It’s likely that most of us have at some point since the pandemic began been tearing our hair out. As it turns out, the phrase that weaves stress, anxiety and hair loss together is alarmingly accurate.

We’re used to hearing of the brain fog and fatigue that plague many Covid sufferers post-infection, but hair loss is another, less well-known, symptom. Known as “telogen effluvium” it is associated with shock and sees the growing phase of hair switch abruptly to shedding. Fever can instigate this phase in the months that follow it, but stress also plays its part. Stress has been typically driven during Covid by fear, confusion, redundancy, and bereavement.

Looking for clues on how to kerb hair-shedding Stephanie Drax, the founder of Leapfrog, spoke to Dr Simmy Kaur, a GP with a special interest in wellness, dermatology, and mental health. Dr Simmy is also a scalp and hair expert and the resident GP for hair care brand Monpure London.

Hair shedding appears to be one of the tangible ways you can see that you’re affected by stress. Can you explain more about the connection between stress and the scalp?

Yes, as GPs we’ve seen a significant rise in the amount of people that are contacting us with regards to stress, hair thinning, and hair loss. Sadly, there is a direct link between stress and hair loss. When our bodies are in a stressful state this can cause telogen effluvium hair loss. If there’s any stress on the body – whether that be emotional stress or if you have just gone through a significant life event or operation or if you have a significant health condition – it can cause telogen effluvium. Most people will experience a significant amount of hair loss a couple of months after the stressful situation. Though we would expect 50-100 hairs to be loss on a normal hair-loss day, it’s abnormal when you’re losing a lot more than that. In telogen effluvium, you tend to lose a lot of hair all at once, approximately three months later because that’s how long a hair-loss cycle is. We’ve been seeing this with a lot of patients with COVID-19. The good thing about telogen effluvium is that the hair does eventually grow back, so it’s not permanent. Usually, it will take 6 months for the hair to grow back.

What can we do to encourage the regrowth?

When you sleep the cells regenerate, and if that’s not happening then that will have a direct impact on your skin, hair and texture of hair. The science is very simple: when we sleep, we produce melatonin, which is a hormone that will regulate our circadian rhythms which is our body clock. This melatonin will have a direct impact on the stem cells within the hair follicles. If you’re not getting that sleep and you’re not getting that melatonin in the same abundant way as before, then of course this is going to have a direct impact on your skin and your scalp.

There are other hormones that play a part too. If you’re stressed, this will cause a rise in cortisol, the stress hormone and this all has a direct impact on the way our body will function. When it comes to the scalp, the first symptoms are dryness, irritation, inflammation, and gradually as time goes on unfortunately it can lead to hair loss and change of texture. In the same way that the skin on your face ages, the same thing happens to your scalp. That’s why it’s so important to treat it the same way.

A lot of us use our cortisol to meet deadlines and to spin all the plates and it becomes a chronic situation that can inhibit your body from performing its most basic functions. It also impedes the hair follicles from growth…

Exactly, that’s why I think it’s so important to look after your body, to get enough sleep, to practice mindfulness if you can, make sure you exercise, make sure you eat well and give your body everything it needs in the first place. That’s why your Leapfrog comes in really handy! The formula is an incredible, innovative combination for an immune support supplement – I love that it combines Vitamin C with Zinc and Lactoferrin.

And zinc is required for hair regrowth! Out of the four fundamental pillars that we regularly mention at Leapfrog to keep ourselves healthy – sleep, nutrition, exercise, and stress management techniques – our number one at Leapfrog HQ is sleep. Looking at all the evidence, it all starts with sleep.

Exactly, and I always say to friends, family, and patients, sleep can have a knock-on effect on everything. If you feel something’s not quite right, then my advice would be to definitely go and see your GP.

What can we do for our scalp that doesn’t cost anything that can make a difference?

My key thing is scalp massage and stimulation. We’ve been doing this for years with the skin, with things like Gua Sha. At Monpure, we really encourage massaging the hair to get the blood moving, and we do a great Jade comb. We also do dry body-brushing, and the stimulation will get everything moving.

How often should we be massaging our scalp?

A great way to get this into your routine is in the morning. Whether that be in your morning shower or when you’re doing your morning meditation.

Which tool is the best?

Well, Jade has been used for centuries for its healing purposes and circulation. But equally, using your fingers is just as good.

Should we be avoiding towel-drying?

Yes, the mechanical action can trigger hair to fall out if you do it vigorously.

Losing hair is so important to how we feel, and for me, it started happening after I gave birth and I was breastfeeding. I feel like it has never got back to my pre-pregnancy hair. Is this normal?

This is very common. During pregnancy there is a rise in oestrogen – I call oestrogen a hair-friendly hormone. When you have an abundance of oestrogen, the hair follicles thrive, and the added oestrogen increases the time that our hair stays in the hair-growing phase. What happens after you give birth is that those levels quickly come down and there’s a significant stress on the body during childbirth, and hence the hair loss. We try and normalise this at Monpure, as it’s a completely normal process in life. It can affect your confidence, your emotionality. If you’re struggling, go and see your GP and ask for help.

This takes us onto the next big phase, menopause. Presumably, you must lose even more hair. Is there a chance you get luscious hair again?

You’re exactly right, there’s a loss of oestrogen and this can lead to female pattern hair loss. There is a specific pathway that can lead to this. What happens is that when you go through menopause, your levels of testosterone can go up, which is converted into a chemical called DHT which is the chemical that leads to hair loss. This is helped by an enzyme called 5-alpha reductase. You’ll find that most hair-loss remedies and medications will act on that enzyme.

So, if you take HRT, does that hair go back?

It’s not licensed for that purpose, so you need to weigh up the risks and the benefits. The only time we really give women HRT is if women are suffering from vasomotor menopausal symptoms such as sweating or mood swings. Women do, however, report that there can sometimes be an improvement in the hair. So, on an anecdotal level, yes we do see that.

Where do you start to see hair loss?

Female pattern hair loss is basically the same pattern as male pattern baldness. It tends to be around the hairline and the crown. The first, most noticeable places are an increase in the parting and a reclining of the hairline.

Before we get onto Monpure, I want to talk about the no-shampoo revolution. I’ve tried apple cider vinegar, and it seems to cleanse my hair. Can you talk about whether regular shampoo strips our hair of our oils?

Ideally, you should be washing your hair every 2-3 days, twice a week if you can. That gives the hair time to rejuvenate itself and it gives your hair follicles a chance to release sebum to nourish the hair. When we wash our hair too often, our sebum may over-produce, which can lead to greasy hair.

With the no-shampoo method, some of my friends have done it, and over time it will balance itself out. In general, the fewer shampoos you do the better and make sure you use great products.

Let’s talk about regular shampoo. Can you talk us through the roll-call of things we should avoid?

We should be avoiding sulphates, parabens, and silicones because they strip the ability of your scalp to nourish itself. Typical, lower-range products seem to be of poorer quality.

Let’s talk about the Monpure range. It’s quite a new brand that has products that are specifically designed to treat scalp issues. What’s in the range and what’s it doing for us?

All of Monpure’s products are vegan, sulphate-free, paraben-free and silicone-free. They use ingredients that “traditional” shampoos wouldn’t use, such as silk peptides and argan oil. The products are really clean and it’s all about scalp health rather than just focusing on the hair, as our scalp is an extension of our skin so we should be treating it like that.

I say to people, use the products in the exact same way we treat our face: we exfoliate, we cleanse, we moisturise.

I adore the scalp scrub, which contains biodegradable jojoba beads. The other thing we have is the follicle dense serum as it contains AHA acids and retinol, which is great for resurfacing, and pumpkin seed extract which is clinically proven to help post-menopausal hair loss.

How often do you use the products?

It totally depends on your body, but I tend to use the serum 2-3 times a week and the scalp once a week. The shampoo contains silk peptides which is great for nourishing and argan oil. They’re all-natural and scientifically proven. Depending on what you want, I would shampoo, then condition, then exfoliate, and use the serum afterwards. The other thing you can do is use the scalp mask.

So: last words for avoiding hair loss in future?

Treat your scalp like you treat your skin and get in plenty of sleep!

Watch Leapfrog founder Stephanie Drax interview Dr Simmy Kaur here.