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When you think about common symptoms or lingering effects of COVID-19, you may think about loss of taste and smell or a persistent cough, but you may not have considered hair loss.
However, many patients have reported experiencing hair loss after being sick— not just with COVID-19. Temporary hair loss, known as telogen effluvium (TE), can occur after events like illness, childbirth, severe stress, and fever. This type of hair loss happens when more hairs than normal enter the shedding, or telogen, phase of the hair growth cycle.
“This type of hair loss isn’t unique to infection COVID-19,” says board-certified dermatologist Shoshana Marmon, MD, PhD, FAAD, Assistant Professor and Director of Clinical Research in the Department of Dermatology at New York Medical College. “Any type of severe stress can trigger it. It may be stress on your body from illness or severe emotional stress such as the death of a loved one.”
In a 2022 study published in the Journal of Medicine and Life, 48 of 198 patients admitted for COVID-19 showed hair loss — none of whom had previous TE. Of these patients, 79 were male (39.9 percent) and 119 were female (60.1 percent), and their ages ranged from 18 to 85.
The good news: This type of hair loss is usually temporary and not permanent. Once the trigger is removed, the hair follicles return to their normal growth cycle, and the hair shedding decreases.
Understanding Hair Loss and COVID
The process of hair follicles returning to their normal growth cycle after TE can take three to six months (and in some cases, up to a year). However, some people may experience a more persistent form of the condition called chronic telogen effluvium.
Certain populations may be more prone to experiencing TE after being sick. “Theoretically, anyone is at risk for hair loss after COVID-19, but based on the literature, it is most commonly reported in women, individuals with severe or prolonged infections, and those with preexisting hair loss or nutritional deficiencies,” says Dr. Marmon.
Those who are immunocompromised are more vulnerable to severe infections, including severe COVID-19, and prolonged symptoms, which may put them at higher risk of developing TE due to the physical stress of the illness. “During periods of elevated community transmission, immunocompromised individuals may wish to take extra precautions,” says Dr. Marmon.
These precautions may include:
- Wearing a mask
- Practicing good hand hygiene
- Maintaining social distancing
- Staying up to date on your vaccines, including the COVID-19 vaccine and the flu shot
Nutrition, particularly iron, biotin, and vitamin D, can also play a role, according to the Cleveland Clinic. For instance, if you have low iron levels, your body may prioritize making red blood cells over supporting hair growth.
If you have recently recovered from COVID-19, you may not experience the effects of TE right away. Typically, it occurs about two to four months after the infection or triggering event. This delay is because the majority of hairs on your head (85 to 90 percent) are in the growth phase, known as anagen. Only about 10 to 15 percent are in the resting/shedding phase. A severe emotional or physical stressor like COVID-19 can push more hairs into the resting/shedding phase, also known as telogen.
Telogen has a resting phase of two to four months, followed by the shedding phase. Due to this time lag, patients are often unaware of the connection between a stressful event and hair shedding.
This type of hair loss is diffuse, meaning there are no specific bald spots on your scalp. Instead, you may notice that your ponytail seems thinner or you have less volume overall in your hair.
“Patients typically notice the condition when they are washing or styling their hair, because significantly more hairs will be around the drain or on the brush,” says Dr. Marmon. “They sometimes say their hair comes out in clumps when they run their fingers through it, which can be very distressing.”
To help ease any stress caused by hair loss, it’s important to remember that TE is a common condition and usually resolves on its own within a few months. However, if you do notice hair loss, it’s best to speak to your dermatologist for a thorough examination of your scalp, medical history, and to rule out any more serious conditions.
If you experience any other unusual symptoms such as a rash, itchy scalp, or burning, it’s also important to see your dermatologist as it may indicate a different condition causing hair loss, according to the American Academy of Dermatology Association.
Tips to Cope with Hair Loss
While hair loss due to TE is temporary, hair regrowth can take some time as hair grows at an average rate of one centimeter per month, according to Massachusetts General Hospital. This means that if you have shoulder-length hair, it may take around 2.5 years for your ponytail or the length of your hair to feel normal again. You may also notice short hairs growing on the top of your scalp, which will eventually catch up with the rest of your hair.
During this time, a few lifestyle habits can help you handle hair loss from TE, including:
- Managing anxiety and stress as much as you can
- Avoiding aggressive hair treatments, chemical processes, and tight styling
- Maintaining a well-balanced diet
While you may not need treatment since telogen effluvium usually resolves on its own, your dermatologist may recommend over-the-counter medications you apply to your scalp like minoxidil (Rogaine), multivitamins or supplements that contain iron or biotin, and hairstyles or wigs and weaves that help obscure the hair loss.
Above all, don’t panic. Be patient and give it time to resolve.
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Can COVID-19 Cause Hair Loss? American Academy of Dermatology Association. Accessed March 21, 2023. https://www.aad.org/public/diseases/hair-loss/causes/covid-19.
COVID-19 Related Hair Loss. Cleveland Clinic. July 30, 2020. https://consultqd.clevelandclinic.org/covid-19-related-hair-loss/.
Interview with Shoshana Marmon, MD, PhD, FAAD, Assistant Professor and Director of Clinical Research in the Department of Dermatology at New York Medical College
Massachusetts General Hospital. Hair Loss Clinic. Accessed March 21, 2023. https://www.massgeneral.org/assets/mgh/pdf/dermatology/temporary-hairloss.pdf.
Seyfi S, et al. Prevalence of telogen effluvium hair loss in COVID-19 patients and its relationship with disease severity. Journal of Medicine and Life. May 2022. doi: https://doi.org/10.25122/jml-2021-0380.