Stress Does not Cause Permanent Hair Loss

In my opinion, excessive stress can almost never cause permanent hair loss in humans. At worse, it causes temporary telogen effluvium hair shedding. I explain my reasons in the numbered bullet points in the second half of this post. Grey hair is also rarely caused by stress, even though that myth will never go away. See my two posts on the cure for grey hair cure for more details. And of course the main reason for all of this is hair loss genes.

Update: June 21, 2024

Stress Hair Growth UK-5099
An interesting image from the study comparing hair treated with UK-5099 versus hair treated with UK-5099 plus Integrated Stress Response (ISR) inhibitor ISRIB.

Integrated Stress Response and Hair Growth

Yet another new study suggests a connection between stress and hair loss. Covered by sites such as Daily Mail and NY Post as well as Phys.org. The University of Manchester scientists found that when a mechanism called Integrated Stress Response (ISR) was over-activated, it had a negative impact on hair growth.

However, what really stood out to me is that the researchers made use of the Pelage Pharmaceuticals affiliated UK-5099 compound to inhibit the Mitochondrial Pyruvate Carrier (MPC). MPC inhibition promotes lactate generation, which activates epithelial hair follicle stem cells (eHFSCs). Earlier this year Yuva Biosciences (in partnership with Bosley) came out with a new hair loss foam product that partially restores mitochondrial function.

The senior author of this study, Dr. Talveen Purba, said the following:

“We were testing a drug that targets metabolism in human hair follicles to influence how cells generate energy, which (based on the work of others) we expected to stimulate stem cells. However, we found the opposite was true: Hair growth was instead blocked, as cells, including stem cells, quickly stopped dividing.”

May 8, 2021

On rare occasions, new studies come out that suggest that hair loss and grey hair are often caused by stress. I never buy such findings. Nevertheless, I will discuss such new studies when they get widely reported in the global media.

Stress effects the hair growth cycle.
Stress pushes hair into a resting Telogen phase.

Chronic Stress and Hair Loss

On March 31, 2021, researchers from Harvard University released findings (in mice) that chronic stress causes permanent hair loss. These findings were published in numerous newspapers around the world. The lead researcher was the respected Dr. Ya-Chieh Hsu, and the paper was published in Nature on March 4, 2021.

It was titled: “Corticosterone inhibits Gas6 to govern hair follicle stem-cell quiescence.” Chronic stress seems to increase levels of the corticosterone stress hormone in mice. This in turn prolongs hair follicle stem cell (HFSC) quiescence, resulting in hair follicles remaining in an extended resting phase.

The scientists believe that restoring Gas6 gene expression overcomes the stress-induced inhibition of HFSC activation and hair growth. Another summary from Harvard Stem Cell Institute (HSCI).

“Stress essentially just elevates this preexisting ‘adrenal gland–hair follicle axis,’ making it even more difficult for hair follicle stem cells to enter the growth phase to regenerate new hair follicles.” — Dr. Hsu.

Ronald Reagan Hair
Ronald Reagan never had any hair loss despite insane levels of stress. But he was not a mouse of course.

Since that day, readers have regularly posted or e-mailed me links to newly published versions of the story. This has annoyed me, since I do not believe these findings hold much merit in humans. However, to avoid further e-mails, I am now writing my counterarguments.

Besides the fact that the research was done in mice, there are some obvious issues that the researchers have surprisingly failed to address.

The Hair Loss and Stress Myth

  1. Why do young people virtually never go bald? In my whole life, I have never seen a person below age 14 suffering from androgenetic alopecia (male pattern hair loss). The few young children that I have seen with major baldness had: alopecia areata (or alopecia totalis and alopecia universalis); or were undergoing chemotherapy treatments for cancer; or were suffering from progeria (Hutchinson-Gilford). I am of course not counting any pre-teens who shave their head as a fashion statement.
  2. Major baldness is rare even in those who are younger than 20 years in age. And also not too common in those who are below 25. It is surely not believable that young people do not suffer from major stressful events!? If anything, stress is perhaps worst in those who are in high school and college. Permanent hair loss is almost always caused by male hormones (hence the term androgenetic alopecia) and NOT stress. More specifically, male pattern hair loss is usually due to a person’s genetic sensitivity to the effects of dihydrotestosterone (DHT). The latter in turn is converted from testosterone via the 5-alpha-reductase enzyme. Also make sure to read my post on destroying the androgen receptor.
  3. Why do Native Americans who are not mixed with Europeans never go bald? Are the Harvard Researchers implying that Native Americans never have chronic stress? Why do eunuchs never go bald?
  4. The findings do not address why women are less likely to have significant hair loss in comparison to men. Especially in their younger years. Most news sources seem to suggest than women in fact have more stress than men. So if anything, they should have higher rates of baldness than men.
  5. Why does stress not seem to impact body hair growth? Or even nail growth. Most men get an increasing amount of body hair as they get older. I have never heard someone say that they permanently lost their body hair after prolonged stress. Nails are made from keratin, just like scalp hair. Yet stress does not seem to cause nail stem cells to go into a permanent “resting phase”. Even people over the age of 100 have to keep cutting their fingernails and toenails unfortunately. My elderly father still has to shave his beard daily, while his hands shake a lot.
  6. Mahathir Mohamad Hair
    95-year old Mahathir Mohamad has not lost any hair even with a lifetime of stress.

    Why do many people who go through tremendous stress in their lives still never go bald? Among the most famous examples of this are: 93-year old now deceased ex-US president Ronald Reagan. And 95-year old still living ex-Malaysian prime minister Dr. Mahathir Mohamad. These two men went through numerous periods of chronic stress during their long lives.

  7. A lot of such research findings are in mice, rats, rabbits, hamsters and other such animals. Or sometimes just in extracted human skin rather than on actual human scalps. It is also virtually impossible for researchers to accurately measure and compare years of stress levels in humans.

Stress and Hair Greying

Interestingly, the same Harvard researcher (Dr. Ya-Chieh Hsu) and her team published a paper in January 2020 titled: “How stress causes gray hair.” At the time, I also ignored the work due to skepticism. Especially in regards to how findings in mice do not necessarily translate to humans.

Some of the same arguments I made earlier apply to these conclusions. Why do you almost never see children with grey hair? Young people often suffer from chronic stress. Yet I would guess that less than one percent of those below age 15 have prematurely graying hair.

I do think that the chances of getting more rapid development of grey hair after prolonged stress is at least somewhat possible in many humans. i.e., it could slightly speed up your genetic proclivity of hair graying.

However, I do not believe that stress can cause permanent hair loss in almost any humans.

31 thoughts on “Stress Does not Cause Permanent Hair Loss”

  1. I agree admin. It’s most likely DHT in most cases. Always it seems, studies proving otherwise, are done on poor mice. (Their skin is thinner anyway). Btw: be sure to pass on ur views to Rob English and the head-rubbing ‘subscription’ gang.

  2. Reagan is really not a good example. This is the man who famously said (allegedly) that hard work never killed anyone, but “hell, why take the risk”. Even when he was shot, he took it all in his stride. If he was stressed out, he certainly hid it well! Just very lucky with his hair genes. Not so lucky when it came to the likely genetic component for Alzheimer’s….If it were a choice between the two I’d obviously pick baldness. If only it were that simple.

  3. Any news from stemson therapeutics there financial backers fortunis announced that stemsons therapeutics finished mice trials and pig trials and that they’ve cured baldness for everyone even cancer patients! That’s amazing news how come no-one is talking about this?

    1. The statements in the video are somehow vague and already 5 months old, so this is no new news.

      Besides that, I assume they did many mice and pig tests already years ago. This is the only way to test “in vivo“ without human involvement. It’s not something unusual or extraordinary.

      The next step can only be human clinical trials which were originally announced for 2021. And that‘s basically the only possible news from Stemson which are of interest.

      1. On Stemson site, no news articles since last year. Tsuji and Stemson have not even start first human trials. Not sure why people keep wasting time every week.

  4. I remember having a bald spot between the side and back of my head. It came out of nowhere. When I say bald, I don’t mean thinning. I mean completely bald. Bald to the point I thought I was rubbing my face until I realized my fingers was actually at the side/back of my head. When it hit me, I jumped out of bed and ran to the mirror like someone lit fire under my butt.

    To this day, I have no idea why it happened. It was about the size of a quarter. About a year later my hair started to grow back. My cousin said it was stress. Of course he was the same person that disregarded me 5 months prior when I initially told him about it. He never asked the one thing that would have easily resolved his doubt – “Let me see it”.

    I have frontal scarring alopecia now. Styling my hair is a nightmare so I have more stress now than I did back then when I was dealing with thinning so I doubt it was stress, but who knows.

    1. Temporary patches of hair loss can often also be due to telogen effluvium (see link in the beginning of the post). Or even patchy alopecia areata that for some reason never became a lifelong issue.

    2. My brother had the same, he was told it was stress, when he removed the stress from his life it all grew back.

  5. I agree.
    As for the role of androgens, why is she always the culprit ? What is the part of testosterone in hairloss ? I remember when I fist started to notice something was off, my s was pretty low, and my testosterone just a bit above the normal range for a 20 year old woman. Yet as soon as I started antiandrogens, my hairloss stopped…of course it is possible that i have just a low tolerance fresh old for why, but it is weird that my hairloss started when my T started to rise a bit and not before…

  6. I have been waiting for a cure for so long (30 years) that I am almost afraid of it, what can happen to my personality? … is like a blind man who gains sight from one day to the next, he could go mad. I have been suffering from baldness for too long :( If you spend most of your life in prison you struggle once you get out … Baldness made me who I am.

  7. Prolonged stress can certainly trigger androgenic alopecia to kick-in earlier, And undoubtedly stress can cause pre-mature greying of hair. Speaking of grey hair – I’m 30 years old and have started seeing white hairs on my right temple, and it looks like bimatoprost can help with re-pigmentation of hair. Also, I found this patent by Allergan published 2021-04-01 on using topical bimatoprost for AGA. https://patents.google.com/patent/US20210093646A1/en

    1. Nice find on the patent!

      So why does prolonged stress almost never cause androgenetic alopecia in 15 year olds? And rarely in those below 20? Or never in Native Americans for their whole lives? Or rarely in most women below age 30?

      And is it possible for prolonged stress to also cause my beard hair to stop growing? That would be amazing and I would try to force myself into stressful situations! For some reason, all such mice theories never apply to body hair :-(

      1. ^Admin, as you know, your beard hair isn’t sensitive to DHT, which is why some patients get beard hair transplants. Also, as you know, it all comes down to genetics.

        Who says prolonged stressed never causes AGA in adolescents? Case reports are rare, and of course such patients have abnormal androgen levels.
        “[AGA] disease starts after puberty when enough testosterone is available to be transformed into dihydrotestosterone.” https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1365-2133.2004.06279.x

        Oxidative stress and reactive oxygen species destroy the blood supply to the hair follicle, and therefore also decreases ATP stores necessary for cellular growth. Which is why hair surgeons give their patients ATP spray to spray onto their recipient site after hair transplant. https://www.ishrs-htforum.org/content/htfi/24/4/121.full.pdf
        …also, Follics puts adenosine (ATP) into their topical products: https://www.follics.com/fr12

        Cwynar A, Olszewska-Słonina DM, Czajkowski R. The impact of oxidative stress in androgenic alopecia in women. Postepy Dermatol Alergol. 2020 Feb;37(1):119-120. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7247070/pdf/PDIA-37-81685.pdf

        Upton JH, Hannen RF, Bahta AW, Farjo N, Farjo B, Philpott MP. Oxidative stress-associated senescence in dermal papilla cells of men with androgenetic alopecia. J Invest Dermatol. 2015 May;135(5):1244-1252. https://www.jidonline.org/action/showPdf?pii=S0022-202X%2815%2937231-6

  8. Straightforward question to all the readers: do you think something serious will have come out in the hair loss industry within 3-4 years?
    I’m 20 and already dealing with alopecia (I know that many of you have been suffering from this for decades, and you have all my respect because I don’t think I’d have been able to do it), I’m generally quite optimistic but my hope decreases as time goes by… I feel like nothing is moving forward.

    Sorry for the language mistakes, I’m not a native, and have a good day!

    1. Simple answer is no. Don’t put your life on hold for a miracle.

      I remember asking the same question 15 years ago. People were like, yeah of course so and so solution is coming out in 2 years, guess what nothing came out.

      Just being honest with you.

  9. Stress is a shock loss to the body that isn’t 24 7 attack like how dht and mpb is. Mpb can start at 16 yr old for thr very rare or mid 20s 30s for most. Stress hair loss grows back. Androgen hair loss is triggered by a gene that is turned differently for every hair loss sufferer. This gene programs dht to shrink your hair. Stress doesn’t do that. Stress shocks the follicles to fall out and enter prolonged telogen. You dont see many young kids lose their hair to stress because most of them dont have legit stress. Just minor stress like homework, exams, break ups etc. They may have shock loss but they have so much hair the loss is not really visible.

  10. non-verifiable anecdotal experience:

    As I’m sure many here can relate to, I deal intermittently with health anxiety, specifically from imagined conditions.

    I noticed some incipient temple recession 3 years ago at age 24 (incidentally had spent the past few months VAPING aka e-cigarette smoking). This shocked me as my father and his brothers (mixed caucasian/mesoamerican Mexican-Americans) had THICK heads of Mexican hair all through their 30s and into their 40’s and 50s. Since I have the same hairtype, I never thought that I would have to worry about hairloss throughout my life. My mother’s father and brothers started going bald (NW 4-5) later in life, starting in their 40’s and 50’s.

    After noticing very mild temple recession and researching hair loss obsessively, I became so obsessed with my hairline that I gave myself…. stress induced hair loss AKA telogen effluvium <2 years ago in summer 2019. I am 100% certain that this was the cause based on the presentation. Severe shedding out of nowhere (going from minimal shedding to hundreds of full-length telogen hairs in the shower and sink every single day) which persisted for 6 months. After this point, my shedding reduced but never completely to baseline. My hair has stabilized at approximately the same hairline but with much less density from baseline. I have new hairs sprouting at my hairline now which are either from normal regrowth or minoxidil + dermarolling treatment started 6 months ago. The only obvious area of thinning is above my left temple where there is a streak of missing hair, different from typical NW pattern.

    I currently cycle between zinc pyrithione/nizoral/piroctone olaomine shampoos and use 2 ml minox per day. I tried finasteride via various mechanisms on a few occasions and got bad sides and am not willing to experiment any further. At this point I am committing to minox + medicated shampoo and want to find a convient and effective method to add in caffeine until I can cycle in a topical antiandrogen.

    At this point I doubt my hair will ever return to full density from baseline, but I am glad my shedding is substantially reduced and have gotten past the initial shock. TE is a horrifying condition.

  11. My biggest hope was based on the discovery of that famous protein that was supposed to reactivate dormant follicles, what happened to that?

    1. Omg. Maybe there is a language barrier because im not a native speaker but i thought top-line results means great results?? But i read the article and the hair growth after treatment is literally 1 hair per cm2 more than placebo??? This is terrible :D

    2. Yeah ive always Said that i dont believe in topicals anymore this isnt the 90s! we can clone every mammal earth except being able to clone one single hair, that doesnt make sense to me!

  12. My anecdotal experience is stress 100 percent plays a part in permanent hair loss and greying, the caveat being, this is only if you have the hairloss gene, those who don’t won’t see any difference no matter how stressed they are.

    I naturally work in a highly stressful role, my hairloss coincided with this job, I was always bound to be bald, but I just started the process earlier due to stress, on 2 occasions since having this job for the last 8 years, I had a extended break 2 months each time, my hairloss whilst showering drastically reduced from hundreds to maybe 10-15.

  13. Its nice to see more future things coming, but keeping your existing hair safely is always going to be a thousand times cheaper, and more practical than some elaborate medical procedure costing 50K. I mean we have a 30 year old finasteride as the only thing in existence addressing the DHT thing. We could argue and debate if this approach is safe or not, but its all there is. We really need another alternative or something safer for keeping hair that is on our head.

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