Dear Doctors column for February 26, 2007
Physical or Emotional Stress Can Cause Hair Loss
Question:
Can stress cause hair loss? I've recently gone through a very difficult divorce and am starting to notice a lot of hair in my shower drain. I don't see any bald patches, but I'm losing more hair than is normal for me.
Answer:
Both extreme emotional and physical stress can cause hair loss. The most common cause of sudden unexpected hair loss is a condition called telogen effluvium. Telogen effluvium can develop as a consequence of severe mental stress, which can be caused by a divorce, the death of a loved one, major financial problems, or other traumatic emotional events. Physical stressors such as a major illness or surgery, high fever, and severe infection also can trigger stress-related hair loss.
Hair normally grows in 2- to 5-year cycles. At any time, about 90% of your hair is in the growing phase, while the remainder is in the telogen, or resting, phase. After 2 to 3 months in the telogen phase, resting hairs are pushed out by new growth.
Severe stress can affect the hair's normal growth cycle, causing large numbers of hairs to shift from the growing to the resting phase. People typically notice sudden hair loss from all over the scalp 3 to 6 months after the stressful event. In most cases, this loss is temporary. Once stress-related problems are resolved, shedding slows and hair regrows, usually within 6 to 9 months after the initial loss.
Telogen effluvium also can be caused by underlying medical conditions. Hormonal imbalances, such as an overactive or underactive thyroid gland, can cause hair loss. Women often notice some hair loss about 3 months after giving birth. This temporary loss is triggered by a sudden shift in hormone levels.
Iron deficiency, diabetes, and systemic lupus erythematosus also can cause hair loss, as can some medications, particularly retinoids, beta blockers, calcium channel blockers, and antidepressants.
Hair loss caused by physical or emotional stress usually resolves on its own and doesn't require any treatment. If you suspect the cause of your hair loss is due to an underlying medical condition or medication, talk to your physician. Your doctor can order lab tests to check for medical causes, change your medication, or refer you to a dermatologist for further evaluation and treatment.