Amita is a 3-year engineering student. She is dealing with a lot of pressure currently in her life, the grades, focus on self-development, pressure of placements, etc., etc. She has been a strong person in her life and is trying to handle all of it. However, one thing that surprises her is that all of a sudden she has started experiencing hair fall. She has always been proud of her hair, which she loved colouring in different colours, but now she is even fearful of trying a different shampoo.
Many people like Amita are facing a serious issue of hair loss, and for them, the impact is internal. The change is not just physical but also psychological, with a shift in self-image. The relationship is a complex, bidirectional cycle: high levels of stress can trigger physiological changes leading to hairfall, while the thinning cause change in appearance leads to emotional distress.
What are the Causes of hair loss?
Various factors like rest, diet, exercise, sunlight, mental health, physiological health, environment and social circle affect the skin and hair health. Disbalance in any factor can lead to poor hair health.
1. The biological reason
When an individual experiences a stressful situation, the body releases the stress hormone – cortisol. When a stressful situation is extended for a long time, the body maintains a high level of cortisol for a long time in order to cope with stress; however, it harms the body in many ways. Cortisol causes cells of the hair follicle into resting phase, leading to a condition known as Telogen Effluvium.
This leads to hair fall months after the stressful situation. Similarly, stress also suppressed the GAS6 protein present in the dermal papilla, preventing stem cells from regenerating hair. (Choi, Zhang, & Ma, S. et al. ; 2021). Research published in the Journal of Drugs in Dermatology showed that high cortisol levels reduce the synthesis of skin elements (mainly hyaluronan and proteoglycans) by 40%, hence indirectly affecting the skin and hair health. (Thom; 2016, Thom; 2024)
2. The psychological effects
The hairfall mainly occurs after 2 – 4 months of the stressful period, people are not able to make the connection between the cause and effect, hence end up feeling anxious about the hairfall. Also, the hairfall causes stress and anxiety, affecting and individuals mental well-being. A Recent meta-analyses (2025) studied 5,553 patients with alopecia; the results found that nearly 47% of individuals with alopecia meet the criteria for a clinical anxiety disorder.
3. The feedback loop
Stress is a common event in modern life. Individuals get stressed about their career, their performance, their relationships, etc. This is stress over time affects physiological health and causes hair fall; however, the hair fall itself challenges the self-image of an individual and changes their perception about themselves, causing them to stress and feel anxious. This overtime can form a cycle that becomes difficult to break. Especially younger individuals who are prone to hair fall due to genetics or poor life choices, enter this loop after the hair fall.
Stress often causes individuals to skip meals, exercise and avoid company, affecting their mental and physical health. Also, research shows that individuals under stress often tend to be more prone to unhealthy habits like junk food, excessive sugar, smoking or alcohol, which often contribute to hair loss.
Read More: The Meaning of Self-Image for Girls
How does hair loss affect the self-image of an individual?
Hair has always been more than just a body part. It is a function of one’s identity, a reflection of who they are. It is also a communicator of culture, social and professional status, upbringing and mood. Many people feel good and confident when their hair looks good – a study conducted in 2025 found that the days the hair didn’t look good were commonly described as bad hair days by participants. Individuals reported higher levels of insecurity as well as a decreased sense of perceived worth.
Hair acts as a symbol of culture, gender and youth
For many, female hair is a symbol of feminine energy. Studies in past have shown that women equate hair quality with their attractiveness and social visibility. In many cultures have long, thick and healthy hair determines the status of the individual and their family. In some cultures, it is also seen as a symbol of economic status.
For males, a headful of hair is often a symbol of youth and health. Issues like balding or premature greying of hair have often been correlated with midlife crisis. People with groomed or polished hair are often unconsciously attributed with other positive traits like health, competence and discipline. (Newton-Fenner, Hirst, Jones, Scott, Roberts, Smeets, Shen, Thomas, & Giesbrecht, 2025).
Hair acts as a toolkit for one’s identity
For many people, changing their hairstyle feels like clicking the reset button; it makes them feel like they are a new person. A study conducted in 2025 found that hair acts as a primary signal that directly influences how the individual is perceived in society and by others, playing a key role in identity transformation. (Vince, 2025). It can be concluded that hair is a primary medium for self-expression and autonomy. (Vince, 2025). Hair loss often acts as fuel to the fire of body dysmorphia. People with hair and body-related insecurities often spend excessive time, money and cognitive energy worrying about how they look under certain lights.
Recent findings show that psychiatric disorders often contribute to hair loss, while hair loss may lead to psychological symptoms such as anxiety, depression, and body dysmorphic disorder. A 2025 research show that individuals with pattern hair loss showed more symptoms of body dysmorphic disorder as compared to the control sample, and they even showed higher symptoms of social withdrawal. (Zhang, Kong & Shang, 2025)
How can one improve their mental health with the aim to improve hairfall?
Simple habits like healthy food habits, exercise and support can help reduce hair fall. Along with these medical interventions, in the past, have shown to help reduce stress. There have been proven studies about treatments like Minoxidil and Finasteride in reducing hair fall and regenerating hair follicles. However, managing emotional health is as important as medical treatments.
1. Management of Stress
Stress management techniques like yoga, meditation, workout, and mindfulness have shown to control the level of cortisol in the body, hence indirectly controlling the hairfall.
Read More: Mindfulness Meditation has a Positive Effect on Mental Health
2. Integration of CBT and mindfulness
A study on Integrative Cognitive Behavioural Therapy (CBT) showed that patients who underwent psychological counselling saw their anxiety scores drop from severe to mild/moderate within months. (2025). This could help improve the viability of the hair follicle, improving hair health. Similarly, research found that MBCT specifically reduced social anxiety in people with patchy hair loss (mainly alopecia areata). Those who practised mindfulness regularly reported being comparatively less hypervigilant. (Heapy, Norman, Cockayne, & S. et al, 2023).
Read More: Strategies for Managing Social Anxiety
3. Social Support Groups
Forming social support groups might help reduce the feeling of loneliness and shame. This often helps reduce social anxiety. Loss of hair at an early age can create social phobia – A current study of patients of Alopecia found that 98% of adolescents and 80% of adults reported a “very large” to “extremely large” impact on their daily life. (Hanson, Vañó-Galván, Messenger, Tran, Napatalung, Davis, Esterberg, & Law; 2025) Various other strategies, like cognitive restructuring, focus on shifting focus from loss to appreciating the current attributes. It mainly focuses on changing the perspective.
Conclusion
In the end, hair is much more than just a physical feature; it forms a crucial part of one’s identity. Scientific research shows that the scalp and the mind are constantly communicating biologically. While stress and cortisol can interfere with hair growth, understanding this connection is the first step in getting better. Long-term recovery involves looking at both the physical health and the emotions that come with losing hair. Individual needs to reduce the mental burden of self-criticism to accept themselves, truly love themselves, and be confident in who they are.
FAQs
1. Does one need therapy for hair fall?
It is not a major requirement for controlling hair fall, however, it might help in making a mild improvement over the maintenance of basic good habits like a clean diet, regular exercise, meditation and maintaininga supportive social circle. If an individual is suffering from chronic stress, then therapy might help them control their stress, which in turn may reduce hairfall.
2. Is it possible that one’s genetics are responsible for hairfall?
Yes, in case of male pattern baldness, genetics plays an important role whic,h however, can be increased if one is under stress for a prolonged period of time.
References +
Choi, S., Zhang, B., Ma, S. et al. Corticosterone inhibits GAS6 to govern hair follicle stem-cell quiescence. Nature 592, 428–432 (2021). https://doi.org/10.1038/s41586-021-03417-2
Heapy, C., Norman, P., Cockayne, S. et al.(2023). The effectiveness of mindfulness-based cognitive therapy for social anxiety symptoms in people living with alopecia areata: a single-group case-series design. Behavioural and Cognitive Psychotherapy, 51 (5). pp. 381-395. ISSN 1352-4658
Hanson KA, Vañó-Galván S, Messenger A, Tran H, Napatalung L, Davis KL, Esterberg L, Law EH. Comparison of Dermatology Life Quality Index Scores in Adults and Adolescents with Alopecia
Areata. Dermatol Ther (Heidelb). 2025 Jun;15(6):1543-1553. doi: 10.1007/s13555-025-01417-y. Epub 2025 Apr 24. PMID: 40272705; PMCID: PMC12092309.
Vince, M. Haircut as a Catalyst for Identity Transformation and Social Perception: A Multidimensional Review. Preprints 2025, 2025070508. https://doi.org/10.20944/preprints202507.0508.v1.
Newton-Fenner A, Hirst WM, Jones T, Scott M, Roberts C, Smeets MAM, Shen J, Thomas A, Giesbrecht T. Development of the Hair & Scalp CARE questionnaire: Measuring the impact of hair and scalp issues on psychological wellbeing in healthy populations. Int J Cosmet Sci. 2025 Oct;47(5):807-819. doi: 10.1111/ics.13070. Epub 2025 Apr 22. PMID: 40259785; PMCID: PMC12489877.
Dhami L. Psychology of Hair Loss Patients and Importance of Counselling. Indian J Plast Surg. 2021 Dec 31;54(4):411-415. doi: 10.1055/s-0041-1741037. PMID: 34984078; PMCID: PMC8719979.
Montgomery K, White C, Thompson A. A mixed methods survey of social anxiety, anxiety, depression and wig use in alopecia. BMJ Open. 2017 May 4;7(4):e015468. doi: 10.1136/bmjopen-2016-015468. PMID: 28473521; PMCID: PMC5566602.https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2025.1705957/full?hl=te-IN
