Covid & Hairloss
From the Desk of Dr. Leisha
May 29, 2024
The first time you noticed that your hair was falling out, it may have been because your strands were gathering in the shower drain or your hairbrush. Maybe you glanced in the mirror and felt a jolt when your hairstyle didn’t look quite right, or perhaps you pulled your hair into a ponytail and felt a loss of volume.
If you recovered from Covid-19 or another viral illness within the past few months, such an increase in shedding may not be a coincidence. Research estimates that 22 percent of those who were hospitalized with Covid-19 experienced temporary hair loss. It is harder to evaluate how common the condition is in people who had milder forms of the disease, but studies suggest hair loss is among the more than 60 persistent symptoms associated with long Covid.
The state of your scalp changes after illness.
Sudden and temporary hair loss has a medical name: telogen effluvium. It occurs when stress or illness triggers much more shedding than the typical 50 to 100 hairs a person loses per day. It is not specific to Covid-19:
Experts have known for centuries that severe illness, surgery, blood loss, hospitalization, childbirth, and extreme emotional events, like the loss of a loved, one can trigger telogen effluvium. But researchers have found that people with a history of Covid-19 infection are four times as likely to develop hair loss than those who were not infected.
How can COVID-19 cause hair loss?
To understand why an infection with the coronavirus may cause hair loss, knowing more about the cycle of hair growth is essential. This cycle can be divided into 4 different phases, being:
The anagen phase, during which the hair fiber forms and grows
The catagen phase, marked by a cease in growth
The telogen phase, a resting phase of the hair cycle, during which the hair follicle is dormant and the hair sheds
The kenogen phase, the stage between telogen and anagen, during which the hair follicle is empty. After this phase, the anagen phase starts again.
COVID and hair loss may be caused by hair shedding, which happens when the anagen phase of the hair cycle terminates early, and many hairs move into the telogen phase simultaneously. This state is also called telogen effluvium. Experts have noted that Telogen effluvium short-circuits the cycle for many hairs. As a result, 30 to 50 percent of the hair on your head ends up in the shedding phase and you’re likely to notice clumps falling out two to three months after an offending event.
The hair loss may last six to nine months, which can feel like an eternity. Then the shedding slows down and new hair starts to grow again.
The cause of telogen effluvium may be fever and stress, as often seen with other viral infections as well. When you have COVID, the body produces pro-inflammatory cytokines to fight the infection. This process may cause the formation of tiny blood clots, which may diminish the blood supply to the hair follicles. The inflammation and the virus may cause tissue damage and subsequently may cause telogen effluvium as well.
Besides fever and stress, hair loss may also appear after COVID-treatment, as some medications may contribute to hair shedding. However, additional research is required to conclude.
How long does COVID-19 hair loss last?
The hair loss that results from COVID-19 usually appears 2 to 3 months after the infection. It can take an average of 3 to 6 months, but up to 18 months before the hair returns to its original fullness. It’s also important to de-stress as much as possible, as stress may prolong the duration of hair loss and stall regrowth.
Is there anything to do other than wait?
If you start to notice sudden hair loss or are concerned about the amount of volume you’re losing, it may be a good idea to see a doctor early on. Usually, you’ll know if you’re losing hair long before anyone can clinically see it. By intervening early, particularly if your hair loss is linked to an underlying condition, you can treat it effectively.
Managing your stress may be another solution to telogen effluvium.
Hair is an important part of most people’s identity. Managing stress and seeing a therapist may benefit those struggling with hair loss. Most people will have some short regrowth even before their hair loss completely subsides. Treatment can help you grow hair back within four to six months. But if you decide to wait things out, your hair will grow back naturally. It may take 12 months or more, especially if you wear a shoulder-length or longer style, because hair grows extremely slowly — usually less than half an inch per month.
Some people may never feel like their hair has returned to its previous volume: Doctors said they have noticed that telogen effluvium can occasionally set off other types of more permanent hair loss, such as female- or male-pattern baldness. This is likely due to chronic underlying inflammation. Telogen effluvium may be a sign of an ongoing health issue, like a thyroid problem or autoimmune disorder. It’s best to handle your hair with care while you wait for it to grow back. Avoid using heat styling tools or hairstyles that cause a lot of tension, like a tight ponytail that may further weaken the hair follicles. And try to be optimistic about the process.
Is my hair loss due to COVID-19?
Studies suggest that hair loss is possible due to COVID-19, especially in the months following your recovery. However, knowing that other conditions may cause hair loss is important. Hair loss that occurs after COVID has been reported as hair shedding only. This means that you shouldn’t experience other scalp symptoms such as a rash, white plaques, an itchy scalp, or a burning sensation. If you experience such symptoms or are unsure about the cause of your hair loss, then it’s recommended to visit a dermatologist or general practitioner for advice and treatment.
COVID-19 and hair loss treatment
Hair loss due to COVID-19 usually doesn’t require any specific treatment. It’s a normal reaction of the body to shed hair after physical or emotional stress caused by the coronavirus. Acute telogen effluvium is self-limiting and usually ends within 3-6 months. The hair thickness may take up to 18 months to return to its original state. People can manage COVID hair loss by decreasing inflammation in their diet, managing stress levels, getting restorative sleep, anti-inflammatory IV therapies, and supplements such as:
Nutrafol.
Wrapping up
Hair loss is a normal consequence of a viral infection or a stressful situation. The connection between COVID-19 and hair loss in females and males is still being researched, but many studies suggest a positive correlation. Luckily, hair shedding due to COVID-19 usually stops after 3 - 6 months without any specific treatment.
For any questions or concerns please reach out to the Wellness Lounge to schedule an IV treatment, talk with one of our staff, or request a consultation with our functional medicine provider, Dr. Fowler, ANP.
References
1. Sharquie K. et al. (2022). COVID-19 infection is a major cause of acute telogen
effluvium. Accessed on 12 April 2024.
2. Wall D. et al. (2022). Advances in hair growth. Accessed on 12 April 2024.
3. Hussain N. et al. (2021). A systematic review of acute telogen effluvium, a
harrowing post-COVID-19 manifestation. Accessed on 12 April 2024.
4. Seyfi S. et al. (2022). Prevalence of telogen effluvium hair loss in COVID-19
patients and its relationship with disease severity. Accessed on 11 April 2024.
5. Ohyama M. et al. (2022). Management of hair loss after severe acute respiratory
syndrome coronavirus 2 infection: Insight into the pathophysiology with
implication for better management. Accessed on 12 April 2024.
6. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-
8/fulltext
7. https://www.bmj.com/content/378/bmj.o1887
8. https://www.nature.com/articles/s41591-022-01909-w
9. https://www.nature.com/articles/s41586-021-03417-2