Stress and hair loss appear to be strongly linked, at least as a popular conception. But is there any truth to it? And if so, what can you do to reduce stress and its effect on your hairline?
In this article I’m going to argue that stress can cause hair loss, and I’ll highlight the scientific proof. I’ll then look at the most effective ways to combat it. I’ll show you some powerful techniques that when used consistently, work as a powerful way to protect your hair.
Does Stress Actually Cause Hair Loss?
Hair loss is a complex problem, and there are many factors that play a part. These include genetics, environment, overall health and wellness, diet, and lifestyle.
Let’s look more closely at one of the above factors, lifestyle.
An interesting thing to point out is that all of the above facets have one thing in common: they play a large role in your body’s oxygen levels.
But how is stress linked to oxygen levels?
Breathing has been shown time and again to have a positive impact on stress levels. More specifically, controlled breathing practices can reduce stress and anxiety, and assist in mood regulation (1, 2).
An interesting explanation for why this happens is “the close structural connection between respiratory regions and neurons within the amygdala complex”. This means an improvement in respiratory usage can reduce stress levels and regulate moods via biological mechanisms.
However, the practice of purposeful breathing exercises can also have a more obvious effect: increased oxygen intake.
How does this relate to hair?
Oxygen and the Dermal Papilla
The hair follicle is made up of various structures, including the dermal papilla. This is the part responsible for the growth of the hair and is located at the very base of the follicle:
One of the dermal papilla’s must important roles is its connection with the blood capillaries of the scalp. These deliver blood to the hair follicles, which in turn delivers oxygen and vital nutrients. The Dermal Papilla Cells (DPCs) are then able to deliver these crucial components to the other parts of the follicle.
But what happens when this blood supply is lessened, or even cut off completely?
In individuals with AGA, a process known as miniaturization occurs. It happens as a result of the presence of DHT in the follicles, and it leads to inflammation and irritation (3).
As the inflammation increases, the dermal papilla is cut off from the blood capillaries. This first occurs slowly, so that only some blood flow is possible, but it can soon turn to complete lack of blood supply.
When this happens, the follicle is unable to sustain itself and dies.
As you can see, oxygen plays a big role in the health of the scalp and hair.
To bring this back to stress and its relation to hair loss, consider this:
The more stressed you are, the less oxygen you take in as a result. This may be due to a decrease in physical activity, or perhaps an increase in shallow breathing with a simultaneous decrease in deep breathing.
Whatever the cause, the decrease in oxygen will have a negative impact on the follicles.
This can be even worse for individuals with already inflamed hair follicles who need all of the oxygen they can get.
In short: It’s crucially important to maintain good circulation to the hair follicles so nutrients, oxygen, and hormones can enable growth. Without them, or with restricted flow, the hair follicle growth phase becomes shorter and the resting phase becomes longer.
The Science Behind Stress’s Effect on Hair Loss
While oxygen plays a major role in the health of the hair follicle, there are other factors which contribute as well. One of those is the presence of inflammation, which was briefly touched on above.
Are you unconvinced that stress can trigger inflammation within the body, and therefore lead to hair loss?
Let’s take a look a 2017 study which studied this very issue (5).
Previous studies have shown that stress can enhance neurogenic inflammation and induce adaptive immunity cytokine-imbalance (6, 7). With this in mind, German researchers have looked to understand whether naturalistic life-stress exposure affects cytokine balance and hair growth in healthy individuals (5).
First, it’s important to understand cytokines and the role they play in inflammation.
Cytokines are pro-inflammatory substances that are released by immune cells in response to injury, illness, or foreign attack (such as an allergy). These substances include the proteins interleukin 4 (IL-4) and interleukin 10 (IL-10), as well as growth factors.
One of the easiest ways to ‘diagnose’ inflammation is by measuring the levels of cytokines present.
In this study, researchers recruited 33 female medical students. 18 of these students were in the midst of exams, while the other 15 were simply for comparison.
To track stress levels and its impacts on the students, there were four assessments utilized throughout the study:
- Self-reported distress and coping strategies (Perceived Stress Questionnaire [PSQ];
- Trier Inventory for the Assessment of Chronic Stress [TICS];
- Cytokines in supernatants of stimulated peripheral blood mononucleocytes (PBMCs); and
- Trichogram (hair cycle and pigmentation analysis).
The study was split into three periods, and the assessments were taken at the beginning of each new period. They were:
- T1 – before the start of the learning period;
- T2 – between the 3-day written exam and oral exam; and
- T3 – after 12 weeks of rest following exam period.
As the study revealed, there was a noted increase in stress perception in exam periods at T2 in the 18 students who were in the midst of exams. Perceived stress levels remained the same in the control students at this time.
In addition, the exam students experienced changes in TH1/TH2 cytokine balance between T1 and T2:
As shown above, the ratio of TH1 and TH2 cytokines increased in exam students (red) in T2 when compared to their non-exam counterparts (blue). This indicates that stress levels induced the increase in TH1/TH2 ratios.
Even more interestingly, the TH1/TH2 ratios had not returned to that of their non-exam counterparts even 12 weeks after the exam period. This indicates that stress, even short term, can have long-term biological effects.
But what about hair loss?
The participants’ hairs were plucked (100 in all) and analyzed by two different investigators. The hairs were analyzed for current stage of hair growth, and pigmentation was also noted.
Reduced pigmentation of the hair tip (which is not affected by dyes) is an indicator of transgression from anagen (active) to catagen (rest) phase.
These were the results:
As shown above, the exam students (red) saw a decrease in anagen phase hairs and an increase in telogen phase hairs during T2.
And what about pigmentation?:
The exam students (red) saw a decrease in pigmentation during T2, which indicates a transgression from anagen to catagen phase. This puts an end to active hair growth.
What does all of this mean?
In summary, periods of stress can have a biological impact (a change in cytokine ratios) as well as physical (an end to active hair growth). This strongly suggests that stress can have a direct role in hair loss during prolonged periods of time.
In fact stress is so important that not only does it knock your hair out but it can knock years off your life. For example a difficult childhood reduces life expectancy by 20 years among adults who experienced six or more particular types of childhood trauma. So stress reduction should be an absolute priority for overall general health as well.
Stress & Tension: An Additional Theory?
While I do believe low oxygen levels contribute to stress-induced hair loss, there’s evidence that another mechanism is at play: tension.
According to Rafael Tellez-Segura, there are five layers of the scalp. From outermost to innermost, they are: skin, subcutaneous, galea, subgalea, and pericranium.
The tension theory of hair loss goes something like this:
The galea is a fibrous tissue that covers the entirety of the scalp – from the frontalis muscle (above the eyebrow) to the occipitalis muscle (behind the ears) (9). As it’s connected to the muscles directly, it makes sense then that it would be affected by tension (otherwise known as mechanical stress) (10):
But is it true that stress is linked to increased muscular tension? Yes – this was shown to be true multiple times, such as in a 1994 study that showed emg activity of the trapezius muscle, and again in 2010 in a paper that linked psychological stress and tension-type headaches (11, 12).
So, what is it about tension that does this?
There are a few theories, though perhaps the one to make the most sense is that which discusses the protein Hic-5, an androgen receptor co-activator which improves the function of a cell’s androgen receptors. This protein has been previously shown to induce androgen sensitivity in hair follicles (such as that seen in AGA) (13). And this latest study shows that it may be triggered by mechanical stress (14).
In short? Tension (as a result of stress) can activate Hic-5, which then induces androgen (e.g. DHT) sensitivity in the hair follicles.
If you think about it, this doesn’t seem so far fetched. After all, the parts of the scalp affected by pattern hair loss are over the galea (i.e. the hairline and crown). The areas with maximum tension tend to become bald first: i.e. the scalp apex and frontal regions.
So, what does this mean for stress?
Stress, which has been shown to trigger tension, can activate the Hic-5 protein which then increases androgen sensitivity. You must then, find a way to reduce stress levels if you have any hope of preventing further loss and regrowing your hair.
What Can You Do to Reduce Your Stress Levels?
Many men are initially skeptical about how breathing could prevent hair loss and aid in its regrowth. I don’t blame them, but once they see that just like smoking and air pollution can heavily contribute to hair loss, breath control is the immediate remedy and produces the opposite effect.
In Eastern literature breathing is the single most important aspect of health regimens.
Some rather more esoteric Eastern literature has linked shallow chest breathing with premature aging and baldness since breath drives ‘chee’ through the body’s ‘energy channels’ without which energy stagnation and insufficient blood circulation occurs.
This, it explains, can lead to the contraction of the hair follicles, restricting new hair, and preventing thick and strong hair from growing.
And while this may seem like folk medicine, there is proof that deep breathing practices can reduce stress levels (1).
Practicing breathing techniques each day is known to activate the parasympathetic nervous system which flips on the ‘rest and digest’ side of the body and turns off the ‘fight or flight’ side (15).
The most effective techniques to promote hair regrowth through enhanced blood circulation are described below.
This technique is called being breathed because it feels like the earth is breathing for you. The idea is to focus entirely on the exhalation stage of the breath cycle; this completely purges the lungs of stagnant and stale air providing a cleansing affect.
Start by contracting the lower abdominals, then move up past the navel to upper abdominals, lower, and upper chest. Contract inwards, expelling as much air from the lungs as you can.
Once you’ve exhaled all the air, relax the muscles in the reverse order of exhalation (i.e. starting with the upper chest and finishing with the lower abdominals).
Only make a little effort to inhale, and put focus primarily on relaxing and allowing the air pressure to breath for you. This is the opposite of how most people breathe normally, which leaves a continual volume of air in the lower regions of the lungs, where the alveoli are the most abundant.
Without full exhalation the majority of alveoli are exposed only to stale air which is lacking in oxygen and negative ions, but high in carbon dioxide and positive ions (which are the bad ones).
Thus, much more oxygen can be absorbed and carbon dioxide expelled if the lower abdominal region is used in breathing.
The overall affect is that carbon dioxide is expelled from the blood at a much quicker rate, providing an instant cleansing feeling.
Abdominal breathing focuses more on energizing the system and maximizing blood circulation.
It’s best to practice a bit of both. And whereas ‘being breathed’ emphasized exhalation, abdominal breathing is about inhalation, retention, and exhalation.
For this exercise, standing is best. Inhale slowly from the lower abdomen, into the chest, and finally the clavicles. You want to fill the lungs to about 90% of maximum, but if it feels uncomfortable then you’ve gone too far.
Whilst inhaling try to visualize the air stream flowing through the nostrils deep into the lungs. As the lungs reach capacity sink a ‘bubble’ of air as far down into the lower abdomen as possible.
This basically means visualize the air sinking deep into the lungs where the most alveoli are present. Retain the breath for 3-5 seconds but if you have to expel air quickly shorten the retention time until it’s comfortable.
Keep the breathing pattern smooth and rhythmic. The exhalation is very similar to the ‘being breathed’ technique. For added efficacy, raise the arms in an arc as wide as possible on inhalation and lower on exhalation whilst standing.
For the breathing techniques to affect hair regrowth they must be practised daily for at least a month. A combination of the two techniques each day for ten minutes will work wonders.
It will directly affect hair regrowth by massively increasing blood circulation throughout the scalp which helps to dilate and nourish hair follicles.
Indirectly, breathing corrects bioelectric imbalance, relieves stress by activating the parasympathetic nervous system, reduces autoimmune response from allergic reactions, and stimulates the secretion of vital youthful hormones, all of which have been proved to reduce hair loss and promote new hair growth (16).
Breath Control = Stress Control
Another reason to perform this breathing exercise is to relieve stress. The connection between stress and hair loss is fairly well known, but most people fail to understand that breathing is the link that connects them (5).
Stress automatically causes shallow chest-breathing, just watch anyone who’s in a highly stressful situation to see how this is true. But for a lot of people and particularly those who suffer hair loss, the stress in on-going.
It doesn’t peak and then subside like it would in natural settings (which would provide therapeutic benefits), but is actually maintained at a high level by our modern lifestyles.
This is where the real damage is done because it leads to shallow chest breathing 24 hours a day and chronic oxygen deficiency. So the remedy is obvious. Deep diaphragmatic breathing techniques practiced daily.
The best time to perform this exercise is upon rising in the morning or before bed time, but anytime at all is good.
Does this all seem too good to be true?
Remember that mindful breathing is really just a form of meditation. And meditation has been linked to stress reduction (17).
Another important point to remember about relieving stress is that, ‘we unconsciously tense, so we must consciously relax.’ This means taking two minutes every day (before you fall asleep is ideal) to consciously relax every muscle in your body.
Start with the facial muscles and work your way down your body being conscious of relaxing each muscle in turn. I also have to remind myself every day not to worry about the things I have no control over, but to take action on the things I do.
Yoga for Breath Control and Tension Release
As mentioned above, low oxygen levels aren’t the only reason that stress can induce hair loss. Another major factor is mechanical stress, or tension. So, how can you hope to reduce tension? With yoga!
Yoga is an ancient practice which has proven benefits. These include improving self-perception and attention, increasing flexibility and endurance, and even treating the symptoms of depression (18, 19, 20).
But most importantly as it’s related to hair loss, yoga has also proven effective in reducing tension and treating chronic pain (21).
This means that regular yoga practice, especially in combination with meditation or other deep breathing exercises, can help to reduce stress levels and lower tension throughout the body (22).
To get started with a yoga practice, you don’t need much. A membership to a yoga studio would be nice, but that’s not necessary either. All you need is an exercise mat, and a bit of basic instruction on yogic practices. You can commonly find yoga instructionals online, or even a library book will do!
It’s most important that just like with deep breathing, you’re consistent with this practice. This will yield the greatest results, both for your body and your hair.
Posture & Stress
Now, please allow me to get a little weird! The first time I heard about the following ideas in some esoteric eastern literature on yoga and tantra, I was skeptical as well, but the reality is the results speak for themselves.
Whether it’s weird or not is irrelevant to those who will do what it takes to get the results.
Look around you at your fellow men suffering from hair loss and you might start to notice that the majority of them have pretty poor posture. It might seem like they are ‘resting on their bones’ even when they’re standing, instead of using their core muscles to stand erect.
This ‘resting on their bones’ syndrome inevitably leads to very bad posture.
The spinal column becomes misaligned, and the core muscles atrophy. In yogic literature when the spinal column is bent out of shape the body’s bioelectric energy tends to stagnate, and associated problems arise.
When bioelectric energy stagnates and fails to reach the whole body, symptoms of illness start to appear.
When an animal is hurt or in danger, their entire body will tense up. A joke, that when someone is scared is to ‘assume the fetal position’ which is basically being cowered up in a ball.
Well the same thing happens in reverse. If your shoulders are hunched over, and your spine is bent, your body feels in protective mode. This makes us feel tense, and from tension comes stress (23).
Do you see how poor posture leads to stress on a physiological level?
For us, hair loss is our main concern, and so the upper spinal column is the most important area to focus on. When the upper spinal column is in proper alignment energy flows with ease up into the cranium providing ‘direct nourishment’ for the head and scalp.
And if the tantric aspect of this doesn’t appeal to you, just consider the study above which linked tension with hair loss.
We must therefore act to bring the spinal column back into its natural alignment to maximize the amount of blood flowing into the scalp, as well as relieve tension.
It requires a fairly long time to realign it because of the amount of time it took to get there, and requires daily ‘exercise’ or stretches to do so.
An Introduction to the Adrenal Glands
The endocrine system is a network of glands that release hormones into the bloodstream. These hormones control mood, growth, metabolism, reproduction, and so much more.
This system is made up of various glands throughout the body, including:
- pineal body
- the ovaries
- the testes
The adrenal glands are located just above the kidneys. They have an outer cortex which is responsible for hormone production, and an inner medulla which is responsible for producing neurotransmitters like noradrenaline and adrenaline (1).
What is Adrenal Fatigue?
As mentioned, the adrenal glands produce a variety of hormones, including adrenaline, cortisol, and dehydroepiandrosterone (DHEA).
Adrenal fatigue occurs when the glands are unable to produce the right level of hormones.
As the hormones produced by the adrenal glands play various roles in the body, the symptoms of adrenal fatigue can be varied and numerous. The more common symptoms include (2):
- Body aches
- Low blood pressure
- Unexplained weight loss
- Loss of body hair
The cause of adrenal fatigue is still debated in the medical community. One theory is that adrenal fatigue is a milder form of adrenal insufficiency and that it’s caused by chronic stress.
How Does Adrenal Fatigue Cause Hair Loss?
One of the symptoms of adrenal fatigue is loss of body hair. Why is this the case?
The adrenal glands are responsible for the release of various androgen hormones into the body. These include DHEA and testosterone.
When adrenal fatigue occurs, the glands aren’t able to produce enough of these androgen hormones to keep up with the body’s natural processes. This includes hair growth.
The decreased levels of DHEA and testosterone can be particularly devastating in men, though the effects may be present in women, too.
As DHEA and testosterone are available in lower quantities, they will be diverted to more important bodily functions. This means that hair growth will often slow, and hair loss can even occur.
How can you distinguish between pattern hair loss and hair loss caused by adrenal fatigue?
Pattern hair loss, as the name suggests, has a distinct pattern.
In men, thinning and hair loss will be most noticeable at the temples and hairline. The hairline will begin to form an M-shaped pattern that deepens as the condition progresses.
In women, the thinning and hair loss will be most noticeable at the crown.
Hair loss that’s caused by adrenal fatigue will occur throughout the scalp, also known as diffuse. You may first notice an increase in general shedding, and this will progress until you notice thinner hair throughout the scalp.
How is Adrenal Fatigue Diagnosed?
Adrenal fatigue is not an official medical diagnosis. Your doctor may be unfamiliar with the condition, or not believe it to be real. So how can you get adrenal fatigue diagnosed?
If you’re suffering from any of the symptoms listed above, it’s important to speak with your doctor about your concerns. They will likely perform a physical exam, as well as take blood samples.
If your hormone levels are low, this may be a sign of adrenal fatigue. It can also indicate other underlying medical conditions, however, which is why it’s important to work closely with your doctor for a diagnosis.
How to Treat Hair Loss Caused by Adrenal Fatigue
If you suspect adrenal fatigue hair loss, you may be wondering how to combat it. Take a look at the tips and tricks below to get started.
Treat the Underlying Condition
The symptoms of adrenal fatigue, especially hair loss, can be devastating. You may be scrambling to treat the symptoms, but only by treating the underlying conditions can you resolve the problem.
With blood tests, your doctor can determine if you suffer from a deficiency in any of the hormones that play a role in hair growth. This includes the androgen hormones DHEA and testosterone.
The deficiency is likely to be caused by an underlying condition, though.
These conditions include hypothyroidism, hyperthyroidism, pituitary gland dysfunction, obesity, diabetes, etc. A hormonal deficiency can also be caused by certain medications, including chemotherapy.
Your doctor will very likely want to rule these conditions and causes out first.
If you have unexplained hormonal deficiencies, then adrenal fatigue or insufficiency may be to blame. If that’s the case, then you’ll likely be referred to an endocrinologist.
Eat a Balanced Diet
If you suspect you suffer from adrenal fatigue, then you’ve likely come across various dietary recommendations in your research.
There are diet plans, such as the Adrenal Fatigue Diet, which claim to treat adrenal insufficiency and restore proper adrenal function. While these may be true, there is very little in the way of scientific evidence to support them.
So, what can you do?
The best thing for your body, whether suffering from adrenal fatigue or not, is a balanced diet.
A balanced diet is one that includes lean meats, leafy greens, fruits, nuts and seeds, whole grains, and healthy fats.
When eating a mixture of these foods, your body will receive the nutrients and minerals it needs to thrive. If you have underlying conditions, like obesity or diabetes, a balanced diet can also help to manage them.
Reduce Stress Levels
Even if chronic stress isn’t the cause of adrenal fatigue (remember, this is hotly debated in the medical community), reducing stress levels can still have a positive effect on the body.
Chronic stress can be caused by many factors.
The symptoms of chronic stress include (5):
- Muscle tension or pain
- Irritability or anger
- Digestive upset
By decreasing stress, you can naturally lower your body’s cortisol levels. High levels of cortisol have been linked to hair growth disruption, so this step alone can have a significant impact on reversing stress-related hair loss (6).
The easiest way to lower cortisol is to remove obvious stressors from your life. These can be toxic relationships, unhealthy work environments, etc.
If you don’t have any obvious stressors, or if your stress is just caused by the day-to-day grind, then there are techniques you might try.
Deep breathing and meditation, for example, are great ways to ground yourself. They can be practiced just about anywhere. You may also consider yoga or pilates as a way to release physical tension.
Physical exercise is another great way to lower stress levels (7).
If you are unable to get your stress levels under control at home, you should consult with your doctor. It may be that depression or anxiety are the cause.
Stress is a common part of the human condition. However, it’s presence can result in unpleasant physical and mental changes. One such change? Hair loss.
With the link between stress and hair loss clearer, it’s important to be sure you’re addressing your stress appropriately. This means introducing breathing practices into your daily routine, and learning how to let the smaller things go.
And if stress is a regular part of your life? Then some changes may need to be made – such as a new job, or new living situation – so as to reduce stress levels significantly.
Although stress can worsen hair loss, we recommend seeking medical advice and getting a hair loss diagnosis as well. Many people suffer from androgenetic alopecia which can take place whether you are stressed or not.
In such cases it’s best to get a diagnosis from a professional who then may recommend FDA approved treatments based on their analysis.