The assessment of cortisol in human hair: associations with sociodemographic variables and potential confounders.
Open accessAbstract
To inform the future use of hair cortisol measurement, we have investigated influences of potential confounding variables (natural hair colour, frequency of hair washes, age, sex, oral contraceptive (OC) use and smoking status) on hair cortisol levels. The main study sample comprised 360 participants (172 women) covering a wide range of ages (1-91 years; mean = 25.95). In addition, to more closely examine influences of natural hair colour and young age on hair cortisol levels, two additional samples comprising 69 participants with natural blond or dark brown hair (hair colour sample) as well as 28 young children and 34 adults (young age sample) were recruited. Results revealed a lack of an effect for natural hair colour, OC use, and smoking status on hair cortisol levels (all p's >0.10). No influence of frequency of hair washes was seen for proximal hair segments (p = 0.335) but for the third hair segment indicating lower cortisol content (p = 0.008). We found elevated hair cortisol levels in young children and older adults (p < 0.001). Finally, men showed higher hair cortisol levels than women (p = 0.002). The present data indicate that hair cortisol measurement provides a useful tool in stress-related psychobiological research when applied with the consideration of possible confounders including age and sex.
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Hair cortisol reflects the amount of free unbound cortisol, which is unaffected by oral contraceptives.
“Another advantage is that hair cortisol reflects the amount of free unbound cortisol, which is unaffected by oral contraceptives [79].”
From Pre- and post-operative psychological interventions to prevent pain and fatigue after breast cancer surgery (PREVENT): Protocol for a randomized controlled trial (2022) · cites this paper as [79]
The Discussion (page not provided) says hair cortisol is most likely to reflect free, unbound cortisol, but explicitly notes that this has not been experimentally shown. The results section reports no detected effect of oral contraceptive use on hair cortisol among the women studied (p = 0.110); it does not establish that hair cortisol is categorically unaffected by oral contraceptives. (LLM, conf=0.88)
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“Although total plasma cortisol levels during the baseline testing before a stress test were found to be higher in women using OCs than in women not using OCs or men, no differences in the cortisol response to psychosocial stress were found (Kirschbaum et al. 1999).”
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van Aken, M., Oosterman, J., van Rijn, T., Ferdek, M., Ruigt, G., Kozicz, T., Braat, D., Peeters, A., & Nap, A. (2018) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2018.01.001 · Cited by 48 · see citing works
Henley, P., Lowthers, M., Koren, G., Fedha, P. T., Russell, E., VanUum, S., Arya, S., Darnell, R., Creed, I. F., Trick, C. G., et al. (2014) · Canadian Journal of Physiology and Pharmacology · doi:10.1139/cjpp-2014-0035 · Cited by 36 · see citing works
Hair cortisol concentrations in a Spanish sample of healthy adults
Garcia-Leon, M. A., Peralta-Ramirez, M. I., Arco-Garcia, L., Romero-Gonzalez, B., Caparros-Gonzalez, R. A., Saez-Sanz, N., Santos-Ruiz, A. M., Montero-Lopez, E., Gonzalez, A., & Gonzalez-Perez, R. (2018) · PLOS ONE · doi:10.1371/journal.pone.0204807 · Cited by 35 · see citing works
Bossé, S., Stalder, T., & D'Antono, B. (2018) · Psychosomatic Medicine · doi:10.1097/psy.0000000000000569 · Cited by 33 · see citing works
Reme, S. E., Munk, A., Holter, M. T. S., Falk, R. S., & Jacobsen, H. B. (2022) · PLoS ONE · doi:10.1371/journal.pone.0268606 · Cited by 21 · see citing works
“Another advantage is that hair cortisol reflects the amount of free unbound cortisol, which is unaffected by oral contraceptives [79].”
- Authors
- Dettenborn, L., Tietze, A., Kirschbaum, C., & Stalder, T.
- Affiliations
- Technische Universität Dresden (DE)
- Corresponding author
- Dettenborn, L.
- ORCID
- Kirschbaum, C.
- Venue
- Stress
- Publisher
- Informa UK Limited
- Published
- 2012-02-23
- Volume
- 15
- Issue
- 6
- Pages
- 578-588
- ISSN
- 1025-3890 (ISSN-L)
- 1607-8888
- OpenAlex
- W2124651034
- Cited by
- 277
- References
- 74
- Citations by year
- 2026: 16 · 2025: 10 · 2024: 17 · 2023: 23 · 2022: 18 · 2021: 21 · 2020: 24 · 2019: 28 · 2018: 19 · 2017: 26 · 2016: 20 · 2015: 15 · 2014: 17 · 2013: 16 · 2012: 7
- FWCI
- 7.37
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Stress (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Deutsche Forschungsgemeinschaft (DE 1162/3-1)
- Topics
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Veterinary › Small Animals › Animal Behavior and Welfare Studies
- Keywords
- hair cortisol, confounding variables, hair color, oral contraceptive use, smoking, age differences, sex differences, children, stress biomarkers
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Aging, Child, Child, Preschool, Demography, Female, Hair, Hair Color, Humans, Hydrocortisone, Infant, Male, Middle Aged, Stress, Psychological, Confounding Factors, Epidemiologic
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