Inflammatory Cytokines & Hair Loss: What You Should Know

By: Lauren Wilson | Jun 08, 2022

Stress, inflammation and our body’s natural state of balance are intimately connected. Inflammatory cytokines are a family of proteins that our bodies use to regulate our stress response and immune function, but what do they have to do with hair loss?

Keep reading to understand the connection between cytokines and hair loss as well as your general health and wellness. Plus, find out what you should be doing to support holistic hair health from the inside out.

What Are Cytokines?

Cytokines are a large and complex family of proteins that are important for communication between cells and for guiding cell activity. You can think of cytokines as a large family tree with many sub-groups within it, including chemokines, interferons, interleukins, lymphokines, and tumor necrosis factor, for example. Cytokines are important for the production and development of blood cells and in the functioning of our innate and adaptive immune responses:

Innate immunity refers to our body's first line of immune defense, in which our body detects an outside threat, which it then communicates to the adaptive system. Innate immune cells release cytokines that tell our adaptive immunity to activate when the innate system can't mount its own sufficient response.
Adaptive immunity refers to the body's second, more specific line of defense, in which the cells recruited by cytokines (including T-cells and additional cytokines) destroy the outside pathogen.

Inflammatory Cytokines

One important function of cytokines is mediating our inflammatory response—our body's immune response to perceived harm. When it functions properly, inflammation helps our body protect itself against disease, illness or injury.

To regulate inflammation in the body, we have both inflammatory (or proinflammatory) and anti-inflammatory cells that work together to respond to issues like illness or injury. Cytokines work to dial up our inflammatory immune response when needed and dial it back down when it's not necessary. Research has shed light on cytokines' involvement in a wide variety of diseases and illnesses, including, among many others:

Asthma
Cancer
Arthritis
Multiple sclerosis (MS)
Alzheimer’s disease
Autoimmune disorders, including the hair loss condition alopecia areata (AA)

Recently, more research has focused on understanding the broader impacts of cytokine imbalance in the body. Understanding the implications of cytokine imbalance beyond targeted responses to disease and illness might also help us understand how inflammation impacts our general health and wellness, too.

Stress and Inflammation

The VEGAMOUR blog has covered stress and its impacts on hair from many angles over time. And while it’s clear that stress impacts our hair health, research is still emerging with regard to the way that stress impacts our general physiology and our hair follicles.

Stress, like inflammatory cytokines, is an important part of the body's defense system and, when functioning correctly, can help keep us healthy. But when our stress and inflammatory responses fall out of step with our bodies, they can have drastic long-term negative impacts on our health.

Malfunctioning stress and inflammatory response have both been linked to diseases and illnesses including cardiovascular disease, diabetes, non-alcoholic fatty liver disease, autoimmune issues, inflammatory bowel disease, depression and obesity, as well as the previously mentioned conditions and many others. Research indicates that as many as 75 to 90% of human disease is related to activation of the stress response.

There is a connection between chronic stress, chronic inflammation and health. Stress creates inflammation in the brain and in the rest of the body, and it does so primarily by disrupting the immune response. When your body is in a chronic phase of stress, it also experiences an increased risk of inflammation and disease.

Your Immune System’s Role

The adaptive and innate immune system responses are part of the body’s general stress response system. When we experience a singular (or acute) stress—such as fighting off an illness, surviving a car accident or arguing with a loved one, for example—our immune cells release proinflammatory cytokines to fight off the stress. But when acute stress becomes prolonged (or chronic), the body can enter an extended period of inflammation.

Cortisol, also known as the “stress hormone,” is ordinarily an anti-inflammatory agent in the body produced in response to stress while also serving other important functions. Chronic stress, however, causes significantly elevated cortisol levels long-term. Eventually, our body becomes resistant to its effects. This causes our body to continue releasing more and more cytokines to fight off the inflammation, and the cycle continues.

Hair Loss and Inflammation

VEGAMOUR CEO Dan Hodgdon explained how cytokines can affect the hair growth cycle—including premature hair loss.

"Cytokines are markers that show that inflammation is occurring,” Hodgdon explained. “Pro-inflammatory cytokines telegraph to your hair that it's time for it to shed."

When confronted with a major psychological stressor, such as infection, illness or disease, our bodies will often pull resources away from "non-essential" activities, including hair growth.

“Hair is the first thing to go because it’s nonessential to your survival,” said Hodgdon. “Your body signals to stop sending nutrients to [the hair follicles] because your body needs to focus on your immune system, your circulatory system and all the other things that are essential to survival,” he added. In this way, Hodgdon explains, “Hair thinning is an early warning alert system for your health."

Inflammation and Telogen Effluvium (TE)

"Bad" inflammation can often lead to early telogen effluvium (TE), a temporary—and typically reversible—hair loss condition that prematurely moves follicles into the telogen phase of the hair cycle, in which the hair shaft prepares to leave the scalp. Hair shedding due to telogen effluvium is recognizable because the hair bulb will be present at the top of the hair shaft, indicating that the hair was lost from the root and was therefore lost during the telogen phase.

The disease onset can be due to a major psychological or physical stressor. One study looked at the impact of acute periods of stress in college students, and found there was a connection between acute stress, elevated levels of proinflammatory cytokines and hair growth.

Research also suggests there is a link between proinflammatory cytokines and the disruption of hair cycling. Cytokine imbalance is also suspected in cases of TE linked to COVID-19 infection.

While more research is needed, preliminary investigation is suggesting that some folks might have a higher predisposition or sensitivity to risk factors for inflammation in their follicular ecosystem, which could in turn impact a variety of hair loss conditions.

Initial research has looked specifically at how cytokine balance may play a role in two common hair loss conditions, alopecia areata (AA) and androgenetic alopecia (AGA).

Inflammation and Alopecia Areata

Alopecia areata (AA) is a fairly common type of autoimmune hair loss that causes patchy hair loss on the scalp and elsewhere on the body. Patients with alopecia areata typically do not experience scarring, and the condition is usually not permanent.

With alopecia areata and other AA-like hair loss, hair follicle function is impacted by our immunity. In the case of autoimmune conditions like alopecia areata, follicles are mistakenly attacked. Alopecia areata comes in multiple forms ranging from minor symptoms to more extensive alopecia areata and including:

Patchy alopecia areata
Alopecia totalis (AA totalis), an extensive disease with complete loss of hair on the body
Diffuse AA (or alopecia areata incognita)
Alopecia universalis (AU or AA universalis)

Learn More: Alopecia Areata, Explained

Alopecia areata is a complex condition, and more research is needed, but the dysregulation of several types of cytokines has already been observed in patients with AA. Some cytokine-targeting therapies are being investigated and proposed for alopecia areata patients, as well as those with other autoimmune diseases.

Other research links stress hormones as one underlying cause of the condition. Additionally, recent findings have indicated that a certain type of T-cells—one of our bodies' main adaptive immune responses—may provide a window to combat alopecia areata since they communicate with stem cells on the scalp to aid in hair follicle regeneration.

Inflammation and Androgenetic Alopecia

Androgenetic alopecia (AGA) is another common form of hair loss, affecting about 50 million men and 30 million women in the United States. Also known as male- and female-pattern baldness, AGA is believed to be a form of hair loss influenced mostly by genetics and hormones. Like alopecia areata, however, it is a complex form of hair loss that is not fully understood.

Research has drawn a connection between hair loss associated with AGA and increased inflammation around hair follicles. As with alopecia areata, cytokines may prove to be valuable therapeutic targets that could provide new and innovative methods of treatment.

More: Androgenetic Alopecia — What You Should Know

Inflammation, Skin Diseases and Hair

While the connection between skin disease, inflammation and hair growth might not be obvious, the connection is fairly simple: if the skin on your scalp is irritated, experiencing inflammation or if you have a skin disease that affects the scalp, hair follicles don't have an environment to produce healthy hair.

One example of skin disease that affects the hair cycle is atopic dermatitis (AD), also known as follicular eczema. In atopic dermatitis, the hair follicle becomes inflamed, creating a reddish rash when it occurs on the scalp. Inflammation of the hair follicle in types of dermatitis can cause hair loss until the condition is resolved.

A Holistic Approach to Hair Wellness

The good news is that taking a holistic, whole-body approach to hair health will help you support your general health and wellness. Overall health affects hair growth, so by focusing on healthy habits, you can foster the healthiest environment for your follicles while also working to reduce stress and inflammation in the body.

Nutrition and Gut Health

Diet is foundational to hair wellness, since hair wellness starts from within. Focusing on getting a variety of fruits, vegetables, whole grains, legumes, healthy fats and proteins can support healthy hair follicle function, and nutrition can also help reduce inflammation in the body.

Similarly, gut and microbiome health are significantly tied to immunity as well as hair health.

Exercise

Regular exercise is another way to support health and reduce inflammation. It's also another important component of holistic health, with compounding benefits including maintaining a healthy weight for your body, getting better rest and improving your heart health. Plus, it's a good way to stimulate hair growth—exercise helps improve circulation, and good blood flow to the scalp will help your hair follicles produce hair.

Learn: Why Should Exercise Be a Part of Your Hair Growth Routine?

Stress Management

With an understanding of the connection between stress, inflammation, immunity and hair growth, managing stress levels emerges as an obvious part of whole-body and hair health. But you don’t have to be a meditation expert or yoga aficionado to benefit from practices that will help you manage potential triggers for chronic stress. Stress management can be as simple as spending time outdoors, cuddling with a pet or watching a funny movie.

Brush Away Stress: 9 Ways to Naturally Lower Your Cortisol Levels

Sleep

Getting regular, good-quality sleep was an important part of health that all of us learned about as kids. And yet, as adults, many of us treat "good sleep" as a luxury: Almost half of Americans say they feel sleepy at some point during the day. Sleep is connected to our bodies' immune system, inflammation response and cytokine production.

Gentle Hair Care

Especially when caring for stressed-out hair follicles, think gentle. Avoid tight hairstyles, heat tools and chemical treatments whenever possible. Consider putting your hair up with a gentle hair tie or using a pillowcase that's gentle on hair for sleeping, and choose a gentle, balancing shampoo and conditioner.

The Takeaway

While much of the research on cytokines is still uncertain, the connection between stress, inflammation and disease has become increasingly clear. Dermatological science suggests that dysregulation of inflammatory cytokines may play a significant role in hair loss conditions such as alopecia areata, androgenetic alopecia, telogen effluvium and more, and future treatments of these conditions could specifically target cells in cytokine subgroups.

For the time being, taking a holistic approach to your health is central for supporting healthy hair follicles. Nutrition, exercise, regular sleep and stress management are all tools you can use to support healthy hair. Stay tuned to the VEGAMOUR blog for the latest knowledge and to find out what you should be doing to support hair health every day.