1. ^*Department of Dermatology, University Hospital Hamburg-Eppendorf, University of Hamburg, Hamburg, Germany
2. ^†Department of Internal Medicine, Charité, Berlin, Germany

Correspondence: MD Ralf Paus, Department of Dermatology, University Hospital Hamburg-Eppendorf, Martinistr. 52, 20246 Hamburg, Germany Email: paus@uke.uni-hamburg.de

Received 31 May 2003; Revised 25 November 2003; Accepted 4 February 2004; Published online 6 August 2004.

Abstract

Hair loss, as it occurs with telogen effluvium and androgenetic alopecia, provokes anxieties and distress more profound than its objective severity would appear to justify. This reflects the profound symbolic and psychosocial importance of hair. Stress has long been implicated as one of the causal factors involved in hair loss. Recently, in vivo studies in mice have substantiated the long-held popular belief that stress can exert profound hair growth-inhibitory catagen-inducing and hair-damaging pro-inflammatory effects. Insights into the negative impact of stress on hair growth and the integration of stress-coping strategies into the management of hair loss disorders as well as the development of new pharmacotherapeutic strategies might lead to enhanced therapeutic modalities with the alleviation of clinical symptoms as well as the concomitant psychological implications.