Hair and stress: A pilot study of hair and cytokine balance alteration in healthy young women under major exam stress

Abstract

Mouse models show that experimental stress mimicking prolonged life-stress exposure enhances neurogenic inflammation, induces adaptive immunity cytokine-imbalance characterized by a shift to Type 1 T-helper cell cytokines and increases apoptosis of epithelial cells. This affects hair growth in otherwise healthy animals. In this study, we investigate whether a prolonged naturalistic life-stress exposure affects cytokine balance and hair parameters in healthy humans. 33 (18 exam, 15 comparison) female medical students with comparable sociobiological status were analyzed during a stressful final examination period, at three points in time (T) 12 weeks apart. T1 was before start of the learning period, T2 between the three-day written exam and an oral examination, and T3 after a 12 week rest and recovery from the stress of the examination period. Assessments included: self-reported distress and coping strategies (Perceived Stress Questionnaire [PSQ], Trier Inventory for the Assessment of Chronic Stress [TICS]), COPE), cytokines in supernatants of stimulated peripheral blood mononucleocytes (PBMCs), and trichogram (hair cycle and pigmentation analysis). Comparison between students participating in the final medical exam at T2 and non-exam students, revealed significantly higher stress perception in exam students. Time-wise comparison revealed that stress level, TH1/TH2 cytokine balance and hair parameters changed significantly from T1 to T2 in the exam group, but not the control. However, no group differences were found for cytokine balance or hair parameters at T2. The study concludes that in humans, naturalistic stress, as perceived during participation in a major medical exam, has the potential to shift the immune response to TH1 and transiently hamper hair growth, but these changes stay within a physiological range. Findings are instructive for patients suffering from hair loss in times of high stress. Replication in larger and more diverse sample populations is required, to assess suitability of trichogram analysis as biological outcome for stress studies.

Stress Enhances Proinflammatory Platelet Activity: the Impact of Acute and Chronic Mental Stress

“…In other studies chronic mental stress in the form of caregiving has been shown to be associated with increased CD62P reactivity (Aschbacher et al 2008). While this demonstrates that chronic mental stress due to an exam preparation certainly differs from that of caregiving or childhood trauma, it has nevertheless been shown previously to be associated with immunological and other biological changes (Marshall et al 1998;Peters et al 2017).…”

Human Perifollicular Macrophages Undergo Apoptosis, Express Wnt Ligands, and Switch their Polarization during Catagen

“…It is when HF IP is lost that inflammatory hair diseases, such as alopecia areata and lichen planopilaris, develop (Bertolini et al, 2016;Harries et al, 2013;Imanishi et al, 2017;Strazzulla et al, 2018). Despite growing evidence that the HF's immune microenvironment may have an important regulatory role in regulating hair growth (Castellana et al, 2014;Kloepper et al, 2013;Maurer et al, 1995;Peters et al, 2017), in addition to their immune function, work so far has tended to focus on mouse HFs. Specifically in rodent skin, the HF mesenchyme (connective tissue sheath [CTS]), is densely populated with macrophages (MF) (Bertolini et al, 2013;Christoph et al, 2000;Paus et al, 1998), which fluctuates greatly during the hair cycle, being the highest during active hair growth (anagen), showing a sharp decline during regression (catagen) and reaching the lowest count in telogen (Paus et al, 1998).…”

Quantitative mapping of human hair greying and reversal in relation to life stress

“…However, greying in both mice and humans has been shown to be a relatively irreversible phenomenon driven in part by a depletion of melanocyte stem cells, although some stem cells and transient amplifying cells do remain ( Trueb and Tobin, 2010 ). In humans, recent evidence suggests hair growth and pigmentation changes in response to stress ( Peters et al, 2017 ), but this relationship, along with reversal of greying, remain insufficiently understood. The paucity of quantitative data in humans is mostly due to the lack of sensitive methods to precisely correlate stressful psychobiological processes with hair pigmentation and greying events at the single-follicle level.…”