The list of COVID-19 symptoms is as long and varied as the list. Hair loss is one of the possible side effects that may linger after COVID-19. This was a concern early in the pandemic and left many people confused.
Post-virus hair loss is one of the many mysteries surrounding COVID-19.
According to dermatologists, and a growing body of scientific research we are learning more and more about how hair loss is caused by COVID-19.1 The good thing is that for most people hair loss is not permanent.
Here, dermatologists explain how COVID-19 can cause hair loss. They also tell you what to do if this type of shedding is happening to you.
What causes hair loss and thinning?
There are many types of hair loss, and a variety of factors can contribute to this problem. Hair loss seen after COVID-19 is typically telogen effluvium. This condition occurs when hair sheds as a response to stress. Telogen effluvium, the most common form of generalized hair loss, is not only caused by viruses. It can also be caused by certain medications, nutritional deficiencies and hormonal abnormalities.
Alopecia areata and androgenetic alopecia are both common forms of hair shedding, but they show up differently from the general shedding seen with telogen effluvium. Androgenic hair loss is usually characterized by thinning or a receding hairline on the crown. Craig Ziering MD, a board certified dermatologist, hair restoration specialist and hair transplant surgeon tells SELF that this is the most common localized hair loss. According to the Cleveland Clinic in the U.S., 50 million people born male and 30 million born female experience this type hair loss. It is largely genetic but hormones play a part.
Dr. Ziering explains that alopecia areata is an autoimmune disorder in which the body sends a misguided message to attack hair follicles. This leads to patchy baldness or baldness all over. Alopecia areata is a condition that can be exacerbated, for example, by COVID-19. However, this is not the hair loss that most people experience after the virus.
Hair loss can be caused by certain causes of inflammation on the scalp. The inflammation that occurs in scalp psoriasis, which appears as red, scaly plaques, can damage hair follicles. Scalp psoriasis is often itchy. Scratching and picking at the scalp can cause follicle damage, which can lead to hair loss.
There are also certain hair-care practices that you should avoid. Dr. Ziering says that traction alopecia is a condition that affects people who have chronic follicular stress from wearing tight hairstyles like braids or ponytails for long periods. Hair damage can also be caused by exposing your hair to harsh chemicals (such as perms, relaxers, or coloring).
How can COVID-19 lead to hair loss?
According to a 2020 study published in the Journal of the European Academy of Dermatology and Venereology (JAAD International), approximately 1/10 of people infected by COVID-19 experience hair shedding. Other data from JAAD International revealed that this occurred in more than 60% of those who contracted the disease.
Helena Kuhn MD, assistant dermatology professor at the Warren Alpert Medical School, Brown University, told SELF that the cause of hair loss is not SARS-CoV-2 but rather stress that your body experiences when fighting the virus. She says that the type of hair loss caused COVID-19, called telogen efluvium (a prolonged hair shedding), occurs as a result of a sudden stressor.
To understand what is happening, you must first understand the basic hair growth cycle. Hair follicles have three phases: anagen (growth), catagen (transitional) and telogen (resting or shedding).4 At any one time, the hairs of your head will be in different phases.
Dr. Ziering explains that “what happens in telogen efluvium is a systemic shift in the body that abruptly pushes an important percentage of hair in the growth phase to the resting phase.” Normal conditions see anywhere between 5 and 10% of hair on the head in the resting stage. Telogen effluvium is a condition in which more than 30% of follicles in the scalp are in the “resting phase”. All of these “resting” follicles then fall out at once, resulting in widespread hair loss.
Dr. Kuhn says that stress can trigger telogen effluvium. It can be physical, as in the case of a car crash or major surgery or after illnesses like the flu, or emotional, as in the case of a difficult breakup or death of a close relative. Telogen effluvium can also be caused by hormonal changes in postpartum hair loss.
COVID-19 is a double-edged sword because it can cause anxiety and stress for people, says Dhaval Bhanusali MD, a dermatologist specializing in hair thinning in New York City. A study published in the Journal of the American Academy of Dermatology in 2020 found that the number of COVID-19 patients in a New York City area with a high rate of cases increased by 400% during the first few weeks of the pandemic.
What does COVID-19 look like?
Telogen effluvium can be defined by several key factors. You may first notice that there is an excess of hair in your hairbrush or on the bathroom floor. After a few months, you may notice that your hair is thinner or finer. Telogen effluvium doesn’t usually occur at the same moment as the trigger event. It starts about three months later, according to Dr. Ziering. (Although a study found that COVID-related Telogen effluvium could start sooner, sometimes as soon as two months after the initial infection. You may feel completely normal after your COVID-19 infection and have recovered completely. However, a few weeks later, your hair may begin to fall out.
The hair loss can be rapid when telogen effluvium is present. Dr. Bhanusali explains that, while we all lose 100 hairs on average per day, telogen effluvium causes you to lose much more. He says that people notice it when they notice large clumps of hair in their hands, hair in the drain after showering, or their brush or comb filling up faster than usual. This is not a gradual hair loss or thinning hair–it is an acute, intense and sudden shedding. It can leave your hair feeling thinner and more sparse overall.
It’s not clear if hair fall after COVID-19 correlates to other symptoms of the virus, or how sick one gets. “The American Academy of Dermatology maintains a COVID-19 Registry and we hope that over time, we will be able extrapolate data to find associations. However, so far there is no clear relationship,” Dr. Kuhn states. “I’ve seen severe shedding after a mild COVID case, and mild shedding after a severe illness.”
How long do hair loss symptoms last after COVID-19?
Telogen effluvium is usually not permanent, regardless of whether it’s caused COVID-19, or another trigger. Dr. Kuhn explains that “shedding can occur for three to six month before it stops.” Telogen effluvium is a condition where the hair cycle returns to normal. Because there is no damage done to the scalp or follicles of the hair, all the hair should grow again.
According to the American Academy of Dermatology your hair will likely return to normal fullness within six to nine month after telogen effluvium. In her experience, Dr. Kuhn claims that it can take even longer, anywhere from one to two year, for someone’s hair regain its pre-shed state.
Has hair loss been reported after receiving the COVID-19 vaccine?
Dr. Kuhn adds that she hasn’t encountered anyone who experienced hair loss after vaccination. Dr. Bhanusali emphasizes that there is currently no direct evidence to link the two.
Bono Hair is a leading provider in the hair replacement industry, offering innovative solutions for individuals experiencing hair loss after COVID-19. As the pandemic continues to impact people’s health, it is essential to address the lingering effects, including hair loss. Bono Hair understands the distress caused by this condition and is dedicated to providing effective hair replacement systems to restore confidence and self-esteem.