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Cushing’s syndrome is a hormonal disorder caused by excessive cortisol in the body over a long period of time. This prolonged exposure hampers the hair growth on your scalp.
While hair loss may not be the first symptom to visit the doctor when you have Cushing’s syndrome, it is often its most distressing one. But don’t fret. There is some good news. Once your cortisol levels are normal, recovery is possible, even for your hair. There are medications and treatment options available to support hair recovery.
When you look in the mirror and notice symptoms like:
- Hair thinning
- Puffy face
- Increased weight
- Unpredictable mood swings
These might sound like they are separate, unrelated problems, but in reality, they all point to Cushing’s syndrome.
What is Cushing's syndrome?
Cushing’s syndrome is a rare disorder that occurs when your body experiences prolonged high cortisol levels. Cortisol can become elevated either because your body produces too much or because you take medications containing cortisol for conditions like asthma or rheumatoid arthritis.
Cortisol is often called a stress hormone, but it plays many essential roles: regulating metabolism, managing inflammation, balancing blood sugar, and supporting immune responses. Excess cortisol, however, causes significant health problems.
Cushing’s syndrome impacts roughly 10 to 15 people per million each year. In most cases, women are at a higher risk, while those between the ages of 20 and 50 are frequently diagnosed with the disease. Commonly, there are two forms of Cushing’s syndrome.
- Endogenous Cushing's syndrome (coming from within the body)
- Exogenous Cushing's syndrome (coming from outside the body)
Endogenous Cushing's syndrome
You are likely to have an Endogenous Cushing's syndrome when you find a benign tumour in your pituitary gland. The small gland, which is at the base of your brain, triggers an overproduction of Adrenocorticotropic hormone (ACTH), a hormone that passes signals to your adrenal glands to create cortisol. We call this Cushing’s disease.
In even rarer cases, your lungs can also increase cortisol levels. As the disease takes shape slowly and Cushing’s syndrome symptoms can overlap with other conditions, it gets particularly difficult to come up with a diagnosis without the help of an endocrinologist.
Exogenous Cushing's syndrome
Exogenous Cushing's syndrome results from long-term use of cortisol-like medications. This form is more common and often temporary. Under medical supervision, tapering off the medication usually allows cortisol levels to normalize and symptoms to resolve.
How does excessive cortisol from Cushing’s syndrome affect my hair?
Your hair goes through a hair cycle, namely:
- Anagen Phase, growth phase
- Catagen Phase, transition phase
- Telogen Phase, resting phase
- Exogen Phase, shedding phase
In order for your hair to remain healthy, it is pertinent that your hair cycle goes through a balanced, predictable rhythm. So any excessive cortisol in your body can disrupt that rhythm.
Cortisol and the hair growth cycle
When elevated cortisol is stored in your body for months or even years, it can prematurely push your hair follicles from the growth phase into the resting phase. This can increase shedding. This can become increasingly frustrating as the shedding doesn’t always begin immediately. It takes two to four months between cortisol spikes and hair loss to find a connection.
The hormonal trigger
Your increased cortisol levels are also triggering a profound change in your hormones. During this time, you will notice an increase in your androgen levels, disruption of estrogen, and an imbalance in progesterone that is indirectly impacting your thyroid function. Plus, you are likely to stop responding to insulin. If you were to experience any of these shifts, it would affect your hair, too.
What are the common Cushing's syndrome symptoms?
Thinning hair is not the first symptom of Cushing’s syndrome, as there are a number of changes taking place in your body, like:
Physical symptoms
As mentioned earlier, one of the most recognisable ways to recognise if someone has Cushing’s syndrome is through rapid weight gain. You will find excess weight around the abdomen, chest, and face. Many people develop a rounded facial appearance, more commonly called ‘moon face’ and accumulate fat on their upper back, often referred to as ‘buffalo hump’. Plus, excessive cortisol breaks down collagen, making your skin thinner, more easily bruised, and more prone to developing purple stretch marks across the abdomen, hips, and underarms, all the while slowing the healing process.
Cognitive and emotional symptoms
Aside from the physical, Cushing's syndrome can bear a huge toll on the mind. Anyone who has suffered from this condition has frequently experienced forms of depression, irritability, anxiety, and lack of concentration. They find their mind getting foggy and can’t control their emotions. Plus, they are likely to persistently experience deep fatigue.
The psychological impact of Cushing's syndrome
Even though the physical symptoms of Cushing’s syndrome are visible, we often neglect the psychological impact the condition carries.
Take depression, it is not a Cushing’s syndrome side effect, but comes about due to high levels of cortisol. When your cortisol levels are high, you upset your neurotransmitters. This has a bearing on your mood, motivation and emotional resilience. It’s for this reason that you may have heard people feel a sense of sadness and numbness when diagnosed with Cushing’s syndrome.
As all of this is happening, your anxiety builds up. This leaves your body constantly in a state of stress. Disrupted sleep, wavered concentration and indecisiveness are just some of the ways it plays physiologically.
Understandably, a delayed diagnosis is only likely to further elevate your cortisol. The symptoms of Cushing’s syndrome can come about with other conditions that, for many, seem stress-related.
Hair loss only brings another layer. It is our identity, and how we show ourselves to the world around us. So, a sudden loss of hair will only trigger grief, panic, and a sense of helplessness. That is why it is so important to speak to a counsellor or therapist for a meaningful recovery.
Why are women more prone to Cushing's syndrome?
Women are nearly three times more likely than men to get a Cushing’s syndrome diagnosis. A part of this comes from the inherent complexity of a woman’s hormonal system. Women undergo a lot of hormonal changes in their lifetime, like puberty, pregnancy, postpartum recovery, perimenopause, and menopause. These natural transitions also dysregulate cortisol levels in your body.
Plus, certain conditions like PCOS and thyroid disorders are more prevalent in women, only further complicating and making it difficult to distinguish from Cushing’s syndrome. It isn’t rare to find women with scalp hair thinning alongside increased facial hair growth. But in Cushing’s syndrome, this is a sign of androgen imbalance.
It may seem confusing as they are two opposites, but they actually point to the same root cause. There is also evidence to suggest that women are more sensitive to ACTH. This means the pituitary gland can signal the adrenal glands to produce more cortisol.
How is Cushing's syndrome diagnosed?
Your cortisol levels are never constant and fluctuate throughout the day, and this is why you need to do repeated testing for a Cushing’s syndrome diagnosis. Some of the most common approaches include:
- Late-night salivary cortisol test
- 24-hour urinary cortisol test, and
- Low-dose dexamethasone suppression test
If these tests identify elevated cortisol, your next step is to identify the source through an ACTH blood test, an MRI of the pituitary gland or a CT scan of the adrenal glands.
Cushing’s syndrome treatment
There isn’t a one-size-fits-all treatment, and Cushing’s syndrome treatment depends entirely on the underlying causes.
When it’s the use of medication
In exogenous Cushing's syndrome, your path forward is straightforward and gradual. All that would be required is for you to be medically supervised as you slowly taper off the steroid medication while your body readjusts to its own cortisol levels.
When it’s treating a tumour
When you are diagnosed with endogenous Cushing's syndrome, your first line of treatment is to remove the tumour through surgery. It could be in the pituitary gland, the adrenal glands, or somewhere else, but it must be removed. The recovery rate is 70% to 90% when the tumour is small. However, if surgery hasn’t brought about a much-needed resolution, you can try radiation and medications to put a stop to cortisol production.
Can my hair recover from Cushing’s syndrome?
Yes, it can recover very much. And this is very important to hold onto. In nearly every case, once cortisol returns to a healthy level, you see your hair getting better. The results are not immediate, and it will require patience, but a healthy set of hair is possible.
The Cushing’s syndrome hair recovery timeline
In all honesty, your first two to three months could feel very alarming as you continue to shed hair while waiting for your hairline to stabilise. It is important to remember during times like these to trust the process. By the third to the sixth month, you will notice shedding slowing down. Between six months and a year, you will see a visible improvement in your hair density.
All of this is possible, including full hair regrowth, after 12 months, depending on how long cortisol excess was present in your body, your age, nutritional status, and if you have any other hormonal imbalances.
What can I do to support my hair during Cushing’s syndrome recovery?
When cortisol levels are high, your system depletes essential nutrients like protein, iron, vitamin D, and zinc. These are nutrients your hair desperately needs to regrow. So, build a healthy environment for your hair by following a mindful, nutrient-rich diet and, if needed, taking medical supplements. You can do this by keeping it simple and following a protein and iron-rich diet, while taking in zinc and vitamin B regularly.
Even after treatment, women in particular should test their androgen levels and thyroid function. However, regrowth may still be slow due to lingering imbalances.
Scalp care and stress reduction
When it comes to your hair, you can start simple by avoiding aggressive chemical treatments, harsh cleansing routines and tight hairstyles. All of these can go a long way to your hair recovery. And as stress can delay your regrowth process even after medical intervention, invest in sleep, meditation, breathing exercises and follow structured routines.
The Ayurvedic lens
When you look at it from an Ayurvedic lens, excess cortisol reflects an aggravated imbalance in Pitta and Vata. Pitta drives inflammation and heats up the scalp, while Vata disrupts the nourishment required for hair growth and weakens the tissue integrity.
Constant stress will also weaken your Agni, which is your digestive fire, and reduce the absorption of the nutrients that your hair needs. In order to get a complete, meaningful recovery, you need to address more than your scalp. You can easily restore your internal balance by making cooling dietary choices and practising calming methods.
If you are looking for a more traditional and balanced alternative to chemical-heavy treatments, Traya’s Ultimate Hair Supplements Combo blends the wisdom of Ayurveda, Allopathy, and Nutrition. Created with 20+ herbs and essential nutrients, the combo helps correct internal deficiencies and nourish hair.
Cushing's syndrome is just not a medical condition; it can also be a deeply human experience, if you take it positively (which you should). It changes the way you look at yourself, how you feel, how you see others. However, this connection between your cortisol levels and your hair cycle can be empowering. After all, you realise that the cause can be identified and, more importantly, resolved.
FAQs
1. Does high cortisol always lead to thin hair?
No, it is not necessarily the case. After all, a short burst of stress is hardly going to make you lose your hair. It is only when you don’t address it, allowing your cortisol to elevate for a prolonged period, like weeks to months, that you begin to see hair loss.
2. Is hair loss considered an early sign of Cushing’s syndrome?
Honestly, no. After all, by the time your hair loss is visible, you would have already noticed weight changes and signs that there is something wrong with your skin. Therefore, hair loss cannot be considered an early indicator of Cushing’s syndrome.
3. How different is hair loss from Cushing’s syndrome, as compared to other types of hair loss?
Yes, your hair will look different. When you suffer from hair loss due to Cushing's syndrome, your hair is diffused with thinning visible across the scalp.
4. What is the difference in my hair loss when I have Cushing’s syndrome?
In most cases, any loss of hair due to Cushing’s Syndrome is spread across the scalp due to it being diffused. In women, you are likely to see a widening parting line, whereas in men, it is more concentrated towards the crown.
5. Can Cushing's syndrome be prevented?
Yes, if you monitor corticosteroid medications with your doctor, it can be prevented. Sadly, when it comes to Cushing’s syndrome caused by a tumour, there is no way of preventing it, and it is best to consult a doctor for treatment.
6. Should Cushing’s syndrome be considered a life-threatening disease?
Yes, if left untreated, it can indeed be life-threatening. A major reason for this is the pressure it puts on your heart and endocrine system. However, it should not be a worry if the right treatment is in place. Plus, early diagnosis and proper management of the condition can make a huge difference.
7. Should I try any hair growth treatments during Cushing’s syndrome recovery?
It’s best to make this decision after consulting a specialist. Remember, your priority during this period is to address the hormonal imbalance, which is the root problem. Only when your cortisol levels are stable, and you have the go-ahead from a doctor, should you attempt using supportive hair therapies.
References:
- https://www.endocrine.org/patient-engagement/endocrine-library/cushings-syndrome-and-cushing-disease
- https://www.nhs.uk/conditions/cushings-syndrome/
- https://medlineplus.gov/ency/article/000410.htm
- https://www.hopkinsmedicine.org/health/conditions-and-diseases/cushing-syndrome
- https://www.healthdirect.gov.au/cushings-syndrome
- https://www.ohsu.edu/brain-institute/cushing-disease-cushing-syndrome
- https://www.urologyhealth.org/urology-a-z/c/cushings-syndrome
- https://www.niddk.nih.gov/health-information/endocrine-diseases/cushings-syndrome
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