The Science Behind Stress-Induced Hair Loss and Telogen Effluvium
The unwelcome feelings of stress and anxiety creep up when you least expect them. While intermittent feelings of worry are relatively normal, damaging stress levels are on the rise. These feelings of despair and anguish sometimes provoke thinning or shedding on the scalp. Stress-induced hair loss, called telogen effluvium (TE), can be short-lived or long lasting. Thinning or shedding inadvertently caused by anxiety and trauma is not only frustrating, but worrisome. In addition, trichotillomania is a less common but very serious hair loss condition perpetuated by stress. Unlike TE, patients suffering from trichotillomania actively pull hairs out habitually when facing stress and anxiety to cope.
A 2014 national poll from NPR in partnership with the Robert Wood Johnson Foundation and the Harvard School of Public Health found more than one in every four Americans suffered great deals of stress the month prior to the survey. Half of those adults, or 115 million people, experienced a major stressful event that year.  Per the Anxiety and Depression Association of America, anxiety disorders – often explained as chronic high stress and worry – are the most common mental disorder in the United States. Anxiety affects 40 million adults in the U.S., or 18 percent of the total national population. 
The American Hair Loss Association says TE and stress-induced hair loss is likely the second most common form of hair loss seen by dermatologists.  Although little research has been done to help physicians understand why some patients see hair loss because of stress while others do not, three possible cause and effect scenarios exist:
TE Scenario 1: Environmental factors shock the hair follicle into a resting state. Because the follicles are not actively producing more hair to replace ordinary shedding, patients see diffuse patterns of thinning on the scalp. The effects of environmental “shock” show up two to three months after a major life event. Depending on the duration of the event, follicles can return to their normal healthy state without surgical intervention. Patients usually see their condition clear up in less than six months with full regrowth.
TE Scenario 2: Hair follicles enter their resting state as normal but do not regenerate properly, resulting in gradual hair loss. Rather than return to the anagen phase of hair growth, the follicles remain in the telogen state for prolonged periods of time. Thus, fewer anagen, or active, hair follicles are available. Because this scenario is prolonged, patients may not see immediate thinning. This is more common in individuals with chronic anxiety conditions.
TE Scenario 3: A less discussed form of telogen effluvium occurs when hair follicles go through truncated cycles. This results in persistent shedding and thinning hair.
Many short-term hair loss cases are considered normal. For instance, many women experience short-term hair loss after giving birth due to fluctuating hormone levels – a condition called postpartum alopecia. Most women regrow their hair normally a few months later. Certain vaccines, antidepressants, extremely low-calorie diets and physical trauma are also common environemntal triggers of TE. Chronic illness, particularly chronic stress and nutritional deficiencies, are alternative instigators. Research shows a link between tension, hair follicle biochemistry changes and increased resting (telogen) hair follicles.
Treating Stress-Induced Hair Loss and TE
Luckily, treatments for telogen effluvium are available. Assuming your hair loss is stress-induced, regular exercise, therapy and meditation can help. When a specific cause is not determined and stress relief does not reverse telogen effluvium, doctors resort to treatments such as low-level laser therapy (LLLT). In cases where stress-induced hair loss transforms into an enduring condition, many patients turn to hair loss surgery.
At the Hair Institute of Miami, we welcome patients suffering from stress-induced hair loss to undergo a comprehensive evaluation. Our treatment plans include low-level laser therapy (LLLT) caps and advanced follicular unit transplant (FUE) procedures. Either alone or in conjunction with one another, LLLT and FUE helps patients suffering from lingering telogen effluvium regain their confidence and sense of well-being. Call us today at 305-925-0222 to schedule your personalized hair loss consultation in Miami.