(Illustration by Rob Vargas)

Getting so stressed your hair falls out doesn't just happen in movies, and that’s just the beginning. Stress, which can come about in a hundred different ways, can take a severe toll on your entire body. And in terms of the superficial stuff, stress can greatly impact your appearance. From gray hair to stress acne, the list is long.

For the most common ways that stress can impact your skin and hair, we spoke with Dr. Ryan Turner of Turner Dermatology in NYC. Before diving into that list, though, it’s important to define the stress itself. Because “stress” isn’t simply referring to a bad day at work, a fight with a partner or friend, or missing your commuter train. Stress is all encompassing. Even being poorly rested registers as stress on the body.

“[Things like] emotional stress, chronic illness, poor dietary habits, working long hours, and excess alcohol can cause stress on the body. When the body is stressed, different types of hormone signals are released to help the mind and body cope.” You may have heard of these hormones: Things like adrenaline, cortisol, and norepinephrine. This shift in hormones (not to mention the possible exhaustion of it all) start to take a toll on your body, including your appearance. Here’s how.

How Stress Affects Your Hair

1. “Shock Loss”, aka Telogen Effluvium

If you notice sudden, large amounts of hair loss, then it could be stress-induced. You have to be able to distinguish it from your regular loss patterns; perhaps you’re used to seeing one or two hairs in the sink after a shower and toweling-off, but suddenly you see 5 or 10 at a time, every time. Assuming it’s not male-pattern hair loss (androgenetic alopecia), it might be telogen effluvium, says Turner.

“We have seen a lot of telogen effluvium during the pandemic due to psychological stress and due to actual COVID infection itself,” he says. What it does is send the hair follicle into a brand new growth cycle, which must be preceded by shedding the existing hair. The good news is that those hairs fallen to this “shock loss” can and likely will grow back. “Telogen effluvium typically recovers a few months after the stressor has passed but it can be dramatic with rapid shedding,” he says.

Turner adds that stress may be a small contributor to male-pattern loss, but your individual genetic hair loss is going to happen inevitably anyway.

2. Alopecia Areata

Telogen effluvium isn’t the only kind of stress-induced hair loss. Alopecia areata is another: “They are typically circular patches of hair loss of the scalp or beard,” Turner says. With alopecia areata, the immune system attacks the designated hair follicles. “This is often reversible with the removal of the stressor or with treatment by your dermatologist.” (Which is often a steroid injection, alongside regular minoxidil usage—but the doctor will advise what’s best in your case.)

3. Premature Grays

All those late nights at the office can start to take their toll, one strand at a time: Stress can also cause hair to gray prematurely. “Through a complex signaling pathway, stress hormones (most notably norepinephrine) may lead to the depletion of the melanocytes (pigment-producing cells) around the hair follicle,” Turner says. That’s a fancy way of saying, your hair can lose its pigment faster if you press your luck!

How Stress Affects Skin

1. Acne and Increased Oil Production

The cortisol and adrenaline surging through your stressed-out veins can trigger a sudden increase in oil production in your skin. That yields a far greater chance of a breakout or 12. But that’s not the only reason behind the increase in blemishes: “The skin microbiome which contains the ‘good bacteria’ is also weakened, allowing it to be overrun with [bad] acne bacteria,” Turner explains. Time to step up your anti-acne skincare regimen, and maybe some probiotics, too.

2. Hindered Healing

“Stress hormones, largely cortisol, can slow skin’s own healing process by interfering with natural repair mechanisms,” Turner says. “Stress can also negatively impact the production of collagen in the skin.” And it’s this collagen that keeps skin resilient and firm—not to mention, its production in the body already decreases significantly as we age. So you need all the collagen you can get, and that stress is doing zero favors.

3. Hyperpigmentation

Whenever you have a darkened spot or patch on the skin—one that refuses to go away, aside from moles—then you’re likely dealing with hyperpigmentation. It is most commonly caused by excessive sun exposure, but a good ole hormonal imbalance will kick things into high gear, too. (Hyperpigmentation also increases as we age.) But it’s not just the body’s internal stress that can cause it, says Turner. Instead, look at the environment around you: “Environmental stressors such as air pollution and cigarette smoke can lead to free radical formation causing ‘oxidative stress’ on the skin,” he explains. “This can in turn lead to discoloration of the skin.”

4. Dull, Dry Skin

By weakening the skin’s moisture barrier functions and weakening its microbiome, stress can significantly dehydrate the skin. Turner adds that this can lead to skin that is not only dry and rough in texture, but that looks dull, sunken, sullen, and so forth.