Losing more than one hundred hairs per day may indicate hair loss. If you're noticing more hair in your brush than on your head, you're not alone. Many people experience hair loss. Stressful situations can influence 70% of hair follicles to enter the resting phase of the hair growth cycle, suggesting that stress (and high cortisol) might be a factor in hair loss.
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The Role of Cortisol in the Body
Cortisol is a glucocorticoid steroid hormone produced in the adrenal glands. It helps maintain balance in the body, especially during stress, by regulating energy metabolism, blood pressure, blood sugar, immune function, and inflammation.
Effects of High Cortisol Levels
Chronically high cortisol levels, often due to stress and hypothalamic-pituitary-adrenal (HPA) axis issues, can affect multiple body systems, potentially leading to:
- Imbalances in thyroid and reproductive hormones
- Vitamin and mineral deficiencies
- Mood disorders, such as feelings of sadness and worry
- Challenges with insulin and high blood sugar levels
- Chronic, low-grade inflammation, which is linked to the development and progression of chronic conditions
Common Causes of Hair Loss
Hair loss can occur due to various factors, including:
- Genetics
- Diet and nutrient intake
- Hormonal changes, such as those during pregnancy, childbirth, menopause, and thyroid issues
- Underlying health conditions
- Stress
- Medications
- Certain hairstyles and treatments (16, 17, 32)
The Connection Between Cortisol and Hair Loss
Three types of hair loss have been linked to high stress (and cortisol) levels:
- Telogen Effluvium: Sudden and temporary hair loss that may occur a few months after a stressful event.
- Trichotillomania: Recurrent urges to pull out one's own hair, often as a way to cope with difficult emotions.
- Alopecia Areata: An autoimmune condition that may cause sudden hair loss, typically in small, round patches on the scalp
How Cortisol Affects the Hair Cycle
Cortisol imbalances and resulting oxidative stress can disrupt cell signaling pathways that help maintain the health of the hair follicle and the normal transitions of the hair growth cycle.
Studies suggest that high cortisol levels may shift the immune system to favor pro-inflammatory pathways, leading to the production of pro-inflammatory chemicals (cytokines), including tumor necrosis factor-alpha (TNF-α) and interferon-gamma (IFNγ). These cytokines may affect hair growth by influencing the hair growth cycle's transition from the telogen rest phase to the anagen growth phase. (25)
A 2021 study on mice explored another potential mechanism behind stress-related hair loss. Researchers found that corticosterone, the rat equivalent to cortisol, may suppress the expression of a molecule called growth arrest specific 6 (Gas6), which activates hair follicle stem cells. Hair growth slowed, and shedding increased in mice with high corticosterone levels. (4)
Diagnosing Cortisol-Related Hair Loss
Diagnosing stress-related hair loss starts with recognizing patterns of hair thinning. Following this observation, healthcare providers may perform cortisol testing to better understand the body's stress response and its potential role in hair loss.
Symptoms and Signs
These symptoms may suggest stress as a factor in hair loss:
- Increased hair shedding and thinning across the scalp, often with a sudden onset
- Changes in hair texture
- Dry or flaky scalp
- Feelings of anxiety, tension, or overwhelm
- Difficulty sleeping
- Fatigue
- Muscle tension
- Headaches
- Acne
- Centralized weight gain (20, 27)
Laboratory Testing
Unlike serum cortisol, salivary and urinary cortisol tests reflect the portion of bioavailable, unbound cortisol in circulation. This makes these tests relevant because they offer a more accurate representation of cortisol activity and its impact on health in vivo.
The following tests may help in understanding stress-related hair loss:
- DUTCH Plus by Precision Analytical (DUTCH)
- Adrenal Corticoids Profile by Doctor's Data
- Adrenal Stress Profile by ZRT Laboratory
- Adrenocortex Stress Profile by Genova Diagnostics
Managing and Addressing Cortisol-Induced Hair Loss
Stress-related hair loss is often temporary. Hair may regrow once the stressful situation has been resolved and cortisol levels have been balanced.
Lifestyle Changes and Stress Management
Addressing stress with healthy coping mechanisms and supporting the HPA axis may help manage cortisol levels. Consider these strategies:
- The Mediterranean diet is a nutrient-rich, anti-inflammatory diet that is associated with lower cortisol levels and may be a helpful approach for supporting hair health.
- Engage in physical activity while allowing time for recovery
- Spend time in nature
- Practice mind-body therapies, such as yoga, meditation, and deep breathing
- Prioritize sleep and aim to get the recommended amount each night based on your age.
Medical Considerations
If stress-related hair loss continues despite self-care efforts, consider discussing potential medical options with your healthcare provider:
- Minoxidil is a medication that may support hair growth
- Cognitive behavioral therapy (CBT) can help individuals identify and address thought patterns and behaviors to manage stress and the emotional impact often associated with hair loss.
- A multivitamin or other dietary supplements may help address nutrient deficiencies that could be contributing to hair loss.
- Adaptogenic herbs and stress-relieving supplements may help support stress management and resilience.
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Key Takeaways
- Cortisol, the body's stress hormone, may influence the hair growth cycle and contribute to stress-related hair loss.
- Understanding stress-related hair loss involves recognizing specific hair thinning patterns and cortisol testing to assess the HPA axis.
- While stress-related hair loss is often temporary, strategies that manage stress and support cortisol balance may promote healthier hair growth.
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