Understanding the Link Between Cortisol & Hair Loss
Why This Was Updated?
Updates
Losing more than one hundred hairs per day is a sign of hair loss. You're not alone if you're tired of seeing more hair in your brush than on your head. Approximately 35 million men and 21 million women suffer from hair loss. Stressful triggers can push 70% of hair follicles into the resting phase of the hair growth cycle, supporting the notion that stress (and high cortisol) may be at the root of your hair loss problem.
[signup]
The Role of Cortisol in the Body
Cortisol is a glucocorticoid steroid hormone made in the cortex of the adrenal glands. Cortisol helps maintain homeostasis in the body, especially during times of stress, by regulating energy metabolism, blood pressure, blood sugar, immune function, and inflammation.Β
Effects of High Cortisol Levels
Chronically high cortisol levels, commonly resulting from stress and hypothalamic-pituitary-adrenal (HPA) axis dysfunction, have negative consequences across multiple body systems, leading to:
- Imbalances in thyroid and reproductive hormones
- Vitamin and mineral deficienciesΒ
- Mood disorders, such as depression and anxiety
- Insulin resistance and high blood sugar levels
- Chronic, low-grade inflammation, which is associated with the development and progression of chronic disease
Common Causes of Hair Loss
Hair loss can happen due to many variables, including:
- Genetics
- Poor diet and nutrient deficiencies
- Hormonal changes, such as those that occur with pregnancy, childbirth, menopause, and thyroid disorders
- Underlying health conditions
- Stress
- Medications
- Certain hairstyles and treatments (16, 17, 32)Β
The Connection Between Cortisol and Hair Loss
Three types of hair loss have been associated with high stress (and cortisol) levels:
- Telogen Effluvium: Sudden and temporary hair loss that occurs a few months after a stressful trigger.
- Trichotillomania: Recurrent, irresistible urges to pull out one's own hair, often as a coping mechanism for difficult emotions.
- Alopecia Areata: An autoimmune condition causing sudden hair loss, typically in small, round patches on the scalp
How Cortisol Affects the Hair Cycle
Cortisol dysregulation and resulting oxidative stress disrupt cell signaling pathways that maintain the health of the hair follicle and the normal transitions of the hair growth cycle.
Studies have indicated that high cortisol levels shift the immune system to favor pro-inflammatory pathways, resulting in the excessive production of pro-inflammatory chemicals (cytokines), including tumor necrosis factor-alpha (TNF-Ξ±) and interferon-gamma (IFNΞ³). These cytokines arrest hair growth by preventing the hair growth cycle from transitioning from the telogen rest phase to the anagen growth phase. (25)Β
A 2021 study performed on mice further illuminated another potential mechanism behind stress-induced hair loss. Researchers demonstrated that corticosterone, the rat equivalent to cortisol, suppresses the expression of a molecule called growth arrest specific 6 (Gas6), which activates hair follicle stem cells. Hair growth stopped and shedding increased in mice with high corticosterone levels. (4)Β
Diagnosing Cortisol-Related Hair Loss
Diagnosing stress-related hair loss starts with recognizing distinctive patterns of hair thinning. Following this observation, clinicians often perform cortisol testing to better understand the body's stress response and its potential role in the onset or exacerbation of hair loss.
Symptoms and Signs
These symptoms are suggestive of stress as the underlying cause of hair loss:
- Accelerated hair shedding and diffuse hair thinning across the scalp, often with abrupt onset
- Changes in hair texture
- Dry or flaky scalpΒ
- Feelings of anxiety, tension, or overwhelm
- Difficulty sleeping
- Fatigue
- Muscle tension
- Headaches
- Acne
- Centralized weight gain (20, 27)Β
Laboratory Testing
Unlike serum cortisol, salivary and urinary cortisol tests reflect the portion of bioavailable, unbound cortisol in circulation. This makes these tests physiologically relevant because they offer a more accurate representation of cortisol activity and its impact on health in vivo.Β
The following tests can be used to diagnose stress-related hair loss:Β
- 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 Treating Cortisol-Induced Hair Loss
Stress-induced hair loss is self-limiting. Hair will regrow once the stressful trigger has been resolved and cortisol levels have been normalized.
Lifestyle Changes and Stress Management
Treatment should involve managing stress with healthy coping mechanisms and restoring the HPA axis to reduce cortisol levels. Management strategies include:Β
- The Mediterranean diet is a nutrient-dense, anti-inflammatory diet that is correlated to lower cortisol levels and is potentially an effective adjunctive therapy for treating hair loss.Β
- Stay physically active while allowing sufficient time for recovery
- Spend time in nature
- Practice mind-body therapies, including yoga, meditation, and deep breathing
- Make sleep a priority and aim to get the recommended amount each night based on your age.
Medical Treatments
If stress-induced hair loss persists despite your best efforts at self-care, it's time to have a conversation with your doctor about potential medical treatments:
- Minoxidil is a medication that stimulates hair growth
- Cognitive behavioral therapy (CBT) helps individuals identify and address maladaptive thought patterns and behaviors to manage stress and the psychological burden often accompanied by hair loss.
- A multivitamin or other tailored dietary supplements can correct nutrient deficiencies that are exacerbating hair loss.
- Adaptogenic herbs and stress-relieving supplements help treat stress and anxiety by bolstering resilience to stress.
[signup]
Key Takeaways
- Cortisol, the body's stress hormone, can disrupt the hair growth cycle and cause stress-induced hair loss.
- Diagnosing stress-induced hair loss involves recognizing specific hair thinning patterns and cortisol testing to assess the HPA axis.
- While stress-induced hair loss is often self-limiting, therapeutic interventions that manage stress and regulate cortisol levels can promote faster, healthier hair growth.Β
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.
[signup]
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.Β
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 deficienciesΒ
- 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)Β
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-Ξ±) and interferon-gamma (IFNΞ³). 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)Β
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)Β
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 scalpΒ
- Feelings of anxiety, tension, or overwhelm
- Difficulty sleeping
- Fatigue
- Muscle tension
- Headaches
- Acne
- Centralized weight gain (20, 27)Β
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.Β
The following tests may help in understanding stress-related hair loss:Β
- 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:Β
- 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.Β
- 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.
[signup]
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.Β
Lab Tests in This Article
%201.svg){kind=logo}
References
- Adam, T. C., Hasson, R. E., Ventura, E. E., et al. (2010). Cortisol Is Negatively Associated with Insulin Sensitivity in Overweight Latino Youth. The Journal of Clinical Endocrinology & Metabolism, 95(10), 4729β4735. https://doi.org/10.1210/jc.2010-0322
- American Psychological Association. (2017). What is cognitive behavioral therapy? American Psychological Association. https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral
- Carvalho, K., Ronca, D., Michels, N., et al. (2018). Does the Mediterranean Diet Protect against Stress-Induced Inflammatory Activation in European Adolescents? The HELENA Study. Nutrients, 10(11), 1770. https://doi.org/10.3390/nu10111770
- Choi, S., Zhang, B., Ma, S., et al. (2021). Corticosterone inhibits GAS6 to govern hair follicle stem-cell quiescence. Nature, 592(7854), 428β432. https://doi.org/10.1038/s41586-021-03417-2
- Cloyd, J. (2023, March 15). The relationship between the sleep stress cycle. Rupa Health. https://www.rupahealth.com/post/the-relationship-between-the-sleep-stress-cycle
- Cloyd, J. (2023, July 4). The Impact of Stress on Thyroid Health and How to Manage It with Integrative Medicine. Rupa Health. https://www.rupahealth.com/post/the-impact-of-stress-on-thyroid-health-and-how-to-manage-it-with-integrative-medicine
- Cloyd, J. (2023, October 2). A Functional Medicine Approach to Stress Management. Rupa Health. https://www.rupahealth.com/post/a-functional-medicine-approach-to-stress-management
- Cloyd, J. (2023, October 30). How To Interpret Your Cortisol Urine Test Results. Rupa Health. https://www.rupahealth.com/post/how-to-interpret-your-cortisol-urine-test-results
- Cloyd, J. (2024, January 3). Saliva Testing: Cortisol and Hormone Test Result Interpretation Guide. Rupa Health. https://www.rupahealth.com/post/saliva-testing-cortisol-and-hormone-test-result-interpretation-guide
- Cloyd, J. (2024, February 16). Nutrient Deficiencies Responsible for Hair Loss. Rupa Health. https://www.rupahealth.com/post/nutrient-deficiencies-responsible-for-hair-loss
- Cloyd, J. (2024, February 27). Sleep Requirements by Age Group & Why It's Important. Rupa Health. https://www.rupahealth.com/post/sleep-requirements-by-age-group-why-its-important
- Cox, A. D. (2022, December 2). Adaptogen Herbs: Evidence, Medicinal Benefits, & More. Rupa Health. https://www.rupahealth.com/post/adaptogens
- Diorio, B. (2023, March 17). How to test for hypothalamic-pituitary-adrenal (HPA) axis dysfunction. Rupa Health. https://www.rupahealth.com/post/what-is-the-hypothalamic-pituitary-adrenal-hpa-axis
- Do you have hair loss or hair shedding? American Association of Dermatology. https://www.aad.org/public/diseases/hair-loss/insider/shedding
- Dziurkowska, E., & Wesolowski, M. (2021). Cortisol as a Biomarker of Mental Disorder Severity. Journal of Clinical Medicine, 10(21), 5204. https://doi.org/10.3390/jcm10215204
- Gokce, N., Basgoz, N., Kenanoglu, S., et al. (2022). An overview of the genetic aspects of hair loss and its connection with nutrition. Journal of Preventive Medicine and Hygiene, 63(2 Suppl 3), E228βE238. https://doi.org/10.15167/2421-4248/jpmh2022.63.2S3.2765
- Hair loss. (2019). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hair-loss/symptoms-causes/syc-20372926
- Hair Loss Statistics. (2015, January 19). The Hair Society. https://www.thehairsociety.org/hair-loss-statistics-the-facts/
- Hall-Flavin, D. K. (2023, May 10). Can stress cause hair loss? Mayo Clinic. https://www.mayoclinic.org/healthy-lifestyle/stress-management/expert-answers/stress-and-hair-loss/faq-20057820
- Hughes, E. C., & Saleh, D. (2019, July 3). Telogen Effluvium. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK430848/
- Liu, Y.-Z., Wang, Y.-X., & Jiang, C.-L. (2017). Inflammation: The Common Pathway of Stress-Related Diseases. Frontiers in Human Neuroscience, 11(316). https://doi.org/10.3389/fnhum.2017.00316
- Maholy, N. (2023, April 14). How to reduce stress through mind-body therapies. Rupa Health. https://www.rupahealth.com/post/how-to-reduce-stress-through-mind-body-therapies
- Maloh, J., Engel, T., Natarelli, N., et al. (2023). Systematic Review of Psychological Interventions for Quality of Life, Mental Health, and Hair Growth in Alopecia Areata and Scarring Alopecia. Journal of Clinical Medicine, 12(3), 964. https://doi.org/10.3390/jcm12030964
- Perera, E., & Sinclair, R. (2017). Treatment of chronic telogen effluvium with oral minoxidil: A retrospective study. F1000Research, 6, 1650. https://doi.org/10.12688/f1000research.11775.1
- Peters, E. M. J., MΓΌller, Y., Snaga, W., et al. (2017). Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress. PLOS ONE, 12(4), e0175904. https://doi.org/10.1371/journal.pone.0175904
- Pham, C. T., Romero, K., Almohanna, H. M., et al. (2020). The Role of Diet as an Adjuvant Treatment in Scarring and Nonscarring Alopecia. Skin Appendage Disorders, 6(2), 88β96. https://doi.org/10.1159/000504786
- Preston, J. (2023, March 8). 5 Ways That Stress Affects Women's Health. Rupa Health. https://www.rupahealth.com/post/how-stress-affects-womens-health
- Preston, J. (2023, September 5). The Top 10 Evidence-Based Supplements for Stress and Anxiety. Rupa Health. https://www.rupahealth.com/post/the-top-10-evidence-based-supplements-for-stress-and-anxiety
- Preston, J. (2023, September 22). Addressing Inflammation in Chronic Diseases: A Functional Medicine Perspective. Rupa Health. https://www.rupahealth.com/post/addressing-inflammation-in-chronic-diseases-a-functional-medicine-perspective
- Sweetnich, J. (2023, February 22). How Stress Affects Our Gut Health. Rupa Health. https://www.rupahealth.com/post/how-stress-affects-our-gut-health
- Sweetnich, J. (2023, February 28). How to Balance Cortisol Levels Naturally. Rupa Health. https://www.rupahealth.com/post/how-to-balance-cortisol-levels-naturally
- Sweetnich, J. (2023, April 5). Top 5 Labs for Patients Experiencing Hair Loss. Rupa Health. https://www.rupahealth.com/post/top-5-labs-for-patients-experiencing-hair-loss
- Tee-Melegrito, R. A. (2023, May 17). Can stress cause hair loss? Medical News Today. https://www.medicalnewstoday.com/articles/can-stress-cause-hair-loss#types
- Telogen Effluvium. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/24486-telogen-effluvium
- Trichotillomania (hair-pulling disorder). (2016). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/trichotillomania/symptoms-causes/syc-20355188
- Trueb, R. M. (2009). Oxidative stress in ageing of hair. International Journal of Trichology, 1(1), 6. https://doi.org/10.4103/0974-7753.51923
- van der Valk, E. S., Savas, M., & van Rossum, E. F. C. (2018). Stress and Obesity: Are There More Susceptible Individuals? Current Obesity Reports, 7(2), 193β203. https://doi.org/10.1007/s13679-018-0306-y
- Weinberg, J. L. (2023, August 2). Integrative and Complementary Approach to Alopecia Areata: Testing, Nutrition, Supplements, and More. Rupa Health. https://www.rupahealth.com/post/integrative-and-complementary-approach-to-alopecia-areata
- Weinberg, J. L. (2023, November 29). What is Nature Therapy, and How Can You Practice It to Boost Your Health? Rupa Health. https://www.rupahealth.com/post/what-is-nature-therapy-and-how-can-you-practice-it-to-boost-your-health
