The Relationship Between COVID-19 And Hair Loss

By Dr. Melissa (Mel) Irvine, DNP – Clinical Sexologist
Specializes in Sexual Medicine and Beauty

COVID-19 sent out shockwaves through all aspects of society, many of which we still feel today. We all remember the toilet paper shortages and the social distancing requirements, but less known are the long-term effects that can come from those who had this virus, some of which we’re still trying to understand.

Among these conversations about COVID-19’s lasting impact is an increasing number of reports of hair loss, which many people notice only after they have had the virus. By logical reasoning, the question then arises of whether COVID-19 can cause hair loss and how to reverse it in the case that it does.

Hair Loss from COVID-19
COVID-19 is a virus most notably known for its effects on the respiratory system, where it likes to invade the lungs and interfere with breathing. This begs the question, though, of how this virus that prefers the lungs can result in hair loss. However, this hair loss might not be as central to COVID-19 as we expect.

Hair loss is normal after having any high fever or illness, and fever is a common symptom in those who have COVID-19 because of the body’s desire to attack and rid itself of this outside contagion. So, hair loss has less to do with COVID-19 itself, and more to do with it being a virus that causes illness and fever in the body.

Furthermore, while many people may consider it hair loss, it’s actually hair shedding, with the medical name of telogen effluvium. Still, the term hair loss is commonly used to depict the scenario.

A 2022 study into telogen effluvium found that of the 198 patients included in the study, 48 showed hair loss after having COVID-19, making it a prominent comorbidity, or lasting health complication, for those who had this virus.

Telogen effluvium (TE) is one of the most popular types of alopecia in women and can be provoked by:
– trauma
– stressful events
– hormonal imbalance
– malnutrition
– drugs

This condition occurs when more hairs than usual enter the shedding, or telogen, phase of the hair growth lifecycle at the same time.

So, while COVID-19 is not the only cause of TE, as a viral infection it is a possible culprit.

Why Does COVID-19 Trigger Hair Loss?
It can be a distressing situation to have undergone COVID-19 infection, something with aftereffects that are still largely unknown, only to begin experiencing hair loss. Furthermore, since hair shedding due to COVID does not occur immediately following infection, it can often be hard to narrow down if the cause is COVID, genetics, or something else entirely.

There are a few reasons why COVID-19 may cause hair loss, and they all primarily stem from stress. As for the type of stress, it can be physical stress on the body, or mental stress of the mind.

For physical stressors, those with COVID-19 often have a high fever, which is often associated with hair shedding following infection. While this stressor is mild, more serious physical stressors can also lead to hair loss, such as being placed on a ventilator because of respiratory complications. Both of these complications place the body under physical stress, which may trigger TE.

COVID-19 also increases mental stress as you deal with the infection and how you feel because of it.

When you look at it this way, it is clear that COVID-19 infection can place tremendous stress on the body through various means, which is resulting in more cases of TE following infection.

Still, the severity of hair loss does not always relate to how severe the illness was. For instance, some people with severe COVID symptoms may not have any hair loss, while those with mild symptoms experience severe hair loss.

How Long Can It Last?
If you suffer from hair shedding due to COVID-19, or any other illness, it becomes most noticeable about two to three months after having the fever or infection. As for how long it lasts, it may take six to nine months before shedding stops and your hair begins to look normal again. However, some

studies on COVID-19-related hair shedding have seen that it stops sooner than this, sometimes in only two to three months instead of the six-month average.

Is COVID-19 Hair Loss Permanent?
The good news about TE from COVID-19 is that it is not permanent. The hair phase shifts to telogen more quickly than it should, but once the new strand begins growing in, the hair can return to normal.

This is because TE does not cause someone to lose their hair follicles, which is what occurs in the case of hair loss. While there might be a bit of time when the hair does not grow, since the hair follicle is still there, the hair will eventually regrow.

Still, as with most things, there is an exception. In less than 10% of cases, those experiencing hair shedding may suffer from chronic TE, which is when the hair shedding persists beyond six months. While the exact cause of chronic TE is unknown, in cases linked to COVID-19, it’s suspected to be from the significant amount of stress you underwent while infected and the fact that you might not yet be back to normal even after six months. Even in this case, though, TE is not permanent, only longer lasting.

Reversing COVID-19-Related Hair Loss
If you are experiencing hair shedding due to TE, you do not have to worry about losing all of your hair, as the proportion of telogen hairs never exceeds 50%. Still, this is something that you likely want to avoid.

So, what can be done if you are suffering from hair loss? The following are some great steps:

Check For Other Causes of Hair Loss
Since TE is delayed from your COVID-19 infection, it can be hard to know if your hair loss is from COVID or something else. To be sure, you can check other possible causes of hair loss.

Nutritional deficiencies are one such possibility. Hair relies on a balanced amount of nutrients, and in some cases, your hair loss might be because you’re suffering from a deficiency in one type.

A blood test can be used to check for any nutritional deficiencies that might be affecting your hair growth. Furthermore, focusing on a more well-rounded and healthy diet can increase your chances of getting all the nutrients your body needs from the food you eat.

Your hormones might also be the culprit, with thyroids that are unbalanced possibly being the cause of your hair loss. A laboratory test can check your thyroid hormones, and if they are unbalanced, medication can be prescribed to address the low or high levels.

Check Your Stress
If tests for nutrient deficiencies and unbalanced hormones show no problems in these areas, and TE is determined to be the cause of your hair shedding, the only thing that you can really do is wait it out.

However, it’s easier said than done to give your hair months to hopefully regrow, but one very important thing that you can do in this time is focus on your stress levels and keep them as minimal as possible.

TE most often results from stress, whether the stress of your environment or stress placed on your body from the illness. To ensure that TE runs its course and does not stick around longer than you want, you want to ensure that your stress levels do not remain high.

If you experience stress in your life, whether from your work, home life, or even thoughts of your hair loss, you want to work hard to address these concerns to lower your stress. Finding a healthy way to work through your worries, such as meditation, exercise, or counseling, can also be influential.

As for stress due to illness, this involves providing your body with all it needs to properly care for itself and recover from illness. For instance, your body may require more sleep as it heals or a more balanced diet rich in vitamins and nutrients it can use to repair and damage.

Stress can keep TE around longer, so by actively working to reduce stress in all forms, you can increase the odds of your hair finally beginning the regrowth cycle.

Medication
Medication is not always the right choice, but sometimes it can be.

For those with acute TE, hair growth will recover spontaneously, and their hair will begin growing again. Because of this, and since it can be hard to know when to stop medication once it has been started, it’s not often recommended for those with acute TE. However, once you have been experiencing hair shedding for four to six months, and it does not appear to be getting better, it might be time to look into medication.

Remember: It’s Not Permanent
In most cases, hair shedding results because of stress. While it is usually from stress sustained by the body due to illness, any stress you experience from the current state of the world can also influence your hair’s growth phase.

However, it’s also common for hair shedding to then cause increasing stress, perpetuating the problem.

In these cases, it’s important to remember that any hair loss due to TE is not permanent, and your hair will recover. Even chronic cases of TE, which last longer than 6 months, are still not cases of permanent hair loss. Once the body returns to balance, hair will begin regrowing again.

So, the best thing you can do to reverse hair loss is to remain calm, both in your mindset about any hair you have lost and in all other aspects of your life.

COVID-19 Hair Loss: Key Takeaways
Because of the increasing amount of physical and mental stress COVID-19 infection places on the body, more and more people are suffering from hair loss months after their infection.

Unfortunately, there’s not much that can be done to reverse hair loss from COVID-19 beyond waiting for everything to sort itself out. If you find yourself at this point, remember that your hair will grow back, and this is only a temporary process.

Still, while COVID-19 can cause hair shedding, it may not be the cause of your hair loss, which is why it is best to reach out to a doctor to look into your health profile to determine if something else is to blame for your hair loss.

Remember, while hair is often considered only for its influence on physical appearance, it can provide a lot of information about your internal health. If your hair is shedding more than before, it may be wise to listen to your body and look into why this is happening with your doctor.

Dr. Mel Irvine
9250 Corkscrew Rd. STE 5, Estero, FL 33982
239-351-5663
info@sextys.com | drmelirvine.com

 

References
Malkud, S. (2015). Telogen Effluvium: A Review. Journal Of Clinical and Diagnostic Research. doi: 10.7860/jcdr/2015/15219.6492

Sharquie, K. E., & Jabbar, R. I. (2022). COVID-19 infection is a major cause of acute telogen effluvium. Irish journal of medical science, 191(4), 1677–1681. https://doi.org/10.1007/s11845-021-02754-5

Starace, M., Iorizzo, M., Sechi, A., Alessandrini, A., Carpanese, M., & Bruni, F. et al. (2021). Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management. JAAD International, 5, 11-18. doi: 10.1016/j.jdin.2021.07.006

Seyfi, S., Alijanpour, R., Aryanian, Z., Ezoji, K., & Mahmoudi, M. (2022). Prevalence of telogen effluvium hair loss in COVID-19 patients and its relationship with disease severity. Journal Of Medicine And Life, 15(5), 631-634. doi: 10.25122/jml-2021-0380

Can COVID-19 cause hair loss?. (2023). https://www.aad.org/public/diseases/hair-loss/causes/covid-19