Relationship Between Alopecia, Chronic Stress, and Changes in the Hypothalamic-Pituitary-Adrenal Axis: An Integrative Literature Review
February 2026
in “
Brazilian Journal of Implantology and Health Sciences
”
alopecia chronic stress hypothalamic-pituitary-adrenal axis HPA axis anagen phase telogen phase telogen effluvium cortisol hair follicles hyaluronic acid proteoglycans oxidative stress inflammatory events hair loss stress-induced hair loss growth phase resting phase non-scarring alopecia stress hormone skin components
Studysummary This integrative literature review revealed that chronic stress, characterized by elevated cortisol levels, negatively impacts hair follicle integrity and contributes to alopecia by promoting the premature transition from the growth phase to the resting phase of the hair cycle.
Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer
This integrative literature review examines the relationship between alopecia, chronic stress, and changes in the hypothalamic-pituitary-adrenal (HPA) axis. It highlights that chronic stress can prematurely shift hair from the growth phase (anagen) to the resting phase (telogen), leading to telogen effluvium, a common form of non-scarring alopecia. Elevated cortisol levels, associated with stress, negatively impact hair follicles by reducing the synthesis and accelerating the degradation of crucial structural components like hyaluronic acid and proteoglycans. The review analyzed 67 articles, ultimately focusing on 10 relevant studies, and found that both internal and external stressors, along with oxidative stress and inflammatory events, significantly contribute to hair loss. Cortisol is identified as a central mediator in stress-induced alopecia, promoting the anagen-to-telogen transition and compromising follicular integrity.
