Rapid heart rate, sleeplessness, upset stomach—the effects that stress has on your insides gets a lot of well-deserved attention, but we often overlook how it can affect what you can actually see on the outside, including your hair and scalp. Think about it: Have you ever noticed more hair in your brush when you’re under pressure? Or that your scalp feels itchier and more sensitive? You may not have immediately made the connection, but what’s happening on top of your head can be a reflection of what’s happening in it.


What’s Happening: A major psychological or physical stress such as divorce, a death in the family, surgery or childbirth can have a powerful effect on your entire body, potentially causing hair to fall out in clumps. Even the hormonal changes that come with stopping or starting birth control pills may cause shedding. The temporary condition, called telogen effluvium, begins around the time of the trauma, and causes a large number of hair follicles to suddenly shift from the growing phase to the resting phase. (Usually only about 10 percent of follicles are resting at any one time, which is what causes you to normally lose 100 hairs per day.) Increased shedding begins immediately following the trauma, but you may not notice it until two to three weeks later. Telogen effluvium can last for two to six months, and it can take up to 18 months for your follicles to completely recover. Deficiencies in nutrients such as vitamins D and B, iron, zinc, magnesium, protein and essential fatty acids can exacerbate the problem, so doing your best to eat well and take care of yourself during times of stress is key.

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What You Can Do About It: The presence of an additional stressor can only worsen your case, so do what you can to keep your stress in check. Also give your body the time and patience it needs to heal. Even though it may seem as if you’re losing a lot of hair, most people suffering from telogen effluvium don’t typically develop a bald spot. Likewise, while your hair may seem thin now, the majority of people’s strands do return to normal in three to nine months. Until then, if you want to make your hair look fuller, use volumizing or thickening shampoos, conditioners and styling products. Also skip heavy conditioners and styling serums, which weigh strands down, and be gentle when caring for hair to avoid losing more strands. If you feel like more hair than you would expect is falling out, or you are losing it quickly, it is worth checking in with your doctor: Significant hair loss can sometimes signal an underlying condition, such as anemia, polycystic ovary syndrome and certain thyroid disorders.


What’s Happening: Whether you’ve been putting in long hours at the office for months, dealing with an ongoing personal crisis or are simply experiencing a rough few days, your stress amps up the production of certain hormones and releases pro-inflammatory chemicals that can compromise your scalp’s barrier function. That means it’s easier for moisture to escape, potentially leaving your hair and scalp drier, and for irritants to get in and cause stinging, tingling and itching. Once this happens, even hair care products that may not have bothered you before may now cause an uncomfortable reaction.

What You Can Do About It: Wash your hair less frequently in order to allow hair’s natural oils to build up and moisturize your scalp. When you do shampoo, use gentle products, such as baby formulas and those specifically formulated for people with sensitive skin. Look for labels that say “fragrance-free” (perfumes are a common irritant) and “hypoallergenic,” and avoid those with sodium lauryl sulfate, a harsh detergent that many find irritating. Also always use conditioner, which will help replenish and hydrate your scalp. You might even try a deep conditioning or hot oil treatment to soothe your scalp.


What’s Happening: Eczema is a common effect of stress that shows up on your scalp. It usually looks like a red, itchy, scaly rash. With psoriasis, people typically show patches of hardened plaque with fine or thick silvery-white scales that can itch, bleed or flake. At least half of all those with the latter condition get it on their scalp. Both conditions are hereditary, but stress commonly triggers or exacerbates symptoms. Because stress slows down skin healing, disrupts skin’s barrier function and creates an inflammation-friendly environment, the itching and dryness that accompanies eczema can become worse. Meanwhile, psoriasis, an autoimmune disorder, likely flares up thanks to stress’ ability to upset your body’s hormonal balance and normal immune response.

What You Can Do About It: Consult your dermatologist. He or she may recommend over-the-counter or prescription anti-inflammatory or antihistamine ointments to soothe symptoms of eczema until your stress levels have come down. You can treat mild cases of psoriasis with medicated shampoos and other products containing salicylic acid, which help to slough off excess cells that build up and cause scaling. Severe cases, however, need more potent prescription medications, so talking to your doctor is important. Avoid scratching or picking at your scalp, and be gentle when shampooing, towel drying and brushing or combing your hair. If you still don’t see an improvement, you may consider consulting a nutritionist. Psoriasis and eczema can be caused by certain food allergies or sensitivities (such as gluten intolerance), an imbalance in the healthy bacteria in your gut or deficiencies in nutrients such as essential fatty acids.

Remember, the best way to address these symptoms is to manage your stress and what’s causing it; exercise, yoga and meditation can all help, too. But while you may be able to cross a few to-dos off your list or put a work deadline behind you, it’s true that other stressors—like dealing with a loss—can linger. If your best efforts for stress management still leave you feeling burdened, you might also consider speaking with a therapist. Talking to someone about your stressors and reactions to them can help you devise additional strategies for getting to a better place.