One of the most common questions that comes up in our online alopecia support group is “does stress cause alopecia?” I always cringe when I see the word ’cause’ because quite honestly, if researchers knew the exact ’cause’ then they would be able to find a ‘cure.’ I would much rather see the use of the word ‘trigger’ instead of ’cause.’ Learning to look at the four pillars of all autoimmune disorders and how they work may help to unravel the correlation between stress and alopecia areata. After having alopecia areata for over 40 years, stepping back and looking at these four pillars helped me learn not to look for one specific trigger but start focusing on the whole picture…
Let’s talk about stress. If you had talked to me about stress a decade ago, I would have told you that there was absolutely NO WAY stress had anything to do with alopecia. I believed that stress was only one thing… mental. That’s entirely inaccurate. I’ve talked with hundreds of people over the past decade who are affected by alopecia areata. For many people, stress is a definitive trigger…
First, let’s identify what stress is… in fact, let’s actually call it a “stressor” which, by definition, is a response to an environmental condition or stimulus. Stress is your body’s method of reacting to this stimulus. It doesn’t necessarily mean that you are depressed, or scared, or even notice that your body is reacting in some way. Examples of stressors can be environmental (your diet or seasonal allergies), medicinal (vaccinations or birth control pills), physical (accidents or surgeries), or mental (abusive relationship, hostile work environment, or chronic uncontrollable factors). I’ve read testimony from some that say, “Stress didn’t cause my alopecia, having [gastric bypass surgery/changing birth control/dental surgery/insert whatever] caused my alopecia…” And my answer is, all those things are stressors that stimulate and illicit a response from your body.
Another myth that many people believe is “But everyone has stress! But not everyone loses their hair!” and therefore the stress theory must be bogus… but it’s not. Those of us who lose our hair from alopecia areata are genetically predisposed to this disorder. We can’t help it. It’s in our genes. But it’s NOT in everyone’s genes which is why 97.9% of the world’s population can process the stress stimuli without losing one hair and we, the awesomely fantastic 2.1%, are the ‘lucky’ ones who possess these genes which make us more susceptible.
There are also different types of mental stress and for the purpose of this article, it must be defined into categories. A person can experience short term stressors, commonly referred to as the “fight or flight” response. This form of stress causes the body’s immune system to prepare itself for such events as punctures, scrapes and bites. A study performed by Segerstrom and Miller  has proven that short term stressors actually boost the immune system and do not cause long term affects. However, long-term stressors such as life changes that are beyond a person’s control can have a negative impact on the immune system. Through their exhaustive meta-analysis, Segerstrom and Miller  were able to pinpoint that the most damaging stressor to the human immune system were chronic stressors. More importantly, those stressors “which change people’s identities or social roles, are more beyond their control and seem endless.” During a period of chronic, long-term stress, a persons immune function dropped dramatically.
Always keep in mind, there is a difference between a ’cause’ and a ‘trigger.’ Stress did not CAUSE your hair loss but stress may have triggered it. The exact cause is unknown but it boils down to your immune system receiving faulty signals to attack your hair follicles. Stress does not CAUSE this chain reaction but it can TRIGGER the misfire. Besides, if we actually knew what the CAUSE was, we would be able to find a CURE.
- Segerstrom, Suzanne C., and Gregory E. Miller. “Psychological Stress and the Human Immune System: A Meta-Analytic Study of 30 Years of Inquiry.” Psychological bulletin 130.4 (2004): 601–630. PMC. Web. 10 Oct. 2016. [Full Study].