Is stress causing hair loss?

Everyone experiences intermittent stress in life. Professional and personal demands, illnesses and trauma can wreak havoc on your mental health.

Sometimes that stress can trigger your body to react in ways that can be frustrating and embarrassing. These include issues like brittle nails, acne breakouts and hair loss.

What gives?

The type of hair loss that results from physical and emotional stressors is called telogen effluvium, in which large amounts of stress push hair follicles into a resting period. As a result, the hair begins to shed, causing the appearance of thinning, which can be more prominent in certain areas of the scalp than others.

“The hair follicle has its own life cycle — growth, transition, resting and falling out of hair shaft,” said Dr. Julia Tzu, a double board-certified dermatologist and the founder and medical director of Wall Street Dermatology. Stress alters the percentage of hairs in the growth stage and shifts them to the resting, or telogen, stage.

“No one really understands the complex biology that determines the clockwork behind hair cycling,” she continued. “What is known is that stressors do bend the clock and shift hairs towards the telogen phase.”

But this doesn’t necessarily lead to lasting damage. According to Dr. Lauren Ploch, a board-certified dermatologist at the Georgia Dermatology and Skin Cancer Center, telogen effluvium doesn’t always cause permanent hair loss or baldness.

“Complete baldness does not occur unless there is an underlying inflammatory process” like alopecia areata, an autoimmune disease that causes hair loss in patches and can be triggered by severe stress, she said.

You won’t notice a difference in hair loss immediately after experiencing something particularly stressful. 

“Telogen effluvium usually occurs within the first three months after a stressful event,” Ploch said. “Usually, the hair loss is a sign that a new hair is growing again at the base of the lost hair, so new hair growth should be apparent three to six months after the initial shedding.”

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Len Glassman, a certified health nutritionist, trainer and owner of the Personal Best Training Center, offers up the necessary nutrients that will keep the hairs on your head there longer.

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VITAMIN A

An adequate intake of vitamin A is key to helping promote the growth and health of cells and tissues throughout the body, including the hair and scalp. Vitamin A gets delivered to our bodies in two ways: from plant and animal sources. Hair healthy plant sources include red, yellow and orange fruits and vegetables like carrots as well as some dark green leafy vegetables. Some heavy-hitter animal sources for vitamin A include liver, fish oil, eggs and fortified milk.

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VITAMIN B6, FOLIC ACID, VITAMIN B12

All three of these B vitamins are essential to the normal formation of hemoglobin, which carries oxygen from the lungs to tissues in the body, including the hair. Healthy and strong hair relies on a constant supply of blood and oxygen. A deficiency of these B vitamins is like cutting off the blood supply to your hair, leading to increased hair loss, damaged hair and slow re-growth. Best sources of vitamin B6 and B12 are protein-rich foods like meat, chicken, fish, eggs, pork and soybeans. Your best bet for sources of folic acid are leafy vegetables, orange juice, avocado, beets, broccoli, wheat germ and some fortified cereals.

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VITAMIN C

Vitamin C is essential to producing collagen, a connective tissue that gives structure by holding tissues in the body together, such as the tissue in hair. The human body is not able to store vitamin C for long periods of time, so don’t try to load up on it in an effort to make up for lost time; instead, make sure you eat plenty of foods containing vitamin C every day. The best sources of vitamin C are found in plant sources like oranges, berries, melons, peppers, dark green leafy vegetables and tomatoes.

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ZINC

Dandruff and hair loss are both conditions associated with a zinc deficiency. Zinc is a mineral that promotes cell reproduction, tissue growth and repair. Zinc also functions in the maintenance of the oil-secreting glands attached to our hair follicles. Good sources of zinc include foods of animal origin, including seafood, poultry, mussels, shrimp and oysters. Eggs and milk also supply zinc but in smaller amounts. Whole-grain products, nuts, seeds and legumes contain zinc, but in a form that is less absorbable by the body.

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LEAN PROTEIN

Hair is primarily made of protein, so it makes sense to eat protein-rich foods if you’re trying to maintain healthy growth. Without adequate protein intake, the body cannot efficiently make new hair to replace the hair that has shed. However, eating a steak every day isn’t going to help you. High-fat diets result in increased testosterone levels, which have been linked to hair loss—so steaks are not among the foods that prevent hair loss. Stick to leaner proteins such as fish (which has a myriad of health benefits beyond just maintaining your hair), chicken, soy products, low-fat cheese, eggs, almonds, beans and yogurt.

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WATER

Proper hydration is a key factor in healthy hair and in promoting good health. Every cell and every system in the body uses water to function properly, so don’t just wash your hair in it, drink lots of it. Other conditions that may contribute to poor nutrition and cause hair loss as a side effect include eating disorders such as anorexia. Anorexia can cause severe malnutrition and cause a high proportion of hair follicles to stop their growth cycle. Rapid weight loss is another reason for accelerated hair loss. Dropping weight too quickly and/or participating in a fad diet that is not nutritionally sound can cause imbalances in the body and result in increased hair loss.

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RAISE GOOD HAIR

Our daily diet holds the key to the health of your hair. Every day we can make it a priority to choose the best kinds of foods for healthy, long-lasting hair, a healthy scalp and the growth of new strong hair. So the next time your stomach growls, reach for more “hair-raising,” and vitamin packed foods to keep those follicles happy.

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When to worry 

The average person loses 50 to 100 hairs a day. This is completely normal, and compared with the total number of hairs on your head (about 150,000), the absence of those strands isn’t even noticeable. However, shedding is considered a problem when it becomes excessive.

If you notice more strands than usual coming out when you comb or wash your hair or if you see reduced thickness in one area or throughout your scalp, you should see a doctor, Tzu advised.

As for why hair loss happens during stress, Ploch said that should not be cause for alarm. Because hair growth is not a vital function, you can lose it when you’re stressed out.

“When our body experiences stress, it essentially goes into survival mode and diverts resources away from functions that are nonessential for life such as hair growth and nail growth,” Ploch said.

There’s little data behind whether there are groups that experience more stress-related hair loss than others, but Tzu and Ploch said that new moms are likely to have hair loss, given the level of physiological stress that comes with childbirth. 

Postpartum alopecia, a different type of hair loss, can happen because of a sudden decrease in estrogen levels around childbirth. This drastic hormonal shift shocks the hair follicles to the point that they shut down for roughly four months, but new mothers can expect their hair to return to its normal growth and fullness after a year

Additionally, trichotillomania, a mental health condition characterized by compulsive urges to pull hair from various parts of the body, is associated with high anxiety levels. 

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Trying and failing to run away

Lennox calls this scenario "stress dream 101." He said this dream is an "expression of generalized fear and anxiety" — though the specific object of fear will vary from person to person.

"I would say that the person who's having the dream probably has a greater generalized fear response to life than someone who doesn't have that dream," Lennox added. "Although it doesn't make the person pathologically challenged."

Bulkeley said he would ask the dreamer in this situation if anything in their life feels inescapable. Maybe the person is feeling weak or vulnerable in a conflict. Dreams often use "dramatic metaphors" for emotions that are hard to verbalize, he said.

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Being naked

Lennox said dreaming about being naked is a "perfect symbolic expression" of feeling like a fraud at work (also known as impostor syndrome).

Many people privately experience the fear that other people will find out that they don't really know what they're doing. Being naked at work could mean, Lennox says, that "I will be seen for who I really am. And that will be terrifying."

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Being unprepared for an exam

People commonly dream of being unprepared for a test in high school or college – even if they graduated years ago. And Lennox said it’s often triggered by performance anxiety at work.

High school and college "are the first places where we learn about responsibility and accountability. [The dream] will often recur when we’re faced with the same sense of pressure in our current waking life."

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Being unable to graduate college

Dreams about being unable to graduate translate to fears about not being ready to advance, particularly at work.

Lennox said, "The dream would be processing fears that someone else is ready and we're not, that we're going to be somehow passed over."

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Watching your teeth fall out

"Losing teeth is akin to insecurity," Lennox said.

Teeth have a few functions — they allow us to eat, but they also let us smile or snarl at other people. To lose your teeth "would be to not be able to feed and take care of yourself, feel loved, and be protected," Lennox said.

Another potential meaning? Because teeth are in the mouth, Lennox said this dream might come up when "being authentic, speaking up, or having a voice" feel challenging.

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Falling

This dream often occurs, Bulkeley said, around times of great uncertainty, when you "feel like you don't have adequate support or backing." Maybe something or someone in your life that was once your rock is now less stable.

In terms of work anxieties, Lennox said a dream of falling could reflect a lack of authority in the workplace.

"If you're dreaming of falling, look to the places in your work life where you feel like you're trying to exert some control that's unattainable."

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Seeing your loved ones die

"Death is a great symbol of change," Lennox said.

When someone dies in your dream, it might indicate that something about your relationship with that person is changing or growing. That change isn't necessarily negative, but a recurring dream about death might suggest that something about the transformation is scary.

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Forgetting to pack something

Lennox said this dream is fundamentally about feeling unprepared. "When we're unprepared, then we can't navigate a stressful situation effectively."

The dream might also represent a feeling of being out of control.

Interestingly, Lennox said dream scenarios are typically much higher-stakes than anything that happens in real life. For example, showing up to a business meeting and realizing you forgot to pack your laptop is arguably worse than feeling generally overwhelmed by the day-to-day demands in your life.

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Missing a flight

When you miss a flight in your dream, you're probably playing out a fear of missing a deadline in real life.

"In the world of working, there's nothing like a deadline as a supreme stressor," Lennox said.

Again, Lennox said everything is a crisis in dream world. Turning in a project report an hour late probably doesn't have the same consequences as missing an international flight by an hour.

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Forgetting to take care of a baby or pet

Babies in a dream are symbolic of new possibilities, Lennox said. If you dream about neglecting a baby, you might really be worried about that blog post you've been meaning to write or that hobby you've been hoping to start. Essentially, you're neglecting something in your life that needs your attention.

Pets, on the other hand, reflect joy and love. Lennox said someone who dreams about abandoning a pet might be "too stressed to do fun and lovely things for themselves" and might be feeling like "I'm missing out on cultivating and nurturing something that life has to offer."

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Driving

Bulkeley said cars and driving in dreams can have many meanings, but they often reflect our connections to other people.

If you're dreaming of speeding, for example, you might feel out of control in a personal relationship. On the other hand, if you're dreaming of being stuck in traffic, you might be feeling "adrift" in relationships, or life in general.

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Easy ways to stop your shedding strands

Making certain lifestyle changes can help. Along with getting enough sleep and spending time doing hobbies you enjoy to reduce stress, Ploch emphasized the importance of getting adequate nutrients. 

“Eat a balanced diet that is rich in vitamins and minerals. Be careful with biotin supplementation,” she warned, referring to a memo the FDA released in 2017 about how biotin supplementation can affect lab values. Ploch suggested keeping biotin intake to 35 micrograms or less daily. Biotin, a B vitamin that is commonly used to combat hair loss, can be found naturally in small amounts in foods such as eggs, milk and bananas.  

But most important, remember that it is not as crucial to treat hair loss as it is to find healthy ways to handle the stress that causes it. Regular exercise, adequate sleep and a healthy diet can alleviate anxiety. Eating chocolate, hanging with good friends and listening to music can reduce negative moods. (Dozens of other techniques can help as well.) If you think stress is interfering with your daily life, it might be worth trying something like therapy or discussing your mental health with your doctor.

While self-treatment can be an option in mild cases, you should see a dermatologist as soon as possible if you begin to notice excessive shedding. 

“There’s no reason to let hair loss go undiagnosed,” Ploch said. “Even if it’s just telogen effluvium that will likely self-resolve, I would hate for someone to misdiagnose themselves and not seek treatment for what is actually an inflammatory or scarring type of hair loss.”

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  • This article originally appeared on HuffPost.
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