Telogen Effluvium Results from Stress

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Last updated 12/13/2020

COVID-19 has brought unemployment, kids home instead of at school, worrying about the future and maybe stress over wearing a mask as well (please refer to CDC & WHO websites for current updates). This stress has been causing some conditions of hair loss.

Both men and women start losing hair after age 30. Because of hormones men tend to have this occur at a faster rate. Testosterone is associated with pattern baldness. Some women may have more of this in their system.

Our hair changing its texture and thickness through our life is common. Having it come out in clumps is not normal. Visible areas of patchy thinning hair can be alarming.

Mostly women will complain about shedding when they are losing hair with styling, running their hand through hair or finding more than usual in the shower. In styling we can place a lot of tension on our hair follicles. Regularly pulling it back or up, shampooing and blow drying can all cause some hairs to fall out.

If you are currently, seeing more than the usual amount of hair falling after combing or washing it, what resembles a nest on your pillow each morning, or hair that is thinning giving the appearance of a patchy area, this could be due to stress.

Hair loss caused by stress is environmental. It may be easier to control if the stress can be managed. Severe physical or emotional stress can cause either telogen effluvium or alopecia areata.

(Awareness Calendar).


Our Hair Growth

Our hair has its own life span where it falls out naturally. Normally we all lose around 100 hairs a day. It contains four phases of the growth cycle. Telogen effluvium occurs with the telogen phase (resting phase). One hair can live an average of 4.5 years. Then by 6 months it is replaced by a new hair.

What Stress does to Our Hair

When stressed we are flooded with hormones. We take on the flight or fight mode. Our adrenal glands produce more cortisol, epinephrine and norepinephrine.

The cortisol tells our hair follicles to jump from the catagen (transition phase) to telogen phase. The telogen phase of the hair cycle is where the hair stops growing. Being really stressed can put large numbers of our hair follicles into the resting stage.

The anagen phase slows down, having fewer hairs in the next 2 phases. This puts more hairs in the telogen phase resulting in more hair shedding.

Norepinephrine and epinephrine can increase heart rate. A stressor brought on by our environment can also trigger this reaction, like being unemployed, an increased bill, change in routine, the big one COVID-19.

Chronic stress causes conditions making it hard for our body to return to normal with our hormone production.

Stress is a natural part of our lives. However, chronic stress can cause health conditions. We can’t prevent stress due to COVID-19 or any other factor but we can do activities to manage this stress in our lives.

Now more than ever, it is essential to have some form of stress management. Finding activities you enjoy will occupy your mind for a while and making these a regular part of your life is a great plan.

Diagnosing Hair Loss

There are several tests that may be used. The diameter and length of the lost hair is considered. This differs from telogen effluvium to alopecia. A hair pull test could be used to view the amount of hair shed. A wash test could be used to count hairs lost when shampooing (wash).

A blood test can be helpful to rule out an iron deficiency or thyroid insufficiency. The dermatologist will also look at the appearance of the scalp, any areas of baldness or general hair thinning.

Three Types of Hair Loss due to Stress

Telogen effluvium is a temporary and common type of hair loss.

It usually involves a trigger occurring several months before (COVID-19) resulting in abnormal hair shedding. TE is seen towards the center of the scalp and may occur in eyebrows or the genital area. It is associated with the telogen phase of the hair cycle.

This type of hair loss results with thinning hair or there may be an increase of the hair shedding.

This happens more with women and usually is triggered with a disturbance of the hair cycle.

A person with this condition does not lose all their hair but it will be thin making it noticeable.

It can last about 6 months unless it is chronic. There is no certain treatment.  Hair loss due to stress does not have to be a permanent condition. Once the stress is managed the hair growth usually returns. Stress management and improving the diet can have an effect with hair regrowth.

Chronic telogen effluvium is frequent episodes where the hair sheds for longer than 6 months.


hair in brush photo by ShotPrime Studio curtesy Shutterstock

Alopecia areata is another stress related form of hair loss. Alopecia areata may have a number of factors that can result in hair loss. Stress can play a big part. Alopecia areata involves the immune system. The white blood cells attack the hair follicles. The hair usually falls out leaving bare patches.

Alopecia areata may include the entire scalp and even body hair elsewhere. Treatment may be needed if the hair does not replace itself. (You’re Not Alone is a campaign of celebrities for this cause). There are support groups.

Alopecia universalis is a more severe type of Alopecia areata where the whole body suffers hair loss. Over time the hair can repeatedly have regrowth and fall out. AA may affect men and women at any age.

Trichotillomania (AKA hair pulling disorder) is the compulsive urge to pull out hair from your scalp, eyebrows or any other area of the body. This may be a habit done without thinking. It may be out of boredom or being distracted or actually intentional. These are people who deal with negative or uncomfortable feelings like stress, tension, loneliness, or frustration with hair pulling.

This may be noticeable causing more stress and repeating the cycle. It usually develops in early teens and can continue throughout the life. It may be genetic.

(A Victoria Secret Model suffers from trichotillomania). There are support groups.


Treatment depends on the trigger that brought on the hair loss and getting the hair cycle back to normal.

Looking at nutritional deficiencies and improving the diet. Protein is essential for hair growth. It can be found in; meat, eggs, grain, fish, beans and nuts. Especially important is amino acid lysine.

An iron deficiency could be linked to telogen effluvium. These foods contain iron; red meat, liver, dark green leafy vegetables, beans and lentils.

Supplements may be used.

Hair replacement therapy may be an option. Stress management may include a support group.

Any product involving heat on the hair, such as styling with curling or perming and use of chemicals should be avoided. Products that include chemicals may increase inflammation and oxidative stress in the hair follicles.

The hair usually regrows about 3-6 months with telogen effluvium after dealing with the trigger. In some cases, the shedding slows down but does not go away. With most, the hair loss is no more than 50 percent.

Contacting your dermatologist or trichologist (hair specialist) may be considered.

Know that You’re not alone. Are you suffering from hair loss due to COVID-19 stress?

Please share and subscribe to email! Thank you.

Header Photo by Andrea Piacquadio on Pexels

Mary is the founder of All About Our Skin. Former esthetician and CPC. Enjoys researching skincare and has been studying our skin for the past fourteen years.



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This website is for informational purposes and not for diagnosis.

If you have a health condition or concern, please consult your doctor.

Researching content:     accessed 08/06/2020           accessed 08/06/2020    accessed 08/06/2020

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