicles have receptors for all these hormones and are directly affected by stress signaling1.

    Cortisol: The Primary Stress Hormone

    Cortisol affects hair follicles through multiple mechanisms:

    Direct Effects on Follicles

    • Cortisol receptors exist on hair follicle cells
    • High cortisol inhibits hair follicle proliferation
    • Disrupts the normal hair growth cycle
    • May trigger premature entry into the resting phase

    Indirect Effects

    • Increases blood sugar (which affects hair)
    • Promotes inflammation
    • Impairs nutrient absorption
    • Disrupts other hormones (thyroid, sex hormones)

    Telogen Effluvium: Stress-Induced Shedding

    What Is Telogen Effluvium?

    Telogen effluvium is the medical term for excessive hair shedding caused by a systemic shock to the body. Stress is one of the most common triggers2.

    Normal hair cycling:

    • 85-90% of hairs in growth (anagen) phase
    • 10-15% in resting (telogen) phase
    • 50-100 hairs shed daily

    During telogen effluvium:

    • Up to 30% or more of hairs enter telogen simultaneously
    • 200-300+ hairs may shed daily
    • Diffuse thinning, not patchy

    The Timeline

    The 2-3 month delay between stress and shedding often confuses people:

    Month 0: Stressful event occurs

    Month 0-1: Affected follicles begin transitioning to telogen (invisible)

    Month 2-3: Hair shedding becomes noticeable

    Month 3-6: Shedding peaks then gradually decreases

    Month 6-12: Recovery and regrowth (hair will be short initially)

    This delay means you might not connect the shedding to its cause, especially if the stressor was acute.

    Common Triggers

    Physical Stressors:

    • Major surgery
    • Serious illness or high fever
    • Childbirth (postpartum)
    • Significant weight loss or crash dieting
    • COVID-19 (particularly common trigger)
    • Stopping birth control
    • Nutritional deficiencies

    Psychological Stressors:

    • Death of a loved one
    • Divorce or relationship breakdown
    • Job loss or major work stress
    • Financial crisis
    • Traumatic events
    • Chronic ongoing stress

    Research shows that psychological stress alone can trigger telogen effluvium just as effectively as physical illness3.

    Chronic Stress: A Different Problem

    Acute vs. Chronic

    Acute stress causes a single episode of telogen effluvium that typically resolves once the stressor passes.

    Chronic stress creates ongoing problems:

    • Repeated or continuous hair cycle disruption
    • Sustained elevated cortisol
    • Cumulative damage to follicle function
    • May contribute to or accelerate pattern hair loss
    • Harder to recover from

    How Chronic Stress Damages Hair

    1. Prolonged Catagen Phase

    Research published in Nature found that chronic stress hormones keep follicles in the transition phase longer, delaying new growth4.

    2. Stem Cell Damage

    High cortisol may damage the stem cells in hair follicles that are responsible for regenerating new hairs5.

    3. Nutrient Depletion

    Chronic stress increases nutrient demands while potentially impairing absorption:

    • B vitamins are depleted faster
    • Magnesium is excreted in urine
    • Zinc absorption may be impaired
    • Iron utilization can be affected

    4. Inflammation

    Chronic stress promotes systemic inflammation, which damages hair follicles and disrupts the growth cycle.

    5. Hormonal Cascade

    Prolonged cortisol elevation affects:

    • Thyroid function (slows metabolism)
    • Sex hormones (may increase androgens)
    • Insulin sensitivity (worsens metabolic health)

    The Vicious Cycle

    Hair loss itself becomes a stressor, creating a feedback loop:

  • Stress causes hair shedding
  • Hair loss causes more stress and anxiety
  • Increased stress worsens hair loss
  • And the cycle continues...
  • Breaking this cycle requires addressing both the stress and the hair loss simultaneously.

    Recognizing Stress-Related Hair Loss

    Signs It's Stress-Related

    • Diffuse thinning (all over, not patchy)
    • Onset 2-3 months after identifiable stressor
    • More hair in brush, drain, and on pillow
    • Hair feels thinner overall
    • No scalp symptoms (pain, redness, scaling)
    • Often self-limiting if stress resolves

    When It Might Be Something Else

    Seek evaluation if you notice:

    • Patchy or localized hair loss
    • Scalp symptoms (itching, pain, redness)
    • No clear triggering event
    • Hair loss with other symptoms (fatigue, weight changes)
    • No improvement after 6-9 months
    • Rapid progression

    These may indicate other conditions like thyroid disorders, nutritional deficiencies, or autoimmune conditions.

    Managing Stress for Hair Health

    Immediate Stress Management

    Breathing Techniques

    Simple breathing exercises can rapidly lower cortisol:

    • 4-7-8 breathing (inhale 4s, hold 7s, exhale 8s)
    • Box breathing (4s each: inhale, hold, exhale, hold)
    • Even 5 minutes helps

    Physical Movement

    Exercise metabolizes stress hormones:

    • Even a 10-minute walk helps
    • Yoga combines movement with breathwork
    • Avoid overexercising (can become a stressor)

    Grounding Practices

    Bring yourself into the present moment:

    • 5-4-3-2-1 technique (5 things you see, 4 hear, 3 feel, 2 smell, 1 taste)
    • Cold water on face (activates dive reflex, calms nervous system)
    • Nature exposure

    Long-Term Stress Reduction

    Sleep Optimization

    Poor sleep elevates cortisol:

    • Aim for 7-9 hours nightly
    • Consistent sleep/wake times
    • Limit screens before bed
    • Dark, cool sleeping environment

    Regular Exercise

    Consistent physical activity:

    • Reduces baseline cortisol levels
    • Improves stress resilience
    • Supports overall hormonal balance
    • Improves metabolic health

    Mind-Body Practices

    Evidence supports:

    • Meditation (even 10 minutes daily helps)
    • Yoga
    • Tai chi
    • Progressive muscle relaxation

    Social Connection

    Relationships buffer stress:

    • Oxytocin (bonding hormone) counteracts cortisol
    • Social support reduces perceived stress
    • Even brief positive interactions help

    Professional Support

    Consider:

    • Therapy (CBT is particularly effective for stress)
    • Stress management programs
    • Support groups
    • Medical evaluation if stress feels unmanageable

    Nutritional Support During Stress

    Stress increases nutrient needs:

    B-Complex Vitamins

    • Depleted during stress
    • Support nervous system function
    • Essential for hair growth

    Magnesium

    • Calms the nervous system
    • Often deficient during chronic stress
    • Supports sleep

    Vitamin C

    • Used by adrenal glands during stress
    • Antioxidant protection
    • Supports collagen (important for hair structure)

    Omega-3 Fatty Acids

    • Reduce inflammation
    • Support brain health
    • May lower cortisol levels

    Adaptogenic Herbs

    Some evidence supports:

    • Ashwagandha (may lower cortisol)
    • Rhodiola (stress resilience)
    • Holy basil (calming)

    Always consult a healthcare provider before starting supplements.

    Supporting Hair Recovery

    While Managing Stress

    Hair-supportive treatments can help while you work on stress:

    Minoxidil

    Helps by:

    • Extending the growth phase
    • Stimulating follicles
    • Working regardless of the cause

    Lush Lox combines oral minoxidil with biotin, vitamin D3, and vitamin K2 for comprehensive support during stress recovery.

    Gentle Hair Care

    Minimize additional stress on hair:

    • Avoid tight hairstyles
    • Reduce heat styling
    • Use gentle, sulfate-free shampoos
    • Don't brush wet hair aggressively

    Scalp Care

    Support follicle health:

    • Regular scalp massage (improves circulation, feels relaxing)
    • Avoid harsh treatments
    • Keep scalp clean but not over-washed

    Timeline for Recovery

    With stress management and supportive care:

    Months 1-3: Stress reduction begins; shedding may still occur

    Months 3-6: Shedding typically decreases significantly

    Months 6-9: New growth becomes visible

    Months 9-12: Noticeable improvement in density

    12+ months: Full recovery in most cases

    Patience is essential—hair grows slowly (about 6 inches per year).

    When to Seek Help

    See a healthcare provider if:

    • Shedding is severe or prolonged
    • You have other symptoms
    • Stress feels unmanageable
    • Hair loss is affecting your mental health
    • No improvement after 6-9 months
    • You're unsure of the cause

    The Mind-Hair Connection

    Your hair is intimately connected to your nervous system and stress response. This means that caring for your mental health is literally caring for your hair.

    The strategies that reduce stress—sleep, exercise, connection, mindfulness—also happen to be the foundations of overall health. By addressing stress, you're not just saving your hair; you're improving your entire wellbeing.

    Explore hair support options | Learn about our wellness programs


    References:

  • Arck PC, et al. Am J Pathol. 2006;168(4):1279-1287
  • Harrison S, Sinclair R. Clin Exp Dermatol. 2002;27(5):389-395
  • Hadshiew IM, et al. Am J Pathol. 2004;165(3):1099-1106
  • Choi S, et al. Nature. 2021;592(7854):428-432
  • Zhang B, et al. Cell. 2020;184(6):1368-1381
  • Slominski A, et al. Endocr Rev. 2000;21(5):457-487
  • This article is for informational purposes only and does not constitute medical advice. Consult with a healthcare provider for diagnosis and treatment. Compounded medications are not FDA-approved finished drug products.

    Topics:stresscortisolhair sheddingtelogen effluviumwomen

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