Stress Versus the Scalp: How Stress is Impacting Your Hair Health

In recent years, there has been a growing awareness of the mind-body connection. Our mental health has a huge impact on our physical health, and emotions like stress can cause a number of negative repercussions in the body. One consequence of stress is its impact on hair health. Consider, after a particularly busy or stressful period, you may notice your hair shedding more in the shower or looking greasier than usual. Long-term stress can affect the hair in different ways but a lot of these symptoms are rooted in neuroendocrine mechanisms that trigger inflammation and the release of particular hormones and neurotransmitters.

This article will explore how stress affects the hair and scalp, and the biological mechanisms behind this.

When the body perceives stress, the hypothalamic-pituitary-adrenal axis (HPA axis) is activated (Herman et al., 2016). The HPA axis is a neuroendocrine mechanism that causes the release of various stress hormones including cortisol (the body’s primary stress hormone) and corticotropin-releasing hormone (CRH). At the same time, the sympathetic nervous system triggers the release of messengers including norepinephrine (noradrenaline) and various neuropeptides such as Substance P (Schank et al., 2013).

Elevated levels of these chemicals can have negative consequences on their own, but they also trigger the release of inflammatory cytokines, which are small proteins that promote inflammation (Tian et al., 2014). Altogether, this surge of hormones, neurotransmitters, and cytokines can have a detrimental impact on your mood, skin and hair. Below, we will explore specifically how these chemical signals influence hair health and the scalp.

You may have heard common expressions surrounding stress and grey hair, for example “That job’s going to give you grey hair!”. Well, there is some truth in this – stress can actually turn your hair grey or sometimes white.

We get our hair colour from pigment-producing cells called melanocytes. These melanocytes are created from melanocyte stem cells which are found in the hair follicles. Our stores of these cells generally deplete with time, which is why our hair loses its colour as we age. However, stress can also contribute to our supply of these cells. During a period of stress, the neurotransmitter norepinephrine is released. Zhang et al. (2020) showed that this norepinephrine can enter hair follicles causing the melanocyte stem cells to rapidly divide and migrate. This depletes the stem cell reserve and prevents new hair from being pigmented, thus appearing white or grey.

The most common way stress causes hair loss is through a process called Telogen Effluvium. To understand this process, we need to break down the hair growth cycle…

Our hair follows a growth cycle with three main stages: the anagen phase (2-8 years) – where hair actively grows from the follicle, the catagen phase (4-6 weeks) – where hair stops growing and the follicle begins to shrink, and the telogen phase (2-3 months). The telogen phase is known as the resting phase as this is where both the hair follicle and hair strand are completely inactive. This phase ends with the release/shedding of hair from the follicle, which is known as the exogen phase (and sometimes considered an additional, fourth stage of the cycle) (Malkud, 2015).

Telogen effluvium is where hair follicles in the anagen phase (active growth phase), enter the telogen phase (resting phase) prematurely (Kligman, 1961). This occurs following a period of physiological and emotional stress and is likely a result of the hormones and inflammatory cytokines released during stress (Hughes et al., 2024). As the telogen phase lasts 2-3 months, after this time, hair begins to fall out. Because so many hair strands enter the telogen phase under stress, it means they all reach “shedding point” at the same time too. This is why noticeable mass shedding can occur 2-3 months after a stressful event. The good news is that this hair loss is temporary and usually resolves spontaneously, after around 6 months, with full regrowth of hair (Malkud, 2015).

Stress can make both your skin and hair become oilier than usual and this is largely due to hormonal imbalances. During periods of stress, the body produces increased levels of cortisol as well as androgens - both of these hormones increase sebaceous gland activity (Borzyszkowska et al., 2022; Del Rosso & Kircik, 2024). Located in hair follicles, the sebaceous glands secrete sebum (or serum) which is an oily substance that lubricates the skin and scalp.

Therefore, an increase in activity can lead to greasier roots and hair becoming oily. It is also worth noting that neuropeptides released during stress, such as Substance P, can have a similar effect on sebaceous glands (Lee et al., 2008) so this can further exacerbate the issue.

Whilst it may seem contradictory, stress can cause your scalp to become both oilier and drier – sometimes at the same time! For instance, you may notice the roots of your hair feeling greasier than usual, whilst the scalp itself feels flaky and dry. As discussed, stress causes an increase in sebaceous gland activity and oil production causing greasy hair. However, this also indirectly impacts scalp flaking and dandruff. The extra oil provides more “food” for a fungus called for Malassezia globosa (Ro & Dawson, 2005). This fungus causes scalp flaking and is associated with dandruff and seborrheic dermatitis. Often, the combination of oil and flaking can lead to the scalp feeling more sensitive, sore or itchy than usual.

Additionally, the scalp may feel more irritated due to the release of stress hormones like cortisol and CRH. These hormones impair the skin’s keratinocyte epidermal barrier and trigger the secretion of pro-inflammatory cytokines (Zhang et al., 2024). This can cause the scalp to become inflamed and therefore feel more sensitive following a period of stress.

The chemicals released during stress can have a significant impact on your hair and scalp, leading to greying, hair loss, greasiness and/or dryness. The good news is that most of these consequences are temporary and there are things you can do to combat them. Topical scalp care products can be useful to tackle symptoms like dry, oily or damaged hair. Additionally, anti-inflammatory nutrition such as antioxidants and omega-3 fatty acids are a great way to combat the effects of inflammatory cytokines.

That said, it is equally important to address the stress itself. If you feel as though you are prone to stress, or work in a high-pressure job for example, consider incorporating stress-relieving practices into your weekly routine, such as yoga, colouring for mindfulness or meditation. It is also important to prioritise lifestyle habits like getting a sufficient amount of sleep and physical activity, as well as eating a balanced diet.

Remember, in order to address stress-induced hair changes, you should not only address the roots of your hair, but also address the root cause – stress!

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