It’s on your pillow, in the comb, in a ball on the bathroom floor. Your stylist noticed before you did. It’s been three months since your father’s burial, or since the job ended, or since the baby came, and now this.
Yes. A very stressful period, or an illness with a high fever, can make far more hair than usual fall out, usually starting a few months later. It’s called telogen effluvium, it’s temporary, and the hair normally grows back once the stress or illness has passed. Most hair loss has other causes, though, and one that’s especially common in women of African descent, hairstyles that pull too hard on the scalp, can be prevented. Our guide to stress in Nigeria covers stress itself. This piece is about your hair.
See a doctor first
Losing 50 to 100 hairs a day is normal, according to the NHS and the American Academy of Dermatology (AAD). More than that has many possible causes, some of which need treatment early to stop the loss becoming permanent. See a doctor, and ask about a dermatologist (a skin and hair specialist), if you have:
- round or patchy bald areas
- smooth, shiny skin where hair used to be, which can mean scarring
- a bald patch at the crown that’s growing outwards
- a scalp that burns, stings, itches, is sore, or has crusts or bumps
- broken hairs and a hairline that’s moving back
- hair coming out in clumps, or loss along with other new symptoms that worry you
- hair loss that started after a new medicine (talk to the doctor who prescribed it before changing anything)
Hair loss on its own isn’t an emergency. If you feel very unwell, or the stress behind it has brought thoughts of harming yourself, call 112 now, or 767 in Lagos, or Safe Place Nigeria on 0800 800 2000. The full list is on our helplines page.
Stress shedding: telogen effluvium
After a big shock to the body, far more hairs than usual can shed at once, a few months later. The AAD lists the triggers: a lot of stress (caring for a sick relative, a divorce, losing a job), a high fever or a hard illness, an operation, giving birth, and losing a lot of weight. In Nigeria, the illness might be a bad bout of malaria or typhoid with a high fever; our guide to whether stress can cause malaria explains why a fever always needs a test.
You see more hair than usual in the comb, in the shower, on the pillow or when you loosen braids. It starts a few months after the stressful event rather than during it, which is why the link is easy to miss. New mothers often notice it most: the AAD says shedding after childbirth tends to start about two months after the birth and peak around four months.
Shedding like this stops on its own. The AAD says that once the stress stops and the body readjusts, most people’s hair is back to its normal fullness within six to nine months. If the stress carries on, the shedding can carry on too, which is one more reason to deal with the stress itself.
Edges, braids and weaves: traction alopecia
Traction alopecia has nothing to do with stress on your mind. It’s hair loss from constant pulling on the scalp, and the AAD says it’s especially common in girls and women of African descent. Tight styles are common, and the AAD says the shape of African hair follicles makes the hair easier to damage. Styles that cause it when they’re too tight include:
- cornrows and all-back styles
- tight braids, and braids worn heavy and long
- locs
- tight buns, ponytails and up-dos
- weaves and extensions, especially on relaxed hair, and glued-on units
Head coverings worn every day can add to it, especially over hair pulled tight underneath.
The braider who says it has to hurt to look neat has it backwards. According to the AAD, if your hairstyle feels painful, it’s too tight. Change it straight away if you have pain, stinging, crusts or bumps on the scalp, or “tenting”, where the skin pulls up into little peaks. Watch your edges once a month for broken hairs, a hairline moving back, or thin patches where the hair is pulled hardest.
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Caught early, the damage can be stopped. Left too long, the follicles are destroyed, you’re left with smooth, shiny skin, and the hair can’t grow back. The AAD’s advice:
- loosen braids, especially around the hairline
- choose thicker braids and locs, and keep them shorter, since long hair is heavier
- take braids out after six to eight weeks
- take a weave out at once if it hurts or irritates your scalp, and choose sewn-in over glued
- rotate your styles and give your hair rest periods
- if you cover your hair, keep it loose underneath; silk or satin is gentler
The crown: CCCA
Hair loss that starts in the centre of the head and spreads outwards may be central centrifugal cicatricial alopecia (CCCA), a scarring type of hair loss that the AAD says is more common in Black women. The scalp may burn, sting or itch. This isn’t stress shedding, and the AAD says treatment started early can stop it spreading. If you have a bald patch at the crown, see a dermatologist soon. The AAD warns that a small patch tends to get larger without treatment, so don’t hide it under a wig and wait.
Pulling your own hair
Some people pull out their own hair, often without noticing, and often to relieve stress or tension. When it’s repeated and hard to stop, it’s a recognised condition called trichotillomania, and it’s treatable. Our guide to hair pulling and skin picking explains it and the therapy with evidence behind it.
Other causes worth ruling out
The commonest cause of hair loss worldwide is hereditary: male and female pattern hair loss, which runs in families. Hair also thins with age. Other causes the NHS and AAD list include iron deficiency, too little protein, thyroid problems, alopecia areata (where the immune system attacks hair follicles, often leaving round patches), scalp infections, some medicines, and hair damaged by colouring, perming or relaxing. The NHS says a doctor may be able to tell what’s causing your hair loss by looking at it, and advises seeing one before you spend money at a commercial hair clinic.
Can stress turn your hair grey?
Possibly, but the evidence in humans is thin.
- In mice, yes. A 2020 study in the journal Nature found that sudden stress turned mice grey by firing nerves in the skin that release noradrenaline, a stress chemical. That burned out the stem cells that make hair colour, and the greying was permanent.
- In people, maybe, a little. A 2021 study in the journal eLife tracked colour along single human hairs. It found that some grey hairs regained their colour, and that greying and its reversal could happen alongside stressful periods in people’s lives. The authors’ model suggested stress may push hairs that were close to going grey anyway over the line, and that some can come back when the stress eases.
Neither study shows that stress will turn a dark-haired 30-year-old grey. Greying is still mainly part of getting older.
When hair loss gets to you
The NHS says losing hair can be upsetting, and that for many people their hair is an important part of who they are. Thinning edges or a bald patch can follow you into every meeting and every family photo. If hair loss is affecting your mood or keeping you at home, that deserves attention in its own right, and the NHS says a doctor may be able to help you get counselling for it. A doctor treats the scalp. A therapist can help with what the hair loss is doing to you, and with the stress that may have started it. Therapists who work with self-esteem and emotional skills are on Mytherapist.ng, by video, voice or chat, and they work alongside your doctor, never instead of one. Our guide to stress in Nigeria is a good place to start on the stress.
Frequently asked questions
Can stress cause hair loss?
Yes. A very stressful event, an illness with a high fever, an operation or childbirth can cause heavy shedding, called telogen effluvium, that starts a few months later. It’s usually temporary.
Does hair grow back after stress hair loss?
Usually. The AAD says that once the stress stops, most people’s hair returns to its normal fullness within six to nine months. If the stress carries on, the shedding can too. See a doctor if it doesn’t settle.
Can stress cause grey hair?
In mice, sudden stress causes permanent greying. In people, one 2021 study found greying, and even some return of colour, tracking stressful periods, but the evidence is limited. Greying is still mainly part of getting older.
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Can braids cause hair loss?
Yes, if they’re too tight, too heavy or kept in too long. Constant pulling causes traction alopecia, which can become permanent. If a style hurts, it’s too tight.
When should I see a doctor about hair loss?
If you have bald patches, smooth shiny skin where hair was, a patch at the crown, a burning or itchy scalp, hair coming out in clumps, or you’re worried. Early treatment matters for scarring types of hair loss.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
