Does COVID-19 cause sudden hair loss?

Sudden hair loss has increased since March 2020, according to a study that found COVID-19 infections are now a “frequent and common cause of acute telogen effluvium.”

Telogen effluvium is a common cause of temporary hair loss after a stressful experience. The stress can push many hair follicles into a resting phase, and within two or three months, the hairs will fall out. Dr. John Wolf, chair and professor of dermatology at Baylor College of Medicine, discussed how this can happen and how to manage it.

Dr. John Wolf
Dr. John Wolf

In the August 2021 study “COVID-19 infection is a major cause of acute telogen effluvium,” 39 patients between the ages of 22 and 67 diagnosed with the condition were given a hair pull test to confirm the telogen effluvium diagnosis and severity. All participants had a laboratory-confirmed diagnosis of SARS-CoV-2 infection with 15 who reported mild symptoms and 24 who experienced moderate disease.

While no patient required hospitalization for COVID symptoms, all experienced excessive hair loss within two to three months after initial infection, according to the study, which was conducted between September 2020 and March 2021.

While evidence exists of a clear connection between COVID-19 and sudden hair loss, telogen effluvium isn’t directly tied to the virus. Not everyone who is diagnosed with COVID will experience hair loss either.

Hair loss can be caused by a “shock to the system,” such as the pregnancy and birth of a child, major surgery, physical accidents, any infection with a high fever or stress. People who lose weight quickly, either through a diet, exercise or illness also can experience a type of telogen effluvium.

Typically, telogen effluvium will occur about three months after the “shock,” Wolf said.

“In telogen effluvium, you’ll suddenly have as many as half of the hairs on your head in the resting phase, and they will fall out,” Wolf said. “Any time you comb or shampoo, you will see hair falling out as 10% of hair is programmed to fall out. If the hair follicle isn’t damaged, it will always grow new hair.”

Dermatologists have seen patients who have recovered from COVID and experienced hair loss faster than other instances of telogen effluvium – two months rather than three. While most experience hair regrowth, there are a few reported cases of chronic telogen effluvium, he said.

The stress of COVID treatment, or pandemic life, can also be a factor in hair loss. Wolf said it’s not surprising that people experience hair loss after having a high fever or being placed on a ventilator during a hospital stay since all are mentally and physically stressful situations.

In most telogen effluvium cases, the body will heal itself and grow the hair back. There’s currently no treatment or cure, but Wolf recommends shampooing and brushing the hair carefully with a natural-bristle brush or a comb with wide teeth.

If the rapid hair loss continues, a dermatologist may change the diagnosis to alopecia areata, which consists of round patches of hair loss on the scalp. The most common form of hair loss in men and women, however, is androgenetic alopecia but it occurs at a much slower pace. Traction alopecia can occur if the hair is pulled back from the hair follicle too tightly, according to the American Academic of Dermatology Association.

If you’re experiencing hair loss or other scalp issues (dandruff, pimples, general itchiness), it’s best to seek a dermatologist for proper diagnosis and treatment. Talk with a healthcare professional before starting an over-the-counter treatment, like Rogaine, which can have a long-term effect on the hair follicles.

Learn more about Baylor Medicine Dermatology services.

-By Julie Garcia

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