You may not expect a link between COVID-19 and hair loss; after all, the coronavirus causes respiratory illness. But some survivors find that their hair falls out during the recovery period.
In fact, Dr. Esther Freeman, who runs the COVID-19 Dermatology Registry, a database of COVID-19 dermatological manifestations containing 1,000 cases from 38 countries, said TODAY that a growing number of people are recovering of the coronavirus are reporting hair loss as a result of the disease.
This hair loss comes as no surprise to infectious disease expert Amesh A. Adalja, MD, principal investigator at the Johns Hopkins Center for Health Safety in Maryland, and is due to a mechanism called telogen effluvium.
“After [experiencing] physiological stress, there is a condition that affects the growth cycle of hair follicles. It’s called telogen effluvium, and it can be seen after many different types of diseases, including malaria and tuberculosis, ”Dr. Adalja tells Health.
Telogen effluvium typically manifests about three months after the stressful event, and both men and women can be affected, it adds.
Dermatologist Angelo Landriscina, MD, tells Health that this type of hair loss can follow any stressful life event, not just a serious illness, but also surgery or a serious psychological stressor, such as loss of a loved one. “We are not talking about regular daily stress,” he says.
To understand telogen effluvium, it is helpful to understand the hair growth cycle.
“At any given time, 85-90% of our hair is in a phase called anagen, the growth phase,” says Dr. Landriscina. “Meanwhile, 1-2% are in a transition phase called catagen. Up to 10% of our hair is in the telogen phase or “resting phase”, which is the phase in which our hair normally falls out. In telogen effluvium, a larger than normal portion of our hair goes into the telogen phase and falls off. ”
It is normal for some hair to fall out; The American Academy of Dermatology (AAD) says that it is typical to lose 50 to 100 hairs a day. However, losing “significantly more” than this is considered excessive and results in a diagnosis of telogen effluvium.
While there is no evidence of a specific coronavirus mechanism that triggers hair loss, any serious illness can cause telogen effluvium, and COVID-19 certainly falls into that category.
“Many people with COVID-19 become seriously ill with a high fever and other symptoms, which we know may be related to telogen effluvium,” says Dr. Landriscina. “We know that the stress hormone cortisol is released at higher levels during a severe illness, and we also know that cortisol can affect hair structures.”
Even the psychological stress of contracting the coronavirus can cause telogen effluvium.
“COVID-19 has clearly caused us a lot of stress, and not just physiological stress on the body due to infection,” Kristen Lo Cisco, MD, assistant professor of dermatology at NYU Langone Health, tells Health. “The pandemic has caused many types of stress in addition to personal illness, such as financial stress, the death of a loved one, and problems related to childcare.”
Economic hardship and racial injustice could also lead to hair loss, adds Dr. Landriscina, and there has been no shortage of either in 2020 so far.
Typically, telogen effluvium lasts for up to six months, says Dr. Adalja. It is basically a waiting game; A person who has had stress-induced hair loss will begin to see their hair gradually return to normal as a new hair grows.
Patience aside, Dr. Landriscina says that people experiencing telogen effluvium can apply a topical 5% minoxidil solution (such as Rogaine). “This encourages the hair follicles to leave the telogen phase early and return to the anagen or growth phase,” he explains.
