Stress and Your Skin & Hair

Part 2

Unfortunately, stress can affect your hair.

If you have started losing your hair around this stressful time, it may be a hair loss disorder called telogen effluvium. We, at NW Dermatology, specialize in hair loss and are here to support you and give you an individualized treatment plan to stop the hair loss and activate regrowth. At your appointment, a very detailed history will be taken to determine the cause of hair loss. Sometimes there is one issue that can be easily identified and other times there are multiple issues that can be occurring concurrently that are contributing to the hair loss. Either way, we are ready to work with you.

Here is why hair loss occurs:

There are 3 cycles of the hair follicle. They are anagen, catagen, and telogen. At any moment, the majority of our hair follicles (90% or more) are in the anagen phase which is the growing phase. This means that 10% or less are in the telogen phase or resting phase. There is a 2-week transitional phase called catagen that is in between anagen and telogen.
Telogen effluvium is a type of hair loss that occurs when more than 10% of the hair follicles are in the telogen phase. This typically equates to greater than 100 hairs lost per day. Telogen effluvium may be caused by many things including weight loss, surgery, illness, high fever, vitamin deficiencies, pregnancy, childbirth, and some underlying medical conditions. One of the most common causes of telogen effluvium is stress or a stressful/traumatic life event.

In telogen effluvium, large numbers of hair follicles are pushed into the resting phase. This typically happens 2-4 months after the stress has occurred resulting in affected hairs falling out suddenly when simply combing or washing your hair. Telogen effluvium is most often acute, meaning occurring for less than 6 months, and is often completely reversible once the stressor is removed. A person is described as having chronic telogen effluvium if they frequently experience periods of hair shedding for more than 6 months.

Treatment for telogen effluvium depends on what is triggering the hair loss. Once the trigger has been established and addressed, the hair cycle should normalize and hair will begin to grow back. This typically occurs 3-6 months after the event. People experiencing shedding should make sure they are eating adequate amounts of protein as hair is made of protein. Patients should also typically have vitamin D, thyroid, and iron checked to make sure there are not any deficiencies or lab abnormalities. There is often more than one contributing factor to hair loss. Be sure to bring these labs with you to your appointment if you have had these labs tested recently.

When diagnosing telogen effluvium, your provider will examine the hairs that have fallen out after performing a hair pull test to see how much hair is being shed. A 3-day hair count will be recommended prior to your appointment. This will help the provider to quantify the number of hairs lost per day. These can be very helpful in the diagnosis of telogen effluvium.

If you are experiencing hair loss and you think it may be related to stress, make an appointment with one of the NW Dermatology hair loss specialists.

NW Dermatology Institute is now offering telemedicine appointments. If you are interested in speaking with a member of our staff, call 503–223–1933 or schedule an online appointment at https://pdxderm.com/book-appointment/.