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Does COVID-19 cause hair loss?

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Reviewed by Felix Gussone, MD, written by Gina Allegretti, MD

Last updated: Jan 26, 2022
5 min read

Important

Information about the novel coronavirus (the virus that causes COVID-19) is constantly evolving. We will refresh our novel coronavirus content periodically based on newly published peer-reviewed findings to which we have access. For the most reliable and up-to-date information, please visit the CDC website or the WHO’s advice for the public.

It’s a scenario nobody likes to think about—you wake up to clumps of hair on your pillow, or notice more hairs than usual clogging the shower drain. You head over to the mirror to investigate and realize that you’re losing your hair. You may run through a mental list of the usual hair loss suspects: Am I just getting older? Are my hormones changing? Should I get my thyroid checked? But since early 2020, there’s a surprising new question to add to this list: Could this be a symptom of COVID? 

Researchers say yes, COVID may cause hair loss. But why does it happen and will your hair grow back? Let’s see what science has to say about this unexpected and unsettling symptom of COVID-19.

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Does COVID cause hair loss?

As COVID-19 began to ramp up in 2020, healthcare providers started to notice that the majority of their hospitalized patients were losing their hair (Goren, 2020; Wambier, 2020).  

And it didn’t end after admission. One large review found that 25% of so-called long haulers (people who had lasting COVID symptoms for more than two weeks) experienced hair loss for weeks or months (Lopez-Leon, 2021). 

Even people with less severe COVID were affected. Hair loss was a common symptom seen in people with COVID who weren’t hospitalized (Esitri, 2021). But what causes this unwanted side effect? 

How does COVID lead to hair loss? 

COVID is a new diagnosis, and the studies at hand are often small, so researchers are still learning about COVID’s many outcomes. But there are several theories as to how COVID leads to hair loss, including inflammation, stress, and hormone changes. 

Inflammation and hair loss

Inflammation is responsible for many COVID complications, such as lung damage. But is it responsible for hair loss, too? 

In a small study of 10 people with COVID-19 and hair loss, researchers found that the start of the hair loss was associated with the severity of symptoms like high fever (Trüeb, 2021). 

They found that the hair loss looked different from androgenetic alopecia (AGA)—which occurs mostly along the hairline and affects hair that’s in its growth phase—and more closely resembled telogen effluvium (TE), or hair shedding (Trüeb, 2021). TE is a temporary condition that pushes your hairs into a “resting phase” in which they stop growing and shed. This can happen if there’s some “shock to the system”. It can cause huge numbers of hair to fall out at once, from all over your scalp (AOCD, n.d.). 

Stress and hair loss

It’s pretty common to have telogen effluvium after extreme physical or emotional stress. Sometimes, it occurs weeks or even months later. In one small study, researchers found that people with COVID developed TE up to three months after COVID symptoms started. Hair growth improved within six months, which is consistent with TE, since it resolves when the stressful event passes (Olds, 2021).

A web survey found that the stress of pandemic conditions themselves may even contribute. Almost a third of people who didn’t have COVID but quarantined at home reported excessive hair loss (Turkmen, 2020).

How can you stop hair loss from COVID? 

People who get telogen effluvium after infections, inflammatory disease, or stress usually improve when the underlying cause is treated or has resolved, which holds true in COVID-related hair loss (Olds, 2021). Several studies found that post-COVID hair loss improved on its own, usually within 3–6 months after the initial infection resolved (Trüeb, 2021; Mieczkowska, 2021). 

In one study, dermatologists treated some people with topical minoxidil (Rogaine), but there was no evidence that it reversed their COVID-related hair loss (Olds, 2021). The only thing that really seemed to do the trick was time. 

In the meantime, since TE may be triggered by stress, you may want to try some techniques to help decrease your stress levels. Practicing mindfulness, engaging in exercise, and eating nutritious foods are helpful ways to relax and take care of your overall wellness. 

And, if you are experiencing COVID-related hair loss, the good news is that it’s probably not permanent. Hair loss from COVID usually clears up on its own after a few months. If you are uncertain whether COVID is the source of your hair loss, it’s a good idea to speak to a healthcare professional. 

References

  1. American Academy of Dermatology (AAD). (2021). Can COVID-19 cause hair loss? Retrieved on Nov. 22, 2021 from https://www.aad.org/public/diseases/hair-loss/causes/covid-19 
  2. American Osteopathic College of Dermatology (AOCD). (n.d.). Telogen Effluvium. Retrieved on Jan. 14, 2022 from https://www.aocd.org/page/telogeneffluviumha 
  3. Domínguez-Santás, M., Haya-Martínez, L., Fernández-Nieto, D., Jiménez-Cauhé, J., Suárez-Valle, A., & Díaz-Guimaraens, B. (2020). Acute telogen effluvium associated with SARS-CoV-2 infection. Australian Journal of General Practice, 49. doi: 10.31128/AJGP-COVID-32. Retrieved from https://www1.racgp.org.au/ajgp/coronavirus/acute-telogen-effluvium-associated-with-sars-cov-2/ 
  4. Estiri, H., Strasser, Z. H., Brat, G. A., Semenov, Y. R., Consortium for Characterization of COVID-19 by EHR (4CE), Patel, C. J., et al. (2021). Evolving Phenotypes of non-hospitalized Patients that Indicate Long Covid. MedRxiv : The Preprint Server for Health Sciences, 2021. doi: 10.1101/2021.04.25.21255923. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8095212/ 
  5. Gadzhigoroeva, A., Sanchez, D. G., Firooz, A., Moravvej, H., Espinoza, N., et al. (2021). COVID-19 Can Exacerbate Pattern Hair Loss and Trigger Telogen Effluvium – The Role of Proteoglycan Replacement Therapy with Nourkrin® in Clinical Treatment of COVID-19 Associated Hair Loss. Journal of Dermatology Research and Therapy, 103(7). doi: 10.23937/2469-5750/1510103. Retrieved from https://clinmedjournals.org/articles/ijdrt/journal-of-dermatology-research-and-therapy-ijdrt-7-103.php?jid=ijdrt# 
  6. Goren, A., Vaño-Galván, S., Wambier, C. G., McCoy, J., Gomez-Zubiaur, A., Moreno-Arrones, O. M., et al. (2020). A preliminary observation: Male pattern hair loss among hospitalized COVID-19 patients in Spain – A potential clue to the role of androgens in COVID-19 severity. Journal of Cosmetic Dermatology, 19(7), 1545–1547. doi: 10.1111/jocd.13443. Retrieved from https://pubmed.ncbi.nlm.nih.gov/32301221/ 
  7. Lopez-Leon, S., Wegman-Ostrosky, T., Perelman, C., Sepulveda, R., Rebolledo, P. A., Cuapio, A., et al. (2021). More than 50 Long-term effects of COVID-19: a systematic review and meta-analysis. MedRxiv : The Preprint Server for Health Sciences, 2021.01.27.21250617. doi: 10.1101/2021.01.27.21250617. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7852236/ 
  8. Mieczkowska, K., Deutsch, A., Borok, J., Guzman, A. K., Fruchter, R., Patel, P., et al. (2021). Telogen effluvium: a sequela of COVID-19. International Journal of Dermatology, 60(1), 122–124. doi:10.1111/ijd.15313. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7753411/ 
  9. Olds, H., Liu, J., Luk, K., Lim, H. W., Ozog, D., & Rambhatla, P. V. (2021). Telogen effluvium associated with COVID-19 infection. Dermatologic Therapy, 34(2), e14761. doi: 10.1111/dth.14761. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7883200/ 
  10. Trüeb, R. M., Dutra Rezende, H., & Gavazzoni Dias, M. (2021). What can the hair tell us about COVID-19?. Experimental Dermatology, 30(2), 288–290. doi:10.1111/exd.14259. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/exd.14259 
  11. Turkmen, D., Altunisik, N., Sener, S., & Colak, C. (2020). Evaluation of the effects of COVID-19 pandemic on hair diseases through a web-based questionnaire. Dermatologic Therapy, 33(6), e13923. doi:10.1111/dth.13923. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7361059/ 
  12. Wambier, C. G., Vaño-Galván, S., McCoy, J., Gomez-Zubiaur, A., Herrera, S., Hermosa-Gelbard, Á., et al. (2020). Androgenetic alopecia present in the majority of patients hospitalized with COVID-19: The “Gabrin sign”. Journal of the American Academy of Dermatology, 83(2), 680–682. doi: 10.1016/j.jaad.2020.05.079. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7242206/
  13. Wollina, U., Karadağ, A. S., Rowland-Payne, C., Chiriac, A., & Lotti, T. (2020). Cutaneous signs in COVID-19 patients: A review. Dermatologic Therapy, 33(5), e13549. doi: 10.1111/dth.13549. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7273098/

Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.