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Stress and Female Hair Loss: What You Need to Know

Sara Harcharik Perkins, MD

Reviewed by Sara Perkins

Written by Sheryl George

Published 10/20/2020

Updated 11/14/2023

From a global pandemic to signs of a looming economic recession, to most of us, stress likely feels inevitable. Layer on top of that a difficult job or tough relationships and stress becomes about as likely as a Love is Blind binge — we don’t want to take part, but we just can’t help it. 

We all know that stress can take its toll on our mental health, but it can also affect our physical selves. It can lead to symptoms ranging from insomnia and fatigue, to headaches, a weakened immune system and hormonal havoc. 

But on top of all of that, it can affect our hair. If you’re wondering, “Does stress cause hair loss?” the answer is a biiiig yes.

In this article, we dive into how stress can lead to hair loss, what you can do to help treat stress-related hair loss and — maybe most importantly — what you can do to stop the stress in your life from getting so bad it makes your hair fall out.

From a global pandemic to signs of a looming economic recession, to most of us, stress likely feels inevitable. Layer on top of that a difficult job or tough relationships and stress becomes about as likely as a Love is Blind binge — we don’t want to take part, but we just can’t help it. 

We all know that stress can take its toll on our mental health, but it can also affect our physical selves. It can lead to symptoms ranging from insomnia and fatigue, to headaches, a weakened immune system and hormonal havoc. 

But on top of all of that, it can affect our hair. If you’re wondering, “Does stress cause hair loss?” the answer is a biiiig yes.

In this article, we dive into how stress can lead to hair loss, what you can do to help treat stress-related hair loss and — maybe most importantly — what you can do to stop the stress in your life from getting so bad it makes your hair fall out.

Does stress cause hair loss?

For many women, hair loss does have a hereditary component and is influenced by hormonal and genetic factors — like sensitivity to dihydrotestosterone (DHT).  

But in some cases, external factors — like stress — can affect hair, causing everything from thinning hair and a wider part, to a receding hairline, hair falling out in clumps or even patches of complete hair loss.

If you’re dealing with a toxic boss or recently suffered an illness (like Covid) and you’re noticing more hair at the bottom of your shower drain, you may not be imagining things. 

This type of hair loss is called telogen effluvium, which can disrupt your hair’s natural growth cycle.

Your hair growth cycle involves three different phases, and each hair follicle is at a different point in the cycle at any given time. These phases include the anagen phase (or growth phase), the catagen phase (or transition phase) and the telogen phase (or resting phase).

Telogen effluvium often comes on suddenly and is triggered by a stressful event — like the death of a loved one, a sudden physical illness or crash dieting.  

When this stress occurs, hair in the anagen phase can prematurely enter the telogen phase, causing hair loss. People notice abrupt, diffused hair shedding that affects their entire scalp.

An easy-to-notice example is pregnancy. 

Sure, everyone talks about the “pregnancy glow,” but for many women, even though hair seems extra lush, full and ready for styling while pregnant, things can change postpartum

In the first few months following childbirth, you may notice some significant hair shedding — whether due to hormonal shifts or the underlying stress and lack of sleep that comes with caring for a newborn. That is telogen effluvium.

Even if you’re not caring for a newborn, emotional stress can play a role in anyone's life. 

Our bodies are triggered to release different hormones, like cortisol and adrenaline, when we experience stress. Whether it be from one too many burpees or a wrenching heartbreak, too much stress can trigger hair loss in the form of telogen effluvium. 

Another type of stress-related hair loss is a hair-pulling disorder known as trichotillomania. It can also be triggered by anxiety and stress, causing some individuals to pull their hair out. 

The last thing most of us want to see is a clump of hair swirling around the drain — it can quickly turn the upbeat Miley Cyrus we were singing into a full-on downward Adele spiral.

If you’ve been dealing with drain trauma, an unusual amount of strands of hair falling on your pillow (or on the brush after combing) or seeing more of your scalp (especially in bright lighting), you may be experiencing stress hair loss. Here are some common signs of stress-induced hair loss in females:

Diagnosis of telogen effluvium is usually made by a dermatology professional if you shed more than 100 hairs daily or if you don’t quickly regrow the hairs you lose as a result of stress-induced hair loss. 

If you’re here because you’re experiencing stress-related hair loss firsthand and want to know how doomed you are, we have good news: your hair can make a comeback stronger than Rocky Balboa. 

There’re a couple of key steps you can take to restore your crowning glory:  

  • Focus on getting your stress under control

  • Find the right hair loss medication

Just know this: after you’ve treated the root cause of your telogen effluvium, it’s normal for your hair to take three to six months to start growing back.  So, be patient. 

Now, let’s dig into the stuff you really want to know: what exactly can you do to grow your hair back after loss from stress?

Female Hair Loss Treatments

If you’ve found yourself Googling effective hair loss treatments, you’ll typically find two to three medications mentioned more than any others,

  1. Minoxidil. A topical or oral medication, minoxidil will likely be your healthcare provider’s first suggestion. It’s believed to work by increasing the speed at which your hair follicles go into the anagen phase, promoting faster, more effective hair growth. It’s commonly used to treat telogen effluvium. We bet you’ve heard of the common over-the-counter form of minoxidil called Rogaine®. 

  2. Spironolactone. Studies have shown that this once-daily pill can help treat female hair loss and promote new hair growth. A prescription medication, spironolactone blocks androgen production that decreases the amount of DHT, the hormone that causes hair follicles to shrink and hair shafts to become thinner and finer. Like finasteride, spironolactone is typically used to treat androgenetic alopecia but may not be helpful for telogen effluvium. Talk to your dermatology provider to determine if this medication may be right for you.

  3. Finasteride. In its oral, FDA-approved form, finasteride isn’t approved for the treatment of hair loss in women. But as a topical treatment, it’s an easy-to-use spray that helps reduce levels of DHT on the scalp, which is considered, the key hormone responsible for female pattern hair loss. Keep in mind that finasteride may be helpful for those with androgenetic alopecia, but it typically doesn’t work for telogen effluvium. 

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Hair Loss Supplements 

A balanced diet and proper micronutrients are major factors in the development of a normal hair follicle cycle. 

So, before you reach for a bag of Doritos® when you’re feeling hangry, you may want to consider more nutrient-dense options if you want that fuller head of hair. 

And if you’re not ready to go the prescription route or want to supplement other medications with… supplements… there are a few that may be able to help. 

Taking supplements and vitamins may help address some key possible nutritional deficiencies that could get in the way of hair regrowth after experiencing telogen effluvium if you're having a hard time getting the proper nutrients you need from the food you eat.

Keep in mind, there are tons of supplements out there and some may still need more research. And remember: it's always best to consult your healthcare provider to discuss which supplements are right for you and your medical conditions. 

Some of these supplements include:

  • Biotin: Biotin is important in maintaining proper skin, nail and hair health, and a biotin deficiency will certainly cause hair lossBiotin supplementation can’t hurt, but according to research, you’ll only see the benefits if you’re experiencing a biotin deficiency — which is pretty uncommon.

  • Minerals and vitamins: The same review of studies above showed deficiencies of certain vitamins and minerals (like vitamin D, vitamin C and iron) have been shown to contribute to certain types of hair loss — including telogen effluvium, androgenic alopecia and, depending on the vitamin or mineral, alopecia areata.

  • Saw Palmetto: A botanical extract with antiandrogenic properties, saw palmetto has gained commercial popularity for its purported benefits on hair regrowth. A systematic review of studies showed those who took saw palmetto saw an improvement in their hair loss. 

So now you know some ways to treat hair loss, but let’s address the elephant in the room (er, article?) — how can you actually deal with your stress? 

Because remember: treating the symptoms of telogen effluvium and giving your hair the assistance it needs to grow back to normal post-telogen effluvium are great, but the reality is, your hair won’t really start improving until the thing that’s causing it is treated.

Channel a little woosah and consider these ways to reduce or eliminate common causes of your stress. 

Related Articles

Lifestyle Changes

Have a toxic manager or a to-do list that keeps you up at night? For many women, bearing the invisible load can create a lot of stress, eventually leading to stress-related hair loss. 

It might be time to consider removing stressful elements or adding in practices that can help you manage chronic stress levels — and help reduce hair thinning from stress. These can include:

  • Changing things up at work. If the root cause of your telogen effluvium is work-related, it might be time to consider looking for a less stressful job or making changes to your work situation that allow you to reduce stress and anxiety.

  • Upping your exercise. Studies show that physical activity plays a key role in stress management, so exercising more frequently could help you manage stress with feel-good endorphins and avoid further hair loss. Be mindful that exercise doesn’t have to mean a HIIT sweat-dripping session, pilates or strength training can also offer great benefits. 

  • Being more mindful. Yoga, meditation and mindfulness exercises can also help reduce stress, helping you to better manage situations without feeling overwhelmed.

  • Getting your beauty rest. Sleep disorders such as insomnia and stress are closely linked, so aim to get at least seven hours of sleep to help reduce stress. In this case, when you snooze, you don’t lose. 

  • Easing up on the caffeine. We love a latte, but consuming too much caffeine can make you feel more stressed and can raise your cortisol levels. Also, limiting or completely avoiding caffeine in the late afternoon and evening can help you sleep better in the PM so you’re not scrolling through TikTok at midnight. 

  • Talking to a therapy provider. A mental health provider can help you learn how to effectively handle your stress. Can’t make it to see someone in person, or the idea of sitting on someone’s couch freaks you out? Try online therapy from the comfort of your home to determine what type of mental health treatment may work for you.

Medication to Manage Stress 

If you have chronic stress or anxiety, your healthcare provider might recommend medication to help you get your stress under control. Alongside therapy, various types of medication are available to treat stress and anxiety, ranging from SSRIs to anti-anxiety medications

These effective medications are different from one another, with some better suited to some people’s needs than others. Your healthcare provider can help determine which one is best for you — or refer you to someone who can.

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Hair care is hard even when you’re not always stressed out. No matter how you plan to handle stress and hair loss, know that stressing over it may only make it worse. What a vicious cycle, right? But hey, you now know you can treat causes of stress hair loss in a  few diff ways:

  1. Make lifestyle changes and speak with a therapist to reduce the root causes of stress.

  2. Try appropriate hair medications like minoxidil which can help kickstart new growth.

  3. Have a balanced diet and supplement as needed to address nutritional deficiencies

No matter what you choose, there are plenty of treatment options you have to get ahead of stress and hair loss.  If you’re looking to make some changes asap, start a hair loss consultation today with a healthcare provider who can help pinpoint what’s best for you. Plus, you can do it from your couch— no waiting room to deal with. 

10 Sources

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references.

  1. Anatomy, Hair - StatPearls. (n.d.). NCBI. Retrieved April 25, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK513312/
  2. Julianna, M. (n.d.).
  3. Murphrey MB, Agarwal S, Zito PM.Anatomy, Hair, Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513312/
  4. Martel, J.L., Miao, J.H., Badri, T. Anatomy, Hair Follicle - StatPearls. NCBI. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470321/
  5. Institute for Quality and Efficiency in Health Care. What is the structure of hair and how does it grow? Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK546248/?report=reader
  6. Suchnowanit, Poonkiat, Thammaruchu, Sasima & Leerunyakul, Kanchana. Minoxidil and its use in Hair Disorders (2019). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6691938/
  7. Burns Laura J., De Souza, Brianna, Flynn,Elizabeth BS, Hagigeorges, Dina, Senna, Maryanne M. Spironolactone for treatment of female pattern hair loss (2020), retrieved from https://www.jaad.org/article/S0190-9622(20)30510-7/fulltext
  8. Almohanna, Hind M. , Ahmed, Azhar A., Tsatalis, John P. Tosti, Antonella. The Role of Vitamins and Minerals in Hair Loss: A Review (2019). Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6380979/
  9. Jackson, Erica M. Ph.D., FACSM. The Role of Exercise in Stress Management (2013). Retrieved from https://journals.lww.com/acsm-healthfitness/fulltext/2013/05000/STRESS_RELIEF__The_Role_of_Exercise_in_Stress.6.aspx
  10. Lovallo, W. R., Whitsett, T. L., al'Absi, M., Sung, B. H., Vincent, A. S., & Wilson, M. F. (2005). Caffeine Stimulation of Cortisol Secretion Across the Waking Hours in Relation to Caffeine Intake Levels. Psychosom Med. 2. Retrieved May 17, 2023, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2257922/pdf/nihms40260.pdf

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Sara Perkins

Sara Harcharik Perkins, MD, FAAD is a board-certified dermatologist and Assistant Professor in the Department of Dermatology at the Yale School of Medicine. She is the director of the Teledermatology Program, as well as the Associate Program Director of the Yale Dermatology Residency Training Program. Her research focuses on telemedicine and medical education. Her practice includes general medical dermatology, high-risk skin cancer, and procedural dermatology.

Dr. Perkins completed her undergraduate education at the University of Pennsylvania and obtained her medical degree at the Icahn School of Medicine at Mount Sinai. She completed her medical internship at the Massachusetts General Hospital, followed by residency training in dermatology at Yale University, after which she joined the faculty.

Dr. Perkins has been a member of the Hims & Hers Medical Advisory Board since 2018. Her commentary has been featured in NBC News, Real Simple, The Cut, and Yahoo, among others.

Publications:

  • Ahmad, M., Christensen, S. R., & Perkins, S. H. (2023). The impact of COVID-19 on the dermatologic care of nonmelanoma skin cancers among solid organ transplant recipients. JAAD international, 13, 98–99. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518328/

  • Ahmad, M., & Perkins, S. H. (2023). Learning dermatology in medical school: analysis of dermatology topics tested in popular question banks. Clinical and experimental dermatology, 48(4), 361–363. https://academic.oup.com/ced/article-abstract/48/4/361/6869515?redirectedFrom=fulltext&login=false

  • Belzer, A., Leasure, A. C., Cohen, J. M., & Perkins, S. H. (2023). The association of cutaneous squamous cell carcinoma and basal cell carcinoma with solid organ transplantation: a cross-sectional study of the All Of Us Research Program. International journal of dermatology, 62(10), e564–e566. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16700

  • Ahmad, M., Marson, J. W., Litchman, G. H., Perkins, S. H., & Rigel, D. S. (2022). Usage and perceptions of teledermatology in 2021: a survey of dermatologists. International journal of dermatology, 61(7), e235–e237. https://onlinelibrary.wiley.com/doi/10.1111/ijd.16209

  • Asabor, E. N., Bunick, C. G., Cohen, J. M., & Perkins, S. H. (2021). Patient and physician perspectives on teledermatology at an academic dermatology department amid the COVID-19 pandemic. Journal of the American Academy of Dermatology, 84(1), 158–161. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7491373/

  • Belzer, A., Olamiju, B., Antaya, R. J., Odell, I. D., Bia, M., Perkins, S. H., & Cohen, J. M. (2021). A novel medical student initiative to enhance provision of teledermatology in a resident continuity clinic during the COVID-19 pandemic: a pilot study. International journal of dermatology, 60(1), 128–129. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753449/

  • Cohen, J. M., Bunick, C. G., & Perkins, S. H. (2020). The new normal: An approach to optimizing and combining in-person and telemedicine visits to maximize patient care. Journal of the American Academy of Dermatology, 83(5), e361–e362. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316470/

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