Can elevated cortisol levels cause hair loss?

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Last updated: June 10, 2025View editorial policy

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From the Guidelines

Yes, elevated cortisol levels can cause hair loss. Cortisol, the primary stress hormone, can disrupt the normal hair growth cycle when chronically elevated. This disruption typically pushes hair follicles prematurely from the growth phase (anagen) into the resting phase (telogen), leading to a condition called telogen effluvium where increased hair shedding occurs. Additionally, high cortisol can increase sebum production, potentially causing scalp issues that further compromise hair health. Cortisol elevation may also trigger or worsen androgenetic alopecia (pattern baldness) in genetically predisposed individuals by affecting hormone balance. Managing stress through techniques like meditation, regular exercise, and adequate sleep can help normalize cortisol levels. In cases of medical conditions causing high cortisol, such as Cushing's syndrome, treating the underlying condition is essential, as suggested by the latest guidelines 1. Hair loss from cortisol elevation is often reversible once hormone levels return to normal, though this may take several months as the hair growth cycle gradually reestablishes itself.

Some key points to consider:

  • Elevated cortisol levels can lead to hair loss by disrupting the normal hair growth cycle and increasing sebum production.
  • Managing stress and treating underlying medical conditions can help normalize cortisol levels and prevent hair loss.
  • Hair loss due to cortisol elevation is often reversible, but may take several months to recover.
  • The latest guidelines suggest treating the underlying condition, such as Cushing's syndrome, to manage elevated cortisol levels 1.
  • Medical therapies, such as metyrapone or ketoconazole, can be used to reduce cortisol levels, but have limited roles in long-term treatment and can have adverse effects 1.

It's essential to prioritize managing stress and treating underlying medical conditions to prevent hair loss caused by elevated cortisol levels. Treating the underlying condition and managing stress are crucial in preventing and reversing hair loss due to cortisol elevation.

From the Research

Elevated Cortisol Levels and Hair Loss

  • Elevated cortisol levels have been linked to hair loss, as cortisol can affect the function and cyclic regulation of the hair follicle 2.
  • When cortisol is present at high levels, it can reduce the synthesis and accelerate the degradation of important skin elements, such as hyaluronan and proteoglycans, which can lead to hair growth disruption 2.
  • Studies have shown that chronically elevated cortisol levels can contribute to the onset of various health conditions, including cardiovascular diseases and risk factors, but the direct link to hair loss is still being researched 3, 4, 5.

Hair Cortisol Concentrations and Health

  • Hair cortisol concentrations (HCC) have been used as a biomarker for chronic stress, capturing information about cumulative cortisol levels over several months 3, 4, 5.
  • Higher HCC levels have been associated with various health conditions, including cardiovascular diseases, type 2 diabetes, and hypertension, but the relationship between HCC and hair loss is not fully understood 3, 4, 5.

Treatment of Hair Loss

  • Some studies have explored the use of oral supplementation with bioavailable proteoglycans as a potential treatment for stress-related hair growth disorders 2.
  • Other treatments, such as systemic methotrexate and corticosteroids, and topical minoxidil, have shown promising results in treating alopecia universalis, a severe form of hair loss 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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