Hair loss from Stress: The 3 Causes


Stress would not be the first thing that comes to mind when I think about hair loss, but is it fairly common. While growing up I always associated hair loss with old balding men, not a guy in his 30s. It's rather more common than you think, first of all might you might notice that your hair looks a little electrostatic, it stands up and looks rather fragile. Secondly, you might see a few more hairs than usual on your pillow - fortunately, most hair loss associated with stress will grow back.

Hair loss from stress


I was not feeling very alarmed by a few extra hairs on my pillow but I did mention it to my doctor at a general checkup, he reassured that blood tests would not be necessary most of the time and that it could be related to stress. Since I was feeling otherwise healthy, I did have a thought about my stress levels - I had been feeling a little anxious the past few months.

A complete blood count can be done if you are worried about other issues like alopecia areata or hyperthyroidism. In women, it might be worth testing for Iron deficiency since this can lead to brittle nails and hair loss.

Yes, its true, stress can indeed cause hair loss since hair is not an essential part of the body it is often one of the first things to suffer when your body experiences tension. It is important to mention that stress is not the only reason for hair loss, this is why it is essential to see a doctor if you have balls of hair loss.

Stress and hair follicles
In a recent study exploring the connection between stress and hair follicles found that cytokines released in the target area have a significant impact on the hair growth cycle. Cytokines are proteins that work as signaling molecules towards inflammation, you could think of them as chemical messengers. A study on Mice in Hamburg, Germany showed that a stressor would induce programmed cell death near the hair follicles. Furthermore, the study found damage to the skins immune system.


Another study in the American Journal of Pathology found that sound caused or provoked by auditory stimuli would create measurable changes in active hair follicles and promotes their transition into the involution phase (end of active growth of a hair). While conducting these tests, it would hopefully determine what switch in the brain causes these hair growth transitions. The info-graphic below displays the most common causes of stress-related hair loss.

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I will not provide a brief overview of the stress-related causes of hair loss.

Alopecia Areata


Alopecia areata is a condition that causes lumpy bald spots on the scalp, usually in an oval shape. Hair loss can occur anywhere on the body although hair can grow back within a few months. Technically, it is caused by your own body attacking the hair follicles and stops hair growth in the target area. Most people with this condition experience pain and tingling on the site the hair loss takes place, and experience social phobia and anxiety about their changing appearance.

Causes of Alopecia Areata:
Since it is an autoimmune disease, it is not well known as to its cause, however, scientists believe it is inflammatory in nature; white blood cells have been found near the target hair follicles leading to this possibility. It also occurs more in families so if you have a family member with the condition you are more likely to develop this. Some patients experience recurrent attacks of hair loss followed by normal growth again, but these flare-ups should ease over time.


Will my hair grow back after Alopecia Areata


Alopecia Areata cannot be cured, however it is possible for your hair to grow back. A study of Late-Onset Alopecia Areata which affects patients over 50 years of age seems to have a better prognosis for hair to grow back. In a study of 29 patients affected by late-onset AA almost 80% experiences complete hair regrowth.

Patients with early-onset Alopecia Areata often go into spontaneous remission, however the longer you have the condition the poorer the prognosis. In 20% of cases AA can progress to alopecia totalis or alopecia universalis which has a much lower rate of recovery. If your hair loss has been very aggressive, the chances of it growing back are not good. If the hair loss affects the front and sides of the head, the chances are diminished further.

How Long does does Alopecia Areata last.


It is difficult to give an exact estimate as to the duration since remission depends on different factors including the sub-type of AA, and how aggressive your hair loss has been. Some cases can resolve spontaneously with treatment, while others may return, or lead to permanent hair-loss.

There are treatment options including:

  • Steroid creams or Injections: Creams can be applied to the balding patches, and injections can be repeated every few weeks directly to the scalp.
  • Steriod Tablets: These can sometimes result in regrowth of hair, but will often only temporarily fix the issue.
  • Creams: Including Dithranol cream which is usually used to treat psoriasis, but sometimes can stimulate hair growth.
  • UV treatment: Ultraviolet light treatment will mean taking tablets that induce sensitivity to light, and then exposing the patches to UV light.
  • Immunosuppressant tablets.: These can help limit the damage done by the immune system, although more is needed to study their effects on hair loss.

Telogen Effluvium


Telogen Effluvium is one of the leading causes of hair loss, Effluvium means loss or discharge. Hair follicles have two stages namely: the telogen phase (resting) and the anagen phase (growth). Most hairs will switch between these two phases in a cyclical manner, but stress can cause more hairs to remain in the rest phase causing thinning hair on the scalp. Sometimes you will only experience hair loss a few months after a stressful event, and once this passes it can take up to 3 more months for things to return to normal.

Causes of Telogen Effluvium:
Stress caused by a traumatic event or other emotional episode is seen as a reasonable cause of this condition. Some woman may experience TE after childbirth since there is a major change to hormone levels and hence a shut down of the hair follicles - this is recorded in more than 20 percent of women. In most cases, hair goes into hibernation but with time will return to normal working order. Other causes of TE are nutritional deficiencies, a recent fever, or thyroid conditions.


How Long does does it last.


In most cases hair will start to recover within 3 - 6 months, and perhaps sooner if a triggering factor has been identified (underactive thyroid and lower iron levels). There are also many cases of chronic telogen effluvium which may be more difficult to treat - this can result in frequent and prolonged bouts of hair loss that mainly affect women. Chronic TE can often last for many years.

Will my hair grow back after Telogen Effluvium


Your hair should recover in most cases, unless you have been diagnosed with another cause. If you have chronic hair loss for more than 6 months, it would be strongly advised to see your doctor in order to conduct a few blood tests.

Trichotillomania


This is a common issue for smaller children who pull and tug at their own hair resulting in significant hair loss. Doctors believe this is a subtle way to get their parents attention due to frustration or a way to release tension. It is also common to have patients pulling eyebrows, and eyelids, and even arm hair. It is seen as a compulsive behavior that gives the patient a sense of gratification when hair is pulled.

Causes of Trichotillomania:
The root cause could be anxiety, a release of pain may interrupt the normal signals of stress in patients; it may be seen as substituting one form of pain for another. It is also seen as a form of obsessive compulsive disorder (OCD) where patients use repetitive behaviors or patterns to avoid distress. For example, The fear of germs would lead to compulsive washing of the hands. Patients with Trichotillomania often display other signs including picking at the skin, nail biting, or even headbanging
.

It would be advisable to try different behavioral modification therapies in order to change these negative habits, antidepressants have also been known to help with Trichotillomania. For the most part, hair will grow back, unless there has been severe damage to the hair follicle.

Will my hair grow back after Trichotillomania?


There are some triggering factors that have been identified for children including the appearance, issues at home, school-related issues, and concurrent illness. In a recent study less than half of children who had been treated for Trichotillomania had improved symptoms. Behavioral therapy has been shown to be an promising way of changing the behavior of children and a significant reduction in symptoms later on.

Adults who are affected by this condition have a higher rate of relapse but most people should experience no long term side effects if hair-pulling is stopped all together.

Conclusion


Most conditions resulting in hair loss create a vicious circle of distress, these conditions cause anxiety which leads to physical changes in one's appearance - this, in turn, makes them more anxious. Fortunately for me, I was never affected by large chunky hair loss but I was alarmed by how much stress can affect the human body. Writing this article made me release what a delicate ecosystem our bodies have, and if we mess up this balance due to stress or fear it creates annoying side effects. Look after yourselves, eat healthily, and avoid thinking too much about inconsequential things.


references:
https://www.karger.com/Article/FullText/481881



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