Coronavirus and hair loss

Coronavirus (COVID-19) is a disease caused by SARS-CoV-2. The disease spread rapidly across the world after emerging in December 2019, and many countries have endured lockdowns and significant restrictions to prevent further spread of the disease. On 11 March, 2020, COVID-19 was declared a pandemic by the World Health Organization. Although most people infected with the virus will experience mild to moderate respiratory illness and will recover without hospitalisation or special treatment, some people do become seriously ill. There is a higher risk to people who are older or who have an underlying medical condition.

Some people who have been infected with COVID-19 are reporting that they are experiencing hair loss after recovering from the disease, and this is being reflected in a growing number of case studies. It is important to remember that there is a still a huge amount we do not know about COVID-19, and our understanding of post-COVID hair loss is based on current research.

Why might COVID-19 cause hair loss?

Doctors believe that hair loss from COVID-19 is a factor of telogen effluvium. This type of hair loss occurs when the body is under high psychological or physiological pressures, and an example of these pressures can be from the impact of the body fighting against a virus. We have discussed this type of hair loss in a previous article, Hair loss from stress.

When a fever or illness places significant physical stress on the body, it may cause a large number of hairs to prematurely move from the growth phase (anagen phase) to the resting phase (telogen phase) of the patient’s hair’s life cycle. It is this dramatic shift in the natural hair cycle which means that hair loss may occur around two to three months after being infected with COVID-19, as it takes time for hair to shed during the resting phase. A normal person should expect to lose 50 to 100 hairs from their head a day, but telogen effluvium may cause a person to lose up to 300 hairs a day.

It is not just the physical stress of a virus on the body, such as COVID-19, which may cause hair loss. The emotional stress of suffering from COVID-19 can also be a contributing factor for telogen effluvium, particularly because the effects are not fully understood. Some patients may fear the worst outcome, and as mentioned earlier, psychological stressors can cause a shift in the natural hair cycle. Even if a person does not become infected with COVID-19, the emotional stress of living through repeated lockdowns and restrictions can be enough to cause a shift in the natural hair cycle. You should remember that technically telogen effluvium causes hair shedding, rather than permanent hair loss, and hair should naturally grow back.

There is no evidence to suggest that COVID-19 directly causes hair loss as a symptom of the disease. The hair loss is caused indirectly by COVID-19 due to the physical and emotional stress of the disease on the body (telogen effluvium).

How common is hair loss after COVID-19?

This is a new area where research is still ongoing into how common hair loss is after COVID-19. As the number of patients who recover from the disease increases, there will be more evidence to describe the impact on hair following COVID-19 infection.

One recent study by Mieczkowska et al called Telogen effluvium: A sequela of COVID-19 has looked to explore the link. The study analysed post-COVID hair loss for 10 female patients from diverse ethnic backgrounds, and with no history of hair loss. It states that, “they all experienced excessive hair loss within weeks to months after infection, which included hair coming out in large clumps and thinning along the frontal hairline”. The patients did not have any other potential causes of hair loss, such as vitamin deficiency, hormone issues, or autoimmune diseases. You should remember that post-COVID hair loss does not occur immediately after recovery. All the patients in the above study presented to the dermatology clinic around three to six months after recovering from COVID-19, to report significant hair loss. This is because telogen effluvium causes a large number of hairs to shift from the growth phase of the hair's lifecycle to the resting phase. It takes two to three months for hair to shed from the resting phase. This is why patients may experience hair loss a few months after an event has occurred.

This diagram shows the stages of the hair's lifecycle. Telogen effluvium hair loss, a temporary form of hair loss, shifts the hairs from its growth stage to it's resting phase quicker.

Is hair loss permanent after COVID-19?

The good thing about telogen effluvium related hair loss is that it is not permanent. Telogen effluvium is a self-limiting condition, which means the hair loss will resolve on its own and there will be no long-term permanent hair loss. This usually takes up to six months, but no specific treatment is needed and the hair will gradually grow back to its normal volume and thickness.

Managing your stress is so important with COVID-19. Although you might have recovered from the disease and reduced the physical stress on your body, if you continue to suffer from emotional stress (e.g. asking yourself questions such as ‘will I go bald’), you may cause yourself further stress and prolong the period of hair loss. You should remember that hair loss from telogen effluvium is not permanent and your hair will naturally grow back.

How can I reduce hair loss after COVID-19?

As well as following government advice of protecting yourself (such as taking vaccines and regular testing) and minimising transmission physically (social distancing, handwashing etc.), you can stay positive and try doing things that will reduce your emotional stress. The key with telogen effluvium hair loss is to reduce the amount of physical and emotional stress on your body, as this will prevent more hairs from shifting abnormally in the natural hair cycle. You could try going on walks, reading a book, meditating, cooking, or anything else that makes you feel positive.

Like with any other types of hair loss, you should also nourish and care for your hair, to provide the best scalp condition. To read, see our page on products which can help support healthy hair growth. Even though telogen effluvium hair loss is likely to be self-limiting and your hair will recover on its own, by looking after your scalp, hair can feel strong and healthy in the long run. You could also try switching to a gentler shampoo. We have discussed the top 10 shampoos for hair loss and regrowth in the following article.

Research into COVID-19 and the link to hair loss is still growing. If you continue to experience hair loss six to nine months after recovering from COVID-19, you may be suffering from another cause of hair loss. You should always speak with your doctor if you notice significant hair loss, as they will be able to diagnose the cause and provide a treatment plan.

References

1. Mieczkowska, K., Deutsch, A., Borok, J., Guzman, A.K., Fruchter, R., Patel, P., Wind, O., McLellan, B.N., Mann, R.E. and Halverstam, C.P. (2020). Telogen effluvium: a sequela of COVID‐19. International Journal of Dermatology. [online] Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753411/ [Accessed 2 Jul. 2021].

2. Olds, H., Liu, J., Luk, K., Lim, H.W., Ozog, D. and Rambhatla, P.V. (2021). Telogen effluvium associated with COVID-19 infection. Dermatologic Therapy, [online] 34(2), p.e14761. Available at: https://pubmed.ncbi.nlm.nih.gov/33405302/ [Accessed 2 Jul. 2021].

3. CDC (2020). Coronavirus Disease 2019 (COVID-19). [online] Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects.html.

4. www.aad.org. (n.d.). Can COVID-19 cause hair loss? [online] Available at: https://www.aad.org/public/diseases/hair-loss/causes/covid-19 [Accessed 13 Feb. 2022].

5. WHO (2021). Advice for Public. [online] Who.int. Available at: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public.