Is Alopecia "Just Stress?"

Have you heard from your dermatologist, endocrinologist, or primary care physician (or chiropractor or energy worker or massage therapist) the phrase, “You’re just stressed?”

This is a frequent response to people who are experiencing hair loss—of any pattern—and it drives me nuts.

Simultaneous to this trite reply, they may offer you an immune response modifier (?@#%*?!), corticosteroid shots, or a fistful of supplements.

Many of you may be thinking, “Of course I’m stressed! I’m losing [or have lost] my hair. Just thinking about this makes me stressed!”

As I state in this post, these statements aren’t helpful either:

“Sorry, you’ll have to live with this.”
“There’s nothing more we can do for you.”
“This is genetic and you’ll have to accept it.”

(All stressful and all untrue.)

Yes, stress can undoubtedly be a contributing factor to alopecia, whether it’s diffuseandrogenic, or patchy (areata, ophiasis, totalis, universalis). But I’m so tired of medical practitioners (and others) reducing hair loss/alopecia down to “just stress.” Again, stress plays a role. But do these folks truly understand the physiological mechanism (I’ll dig more into the science behind this towards the end of this post) by which this is true? And what can we do about it?

I want to start by saying that this has been a difficult year-plus, on many levels and in differing ways for each of us, whether physical, mental, spiritual, emotional, or all of the above.

A few years ago, I coined the term, “shock and shed.” Please know that “shock” can be physical, mental, spiritual, emotional…or chemical.

Yes, getting at root cause of our stress is important. “Root cause” is the basis upon which functional medicine (“the medicine of why”) was founded. But regardless of the source of the stressors, dealing with it can sometimes feel like turning the Titanic in a bathtub. In other words, sometimes we have to make some big changes in our lives to ameliorate the pressure and that can oftentimes feel overwhelming, which keeps people stuck.

Example of a big change to alleviate stress: I spoke yesterday with a close colleague and financial planner who sold off half of her clientele to reduce her workload and thus, her “extreme” stress.

Please know that it’s entirely possible to become more adaptable to stress.

I’m not advocating becoming more adaptable so that you can stay in a toxic relationship, continue to work at a job you hate, or let that chronic lower back pain go unaddressed.

But it is possible—and I’d argue relatively straightforward—to change your internal environment such that you’re residing more in the parasympathetic (rest and digest) response vs. the sympathetic (fight or flight) response. As some doctors like to put it, becoming more responsive vs. reactive.

It starts with adrenal nourishment.

Trust me, this can make all the difference for the health of your hair follicles.

If you want to dig into some of the science behind this, check out this next section of this post. If not, scroll down to the next heading, where I offer some solutions.

Just *Some* of the Science
When we think of stress, again, we need to consider the status of the adrenals (and the primary adrenal stress hormone, cortisol). And when we think of the adrenals, we need to consider the HPA (hypothalamic/pituitary/adrenal) axis. 

Our hair follicles are sensory organs. There are many nerves in and around the follicles and the actions of these nerves, as well as various nervous system products called neuropeptides, can affect not only the health of our follicles, but also the hair growth cycle.

Below are some studies and articles related to stress/cortisol and follicle and hair health.

This isn’t meant to stress you out. Knowledge is power and when we know better, we do better.


What rocked my world a few years ago was learning more about the brain/skin connection and that our hair follicles synthetize cortisol. As this abstract states, “…human hair follicles display HPA axis-like regulatory feedback systems.”

This article states, “Recently, a fully functional peripheral equivalent of the HPA [adrenal] axis could be demonstrated in microdissected, organ-cultured human scalp hair follicles, which were capable of synthesizing cortisol and showing fully functional feedback controls.”

Not only can our follicles house and synthesize cortisol, but cortisol has also been shown to concentrate in the hair shaft.

Easy Ways to Become More Adaptable
Several members of the functional medicine community state that adrenal dysfunction is the most common hormonal imbalance, but it’s the most straightforward to address.

Here are two reasons why:

  1. Cortisol is a short-cycle hormone, meaning it can be nudged in the right direction relatively easily. It has a diurnal (24-hour) cycle—which is why how someone sleeps is such a good indicator of adrenal status.
  2. Adrenal nourishment/support is “lifestyle medicine,” not a fistful of supplements and a punishing diet overhaul (for most people, anyway).


I can’t claim to help people slay every stressor in their life, but with some pretty basic adrenal supportive lifestyle adaptations, you’ll feel more calm, grounded, and centered in a few short days—and your hair follicles will benefit greatly.

Go here for my Restore Your Adrenals guide—a 25-tenet guide on adrenal nourishment.

(I realize the some of you may have a version of this as a PDF document—it’s a free opt-in on my website, but the above link has a few updates, including a mention of an adaptogenic herb that supports hair growth!)

Please read the guide, but if you were to do only 5 things to support your adrenals, I highly recommend:

  1. Taking an adaptogenic herb: See suggestions in the guide.
  2. Balancing your blood sugar: THIS IS SO IMPORTANT. I believe this to be the single most important dietary factor in supporting the adrenals. And guess what? Insulin is also a short-cycle hormone; it’s regulated meal to meal. When you give attention to TWO short-cycle hormones (cortisol and insulin)? Amazing results.
  3. Having a regular breathing practice: See link to my favorite (and ridiculously easy) breath exercise in the guide.
  4. Sleeping: Circadian rhythm regulates nearly everything…including liver detoxification.
  5. Saying no to whatever drains you, to the extent that you can.

I need to add…B vitamins are not only hair-supportive, but they’re also nicknamed “the anti-stress vitamins.” You can read more about the role of micronutrients in follicle health/hair growth here.

In my work with my private coaching clients and Reversing Alopecia course participants, adrenal nourishment is ground zero. No one is a perfect hormonal specimen, but supporting the adrenals has a far-reaching and beneficial impact on the whole body (beyond what this post even covers!) and without it, other efforts, including clearing an infection, can be challenging.

What can you do to love your adrenals right now?

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If you’re interested in my Reversing Alopecia Homestudy course that’s going to be available for a short time, state of the art hormone testing is included. It will measure both cortisol as well as metabolized cortisol. If you’re not on my newsletter, look to the upper left of this post to sign up and stay abreast of the announcement about the homestudy. 

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Go here for my alopecia interview with Alopecia Life >

Go here for my alopecia interview with Rebuilding My Health >

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