Can COVID-19 Cause Hair Loss?

The pandemic Corona Virus disease 2019 (COVID-19) has made the human population susceptible to several diseases and conditions that can last from months to years.

Some conditions may be asymptomatic, while others can show up as long-term negative impacts known as COVID- Long haulers.

Many long haulers have been reported in COVID-19 survivors. A study in Italy reveals that 32 % of COVID survivors complained of the persistence of one or more COVID-related symptoms (Carfì et al., 2020).

Survivors suffering from long COVID haulers face physical impairment, anxiety, and depression. COVID-19 has been connected to Telogen effluvium (TE); a common form of hair loss characterized by diffuse hair loss (Burns, 2020).

TE occurs when more hairs than normal enter the shedding phase.

Several triggers for Telogen effluvium are known, including drugs, surgeries, or any endocrine disease due to inflammation, any stressful condition (e.g., COVID) forces more hair in the shedding phase (Anu, 2021).

According to the American Academy of Dermatology Association (AADA), COVID -19 survivors find their hair falling out in large clumps after recovering from COVID-19. This shedding can last for six to nine months.

COVID-related stress and Trauma, which millions of people have suffered amid the pandemic, can also be an underlying cause of hair fall.

AADA states that temporary hair loss after any disease, trauma, or illness is completely a normal phenomenon.

Nevertheless, hair fall & Telogen effluvium (TE) related to COVID-19 can last longer, even two or three months after the disease (Androgenetic alopecia present in most patients hospitalized with COVID-19: The “Gabrin sign,” 2020).

A study published in LANCET also reveals that 22% of COVID patients at china hospital reported hair loss after one month (Chaolin Huang, 2021).

Why does COVID-19 Cause Hair Loss?

One of the potential triggers of TE is acute illness fever. People infected with COVID -19 experience fever as a symptom, which later triggers stress-related hair loss.

A body diverts all its blood supply to vital organs during a stressful event. Hence, blood supply towards hair is decreased, which can cause hair to shed.

Is Hair Loss a Side effect of Covid -19 Treatments?

There are currently no studies that support this hypothesis. Hair fall is not related to medications/treatments taken during COVID-19 infection. Rather, it occurs due to the stress of illness and most likely due to Telogen effluvium (TE).

How can You Know that You Are Suffering From Telogen Effluvium (TE)?

It is normal for a healthy individual to lose up to 100 hairs per day. In Telogen effluvium, a person starts to lose more than 300 hairs per day, continuing for several months. Here are a few more signs related to Telogen effluvium.

• More hair falls out while brushing or washing
• Thinning of hair
• Dry, lusterless, and easily pluck-able hair
• Loss in the volume of hair

What is the Mechanism of TE?

Telogen Phase is a phase during normal hair growth in which hair rests for two to three months before shedding off the scalp, meanwhile allowing new hairs to grow. TE happens when hairs enter the resting phase (Telogen Phase) and stop growing mainly due to a stressor (Trost et al., 2006).

What are the Other Factors Related to Hair Loss?

Other causes of hair loss include:

• Hormonal changes (during pregnancy, adolescence, or thyroid conditions)
• Stressors (such as those observed in COVID related hair fall)
• Hair fall can also result as a side effect of certain medications
• Iron deficiency (Trost et al., 2006)
• Underlying health conditions
• Poor dietary habits
• Diet lacking essential micronutrient
• Exposure of hairs to high temperatures
• Scalp ringworm (Hoffer et al., 2020)

How to Diagnose Hairfall?

If hair loss occurs due to health-related conditions, it can be diagnosed in many ways. Following are a few of them:

• A physical examination can be performed in which a few dozen hairs are pulled out to determine the severity of hair fall
• Sample of hairs can also be examined under a microscope
• Biochemical tests can also be conducted to rule out the underlying cause of hair fall
• Scalp biopsy is done to determine whether an infection is causing hair loss

Can You Regrow Your Hair After TE?

Yes, TE is completely reversible. Hair can come back to normal and regrow in 3 to 6 months.

How can Stress-Related Hair Loss be Managed?

Prolonged stress can put the human body at risk for several health conditions. Here are some ways that can help to reduce stress:

• Engaging in exercise and regular physical activity
• Meditation
• Well-balanced diet
• Quality sleep

How Can You Reverse The COVID-related Hair Loss?

• Focusing on adequate nutrition has proven to be very effective to combat hair loss. Suppose you are suffering from hair loss/TE. In that case, your diet should be rich in protein, iron, Vitamin C, Vitamin D, zinc, folic acid, vitamin B2 and all other nutrients necessary for the proper functioning of the body because a well-balanced diet speeds up the process of hair regrowth
• Minimize/ reduce exposure of hair to high temperatures
• Avoid hairstyles that pull off hair, such as hair extensions & tight braids
• Treatments such as hot oil treatment can cause immense damage to hair; hence you should avoid them
• Minimize the use of chemical products
• Multivitamin supplementation can be one step forward in this regard. But it’s necessary to talk to your doctor before taking them because some supplements can interact with your
• Minoxidil (Rogaine) is very effective in promoting hair growth and slowing down hair fall (Price, 1999)
• Spironolactone is beneficial for increasing hair thickness. (Burns, 2020)
• Microneedling devices have also shown promising results in combating hair loss
• Fish oil, onion juice, rosemary oil & amino acids can be used as alternative treatments for hair regrowth

Written by: Emmanuel J. Osemota

REFERENCES

[1] Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The “Gabrin sign”.. (2020). Journal of the American Academy of Dermatology, 680–682.

[2] Anu, P. V. (2021). An Ayurvedic protocol for the management of Post Covid-19 Hairfall wsr Telogen Effluvium-A Single Case Study. Journal of Ayurveda and Integrated Medical Sciences, 271–276.

[3] Burns, L. J. (2020). Spironolactone for treatment of female pattern hair loss. Journal of the American Academy of Dermatology, 276–278.

[4] Carfì, A. B. (2020). Group ftGAC-P-ACS. Persistent symptoms in patients after acute COVID-19. JAMA, 603–5.

[5] Chaolin Huang, J. Z. (2021). 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. LACENT.

[6] Hoffer, L. S.-E. (2020). hair loss due to scalp ringworm irradiation in childhood: health and psychosocial risks for women. Israel Journal of Health Policy Research, 1–7.

[7] Price, V. H. (1999). Treatment of hair loss. New England Journal of Medicine, 964–973.

[8] Trost, L. B. (2006). The diagnosis and treatment of iron deficiency and its potential relationship to hair loss. Journal of the American Academy of Dermatology, 824–844.