Can ptsd make hair fall out?

Hair loss and Post-Traumatic Stress Disorder (PTSD) can go hand in hand, so it pays to know what to say to a client who might be experiencing both. We spoke to Trichologist and Co-Founder of Root Cause Clinical, Wil Fleeson, and got some insights from psychotherapist Andy Griffith, who owns Piece of Mind, to find out more on the topic. Andy Griffith is a psychotherapist that specialises in the treatment of anxiety, trauma and depression all of which has a similar impact on our physiology and psychology. His practice, Piece of Mind, has extensive experience of working with complex trauma and PTSD that can result from childhood issues, illness, assault and accidents. As it's an issue that should be treated with sensitivity and caution, it's always best to refer patients to a trichologist or psychologist if they are dealing with PTSD and associated hair loss. HJ: Are you seeing an increase in clients who have PTSD and are experiencing hair loss? Andy Griffith: My practice has never been busier with clients struggling with the daily impact of PTSD. As a generation that have lived through the global trauma of COVID the prevalence of trauma and PTSD is at an all time high. PTSD very often has a delayed fused and it can be months or even years before the physical manifestations of trauma kick in. The cumulative effects can lead to symptoms like hair loss. This happens because PTSD has you trapped in 'fight or flight’ mode and as a result of this the body is flooded with stress hormones. For some people, this can lead to hair loss months or even years after the traumatic event(s). During stress and trauma, the “fight or flight” response activates the release of - epinephrine which increases our heart rate so we can move faster. Norepinephrine sends blood to our large muscle groups and the lungs. Cortisol is released, which over time suppresses the immune system.  As our emotions intensify and the limbic system springs into action, the executive functioning of the brain decreases, and our reptilian brain takes over. In this heightened survival state some functions such as skin repair and hair growth that are deemed non-essential are placed on hold. What can you recommend to a client who is experiencing this type of hair loss? Clients that seek trauma therapy will find that once balance has been restored in the mind, body hair growth will return to its natural state. We often work with practitioners such as Root Cause Clinical who can focus on the physiological part of the jigsaw.   Wil Fleeson is a qualified trichologist that treats hair loss and scalp health conditions. He is the co-founder of a teleheath concept, Root Cause Clinical, that offers video consultations followed by a detailed consultation report. A person-centred approach allows clients to be supported with a personalised treatment plan. HJ: Are you seeing an increase in clients who are experiencing hair loss and have experienced PTSD? Wil Fleeson: The best way to answer this question would be to say that I am not necessarily seeing an increase in clients who are experiencing hair loss and have PTSD, but that I am seeing clients who are experiencing hair loss that has been triggered by PTSD. This can affect people at any age, and we have worked with teenagers right through to elderly clients. What can you recommend to a client who is experiencing this type of hair loss? The most effective approach for hair loss triggered by PTSD is a holistic one. For example, working in conjunction with a mental health specialist who can assist in unpicking the trigger for the hair loss, while a treatment pathway is developed to alleviate and improve the hair loss. This recommended treatment can only be developed after a formal diagnosis from a qualified trichologist or dermatologist. Why can hair loss be a response to PTSD?  Most commonly, the hair loss response to PTSD that we see is the condition Telogen Effluvium (TE). TE is when the natural growing and shedding phases of a hair follicle are knocked out of their natural rhythm which in turn create a percentage of follicles within a growing phase being prematurely triggered into the shedding phase. The normal percentage of our hair follicles that would be in a shedding phase would be between 5% and 10%, and with PTSD this can convey to as many as 30% of our hair follicles being triggered into a premature shedding phase with an onset of TE. The stress hormone cortisol is thought to be one of the triggers for TE and this reaction would be seen as a side effect to PTSD. Why is it often that hair loss happens months after a traumatic event, rather than during it? Hair loss such as Telogen Effluvium can happen months after a traumatic event.  This is because the hair follicles natural cycle of hair growth. There is a two-to-three-month window between the old growing phase and the follicle then resting for this period of time before beginning a new growing phase. How can you tell if clients are experiencing hair loss or hair damage? The way to tell between a hair that has been shed from the scalp or a hair that has broken off through damage is whether the hair has a little bump that you can feel on one end of the length of hair. This little bump is known as a telogen bulb, and it is that part of the hair that is connected to the dermal papilla which is in the base of the hair follicle. When the hair is being naturally released from the follicle the telogen bulb hardens when it naturally disconnects from the dermal papilla, and sometimes this little bump on the hair can have a white coloured appearance to it. If the hair was a broken hair through damage it would have a shattered, splintered appearance at one end of the hair length. This is where the hair would has snapped and broken away, leaving the part of the hair looking like it had split.   In conclusion, hair loss is hard for a client to deal with at any time of their life, and especially if they've experienced trauma as well, so compassion and clarity is essential. Often it won't be one product, lifestyle change or therapy that works. If you don't have the expertise to help with hair loss (particularly Telogen Effluvium), then refer your client to an expert Trichologist and/or psychotherapist.