Standing in the shower shampooing, you notice clumps of hair washing down the drain. At first, you're confused and worried, but a visit to the dermatologist reveals that the very feeling you are likely experiencing as a result of your suddenly-thinning scalp could also be its cause: stress.
That's right, stress may make you want to pull out your hair, but extreme stress may cut out the middle man.
Usually, it's not mild job or life stress that triggers hair loss, more likely it is extremely serious stress to the body that causes hair to stop growing and fall out. These types of stress can be initiated by some types of medications, diabetes, thyroid disorders and even extreme emotional stress, but also can be caused by commonplace life events like childbirth, miscarriage and surgery.
"The biggest cause of all is pregnancy," says Dr. Michelle Pelle, assistant professor in the division of dermatology at the University of California, San Diego.
In fact, it is estimated that up to 45 percent of new mothers experience some degree of hair loss from the stress of having a baby. Since this type of hair loss is caused by such common triggers, many may suffer from it without realizing its cause. Most of the time, hair will grow back within six months, but sometimes this kind of hair loss can be the start of a more long-term problem.
How Stress Causes Hair Loss
Hair grows in repeating cycles. The active growth phase lasts around two years and is followed by a resting phase that spans three months, after which the hair falls from the scalp. Normally, every strand of hair in your head is at a different point in this cycle, so the shedding is barely noticeable: a few strands in the shower drain, some more on your brush, a hair or two on your pillow. A normal head sheds at most 100 strands of hair a day.
However, when the body undergoes extreme stress, as much as 70 percent of your hair can prematurely enter the resting phase, called the telogen phase. Three months later, these hairs begin to fall out, causing noticeable hair loss called telogen effluvium.
The person will not become completely bald and the thinning will be fairly unnoticeable. However, it's this three month delay and the fact that the trigger seems so unrelated that causes confusion on the part of the patient concerned about hair loss.
Fortunately, in most cases hair will begin to grow back within six months. In a very small percentage of people, however, telogen effluvium may be only the trigger for more long-term hair loss.
Ensuring a Covered Scalp
Whenever a patient has sudden hair loss, he or she should see a board-certified dermatologist, preferably one with experience in this area. Even when the doctor is able to determine the source of the stress, such as with a mom who just gave birth, a father coping with the recent loss of a child or a young woman who stopped taking birth control pills, additional testing should be done, says Pelle.
These tests will check for iron and certain hormone levels and thyroid function. Any abnormalities may slow the re-growth of hair. Low iron levels, for example, is particularly common in young women, says Pelle, and by taking an iron supplement or increasing the amount of red meat in one's diet, a young woman can reduce the amount of time she has to worry about her hair.
Unfortunately, telogen effluvium may also reveal a woman who has a genetic predisposition to lose her hair. Much like male-pattern baldness, these women will lose their hair from the top of their heads and not be able to re-grow it without more extensive medical interventions.
But if you notice a clump of hair in your drain, the worst thing to do is worry about this extreme case of hair loss. If you do have telogen effluvium, worry only causes more stress, possibly making your hair loss worse.
"There's such an anxiety about losing hair," says Pelle. "I tell my patients, the worst thing to do about losing your hair is to be worried about it."