Doctors Are Seeing a Rise in Stress-Related Hair Loss—Here’s the Advice They’re Giving Their Patients

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As “don’t cut your bangs” memes emerge and detailed at-home hair-coloring tutorials circulate on social media, a more serious hair condition is popping up for some individuals during the coronavirus crisis: stress-related hair loss

“These are unprecedented times we are navigating—and it is definitely apparent daily in my practice,” says West Hollywood, CA hair restoration specialist Dr. Craig Ziering. “We are seeing and fielding more phone calls from patients wanting to know what is happening to their hair. Hair health and loss is often an indicator of other medical conditions. In this case, we are seeing many more patients whose hair loss is being triggered by stress, and they are eager to connect and get answers and solutions.”

Case in point: One such patient of Dr. Ziering’s had a consultation with him two years ago, and had not yet committed to moving forward with a hair-transplant procedure. The patient works in the hospitality industry and, as one can imagine, it is an incredibly stressful time for her given her line of work.

Last week, she reached out, sharing that she was very stressed and experiencing increased hair shedding; she was prescribed a combination of non-surgical therapies to begin a medical management of her hair loss. 

“For several years, we have offered virtual consultations: Skype, FaceTime, Zoom and the old-fashioned, but very reliable, phone call as an appointment option,” says Dr. Ziering. “We are working with our existing and new patients virtually right now. People still care about their hair health and their appearance, and we do want to be available to help them get answers to their questions about their hair loss—especially if it is stress-induced.”

“We want to help dial down the stress level as much as possible.”

It’s the stress factor that Palo Alto, CA facial plastic surgeon Jill Hessler, MD blames for contributing to hair loss in multiple ways: “From a biochemical standpoint, when we have increased stress, we have increased levels of cortisol present in our body. High cortisol levels can suppress the release of other hormones that are needed for hair growth. This causes more hairs to covert into the resting phase, as opposed to the active growth phase of the hair cycle.”

As Dr. Hessler explains, there are two main types of hair loss: Telogen effluvium, which is an overall hair loss resulting from more hairs in the inactive portion of the growth phase and alopecia aerata, which is an autoimmune-type of hair loss where the body attacks the hair follicle.

“This results in small patches of hair loss. This secondary type of hair loss is much less common and has a medical autoimmune association—it can also be triggered by stress,” she says. “Luckily, there are many supplements available to treat hair loss and support the hair follicles. We have definitely seen an increase in people stating they needed to get stocked up on their hair supplements, given the stress and uncertainty that is ahead.”  

While Brookline, MA dermatologist Papri Sarkar, MD isn’t starting her teledermatology setup until next week, she says she’s also been receiving a lot of messages about hair loss of late—and having a bit of a personal experience with it as well.

“Stress increases so many inflammatory skin disorders like eczema, psoriasis and acne,” she says. “I’m also personally experiencing and getting LOTS of messages about hair loss. Dermatologists aren’t immune to the stress either!”

As Dr. Sarkar explains, the hair cycle can be a bit confusing, but telogen effluvium typically starts two-to-four months after a major stressor like a job loss, birth of a child, surgery, death of a loved one, and now, the COVID-19 pandemic.

“Typically, because it starts two to four months after the stressor, I’d expect all of these hair-loss cases to happen later, but I think there’s been a lot of low-level stress around this and other topics in 2020 already,” she says. “It just hasn’t been a stellar year so far!”

“I’d ask patients to make an appointment with their doctor so, when offices open, they can see them in-person and work on decreasing stress in the interim with things like meditation, exercise, journaling, leaning on their support system, or making a telemedicine appointment with a therapist. There are a lot of services that are popping up right now from people who really want to help.”

The good news is that most patients will regrow their hair as their environments or circumstances normalize, Dr. Ziering assures. 

“I anticipate that the demand for virtual appointments will only increase as patients begin to understand how easy it is to engage with their providers this way,” he says. “Distance is just a number now. No more sitting in traffic on a crowded street or freeway.”

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