Hair Loss and Stress: What a Korean Dermatologist Checks First

I'm Dr. Hongseok Kim, a board-certified dermatologist with 21 years of practice and the medical director of VOS Dermatology Clinic in Gangnam, Seoul, right in front of Dosan Park. At VOS I see every patient myself, from the first consultation to the last treatment.

Hair loss and stress come up together in my consultation room more often than most people expect. A common story is: "My hair got better while I was on treatment, but as soon as I stopped, it started falling out again." This page is based on my YouTube video from October 2023; I rewrote it for readers abroad. The video above can be watched with translated captions.

Is stress-related hair loss different from hormonal hair loss?

Short answer: yes, they are different problems, and many people have both at once.

Male pattern and female pattern hair loss are driven by hormones (in the video at 00:27). Hairs coming out of the follicles slowly become thinner and then fall out, usually in a recognisable pattern: an M-shaped hairline, a crown that looks sparse, a hairline moving back, or a parting that widens.

Stress-related hair loss behaves differently. People tell me they woke up to a bed covered in hair, or that the shower drain is suddenly blocked. That sudden shedding is called telogen hair loss, or telogen effluvium. It can be acute, but some people shed for a long time in a chronic form. Hormonal hair loss can often be controlled reasonably well with hair loss medication. The trouble starts when the two are combined: one gets solved and the other does not, and treatment becomes frustrating.

Why does stress make some people lose hair and not others?

Short answer: stress is the most common cause of telogen shedding, but how much hair you lose depends on how well your body withstands that stress.

In medical textbooks, telogen hair loss is often described as stress-related hair loss (in the video at 02:20). It can follow certain medicines, surgery, a serious illness or a major emotional shock. Many women notice heavy shedding a month or two after giving birth; that is the same mechanism.

Yet not everyone loses hair after a stressful event. The difference is resilience: how well the body copes with the load. Clinic treatments such as scalp injections, PRP or laser can improve telogen shedding fairly quickly, and when shedding is clearly heavy, active treatment is worth it. Home care alone is usually not enough at that point, because visible, heavy shedding means the body has already gone past what it can handle on its own.

How can stress be measured? HRV and stress hormone tests

Short answer: heart rate variability (HRV) and stress hormone levels give an objective picture of how much stress your body is under and how well it is coping.

HRV measures the variation between heartbeats (in the video at 04:04). From it we can look at the balance between the sympathetic and parasympathetic nervous systems and estimate the body's total energy state. When energy is low, I read that as low resistance to stress.

Stress hormone tests are interpreted with care. A very high level usually suggests acute stress. A very low level does not mean you are stress-free. Simply being alive means your body is handling constant input: light in your eyes the moment you wake, sound, touch. If the hormone level is too low to handle even that baseline, it suggests depletion, which is often seen in chronic stress states. People in that state feel flat and unmotivated, and when a big stressor arrives, they have little reserve left, so hair is more likely to fall out heavily.

What does a hair mineral test show?

Short answer: it shows heavy metals and mineral ratios that help estimate whether stress is acute or chronic and how resilient you are.

For a hair mineral test, a small amount of hair is cut and analysed (in the video at 06:43). Because hair grows slowly, the sample reflects roughly the last few months. The first thing we look at is heavy metals such as mercury and arsenic. When those are clearly high, they can drive chronic inflammation and make hair loss worse.

We then look at the pattern and ratios of minerals. Together they give a fairly concrete estimate of how much stress you are under, whether it is acute or chronic, and how resilient you are. At VOS this kind of work sits under functional medicine testing, which looks at metabolic and physiological balance to find the causes behind recurring problems such as fatigue and hair loss.

What is the functional medicine approach to hair loss?

Short answer: treat the hair loss directly, and at the same time correct the imbalances underneath it so it is less likely to come back.

The foundation of hair loss treatment is still treating the follicles (in the video at 08:45). On top of that, if testing shows a real problem, we correct it: supplementing minerals that are low, working to lower heavy metals that are high, and raising the body's energy state when it is depleted. As resistance to stress improves, hair loss treatment works on one side while the risk of relapse goes down on the other.

That is what I mean by a functional medicine approach: finding the causes behind a problem in the body and correcting them, instead of only matching a symptom to a standard prescription. It can be applied to both male pattern and female pattern hair loss, because hormone treatment and stress treatment can run side by side.

Which supplements help with hair loss and stress?

Short answer: in the video I recommend magnesium, coenzyme Q10, vitamin B and vitamin D, which support energy and overall health and help hair loss treatment indirectly.

Magnesium comes first (in the video at 10:05). It is especially useful for people in their thirties and older who feel tired no matter how much they sleep. Magnesium acts near the top of the energy-producing cycle. I usually start with once a day, and if that is well tolerated it can go up to two or three times a day; I adjust the amount after testing. Without testing, once a day is a sensible default.

Coenzyme Q10 supports the same energy cycle. Vitamin B matters when mitochondria make energy, and it can be taken in a multivitamin or on its own.

Vitamin D acts in the body somewhat like a hormone, and in my experience many hair loss patients have low levels (in the video at 11:25). For people who get little sunlight I suggest 2,000 to 5,000 IU. When I test patients in Korea, most are below 30. If you are starting out, 2,000 to 3,000 IU taken consistently is a reasonable beginning, because 5,000 IU can be too much for some people; going higher should be decided after a blood test with your doctor.

These nutrients do not act directly on the follicles. They support the body's condition so that the state that drives hair loss is held back. If you prefer to discuss nutrients delivered by drip, my guide to how an IV drip works in a Seoul clinic explains the options, and our IV clinic page describes how formulations are chosen after diagnosis.

Will this approach alone treat my hair loss?

Short answer: no; it supports treatment, and it matters most when hair loss keeps returning.

Some patients are sceptical at first and ask why they need tests at all (in the video at 12:49). Over time, many start looking after their minerals themselves and ask me how to keep it up, because they feel less tired and more active, and in some, hair loss progresses more slowly.

Still, these steps alone do not treat hair loss. Some people do well with standard hair loss treatment alone. If your hair improves during treatment and falls out again when you stop, adding a functional medicine approach can make treatment more stable and also look after your general health. Scalp care at home helps as well; my video note on choosing a Korean shampoo for hair loss covers the ingredients I look for. You can also read creator experiences at VOS.

Results, timing and recovery vary from person to person, and the right plan for you is decided at an in-person consultation.

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Results, swelling and recovery vary from person to person. This page is general information from VOS Dermatology Clinic based on Dr. Kim's video and does not replace an in-person consultation.