In 2017-2018, 13% of Australian adults reported high or very high levels of psychological distress.

Long-term stress can lead to mental health problems, cardiovascular disease, obesity, gastrointestinal problems, and even hair loss. But is stress the cause of Alopecia Areata? 

If you’ve ever gone to the doctor to discuss your hair loss and been asked about your stress levels, you might have wondered that exact same thing. So, today, we’re explaining the links between stress, your immune system, and hair loss. 

Read on to find out the difference between stress-related hair loss and AA.

Understanding Stress

Stress occurs when you find it emotionally, mentally, or psychologically difficult to cope with a given situation or experience. This type of stress is referred to as psychological stress, which means that the difficulty coping places distress on the mind.

But every individual reacts differently to stressful situations and experiences. How you and your body react to stress depends on the situation itself, your tolerance to stress, your past experiences, and even your personality type. 

For some people, psychological stress can turn into physical stress on the body. Over a period of time, physical stress can lead to a number of health conditions, up to and including hair loss. 

There are studies that show that people with AA also experience stress, but iIt is important to understand that Alopecia Areata is not caused by stress. 

In order to understand this relationship between stress and hair loss, we first need a better understanding of how our immune system functions.

The Immune System, Hair & Stress

Your skin is the largest organ on your body and it acts as a barrier between what’s inside and outside. As such, your skin is an important part of your immunity. 

For example, when you experience an injury to your skin such as a cut, your immune system sends immune cells to the trauma site. These specialised immune cells are called macrophages and they’re capable of healing in many ways, including removing dead or damaged tissue, allowing the growth of new and healthy cells, and regulating the immune response.

At the same time, your immune system triggers an inflammatory response. This response isolates the trauma site and is intended to help get macrophages there by making it easier for white blood cells and nutrients to move more efficiently.

If you have a healthy immune system, this is how the process should work. But if your immune system is weak or impaired, which can be one consequence of psychological stress turning into physical stress, then this process doesn’t play out as intended. 

For example, a weak immune system may be incapable of regulating the inflammatory response required to get the macrophages to the trauma site. Too much or too little inflammation hinders healing and your body is more vulnerable to hypersensitivity and other problems.

This is the perceived connection between stress and Alopecia Areata (AA). The concept is that psychological stress causes physical stress and physical stress leads to a weakened immune system. A weakened immune system can’t properly regulate its responses to trauma and one of the potential consequences of that is hair loss. And while hair loss can definitely be caused by this relationship, AA is not.

What DOES cause AA?

AA is an autoimmune disorder. An autoimmune disorder is when the immune system can’t tell the difference between your own cells and foreign cells. This leads the immune system to incorrectly identify your normal, healthy tissues and cells as a potential threat and thus attacks them. 

In AA, the cells and tissues under attack are the hair follicles. The immune system sends white blood cells to the hair follicles (especially scalp follicles) as a natural defence against a perceived threat. That attack on the hair follicles interrupts natural hair growth, which eventually leads to hair loss.

As an autoimmune disorder, AA is significantly more serious than an immune system weakened by stress. That means that, if you have AA, when your stress goes away, the hair loss doesn’t. 

Hair Loss That IS Caused by Stress 

So, while AA isn’t caused by stress, there are some ways that stress can cause hair loss. Here are 3 of the most common types of stress-related hair loss. 

One stress-related condition that’s related to hair loss is a high white blood cell count. High white blood cell count indicates that the body is trying to fight an infection, as per the macrophage process discussed earlier. It may also indicate the body is under a significant degree of stress. 

If the latter, it can lead to hair loss. This is because, as per the macrophage process, the white blood cells go to the top of the skin to fight against a perceived threat instead of going down to the hair cell where it can be nurtured and come out as a piece of hair.

Telogen effluvium is another form of stress-related hair loss. Telogen effluvium occurs when significant stress causes your hair follicles to enter the resting phase of their development. In just a few months, that leads to hair falling out at an unnatural rate.

Another common type of stress-related hair loss is trichotillomania. This may occur as the result of stress, tension, loneliness, boredom, or frustration. It’s characterised by an irresistible urge to pull the hair from the body, especially the scalp and eyebrows. Trichotillomania is typically employed as a coping mechanism, albeit, an unhealthy one.

The difference between these 3 conditions and AA is that, once the stress is eliminated and the cortisol levels return to normal, the hair grows back. For individuals with AA, reduced cortisol levels have no impact on their hair growing back.

Learn More About AA Myths & Facts

Does stress lead to hair loss? The short answer is some hair loss, yes, but stress does not lead to Alopecia Areata.  The long answer involves a deeper understanding of the impact of stress on our body, our immune responses, and how AA causes hair loss.

There’s a lot to understand when you or a loved one has been diagnosed with AA, and we can help with that. Visit our blog regularly to learn more about AA myths, facts, and the support that’s out there.