Hair Loss & Covid Stress

Jeffrey Sassmannshausen, MD

CAN HAIR LOSS BE STRESS RELATED?

Reflecting on the onset of the COVID-19 pandemic, we can say with certainty we have all been affected in one way or another. Whether it be physical or emotional, personal or concerning family or loved ones, related to our job or health, we’ve experienced some level of stress during this 2020 health crisis. Stress, as you may have already guessed, can be a top contributor in exacerbating many skin diseases… but can we become so stressed that our hair literally starts falling out? Ironically, yes. Our hair can start falling out because of extreme stress. This is a condition called telogen effluvium that we have been diagnosing in increasing numbers over the past few months.

Telogen effluvium (TE) is, by definition, the result of hair loss caused by a variety of physical and/or mental stressors. It is considered a temporary and REVERSIBLE type of hair loss that can involve the entire scalp. On rare occasions, it can become a chronic problem. To the general population, loss rarely goes beyond 50%. Common triggers include pregnancy/birth, fever, hospitalization, diet or starvation, trauma, poor or abnormal thyroid function, and certain medications. It can sometimes occur without any triggers at all. Generally, we see telogen effluvium most commonly in women but TE can affect anyone, even men and children, and at any age.

Often, we do not notice any change in our hair for several months after the inciting event occurred. However, when we do notice, it can be terrifying! Looking a little closer into the hair growth cycle, when our hair is growing, it is in the anagen phase. The longer the anagen phase is, the longer your hair can grow. Crystal Gale, for example, had a long anagen phase so she was able to grow hair down to her ankles. My anagen phase—well, not so long. The telogen phase is the resting phase that all follicles go through. Usually, 10% of the follicles are “asleep”. TE shedding is the result of many follicles beginning to rest. This effectively results in an increased number of hair follicles that are lying dormant (or “going to sleep”), and will not start growing again until we enter the ‘anagen’ or ‘growth’ phase of the hair cycle. This may take 6 months or more, but one will begin to notice new, fine, short hairs as a sign of regrowth. All the follicles will wake up again as telogen effluvium is not a permanent loss.

So, if you are noticing an increase in hair loss or start wondering why you are seeing more and more hair circling the shower drain, don’t hesitate to come in for an evaluation. The good news is that telogen effluvium is not permanent and, in most cases, will spontaneously resolve. To amplify this ‘regrowth’ process, medications like topical Rogaine and proven hair growth supplements, like Nutrafol, can help speed up new hair growth. In short, the long-term outcomes are quite favorable for telogen effluvium. Make sure you are taking care of you and DON’T STRESS!

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