This is a MedPage Today story.
Clinicians are seeing an inflow of sufferers experiencing an unsettling aspect impact after COVID-19: losing their hair.
Dr. Brian Abittan, the director of pores and skin and hair rejuvenation at Mount Sinai Health System in New York, mentioned that he sees a number of sufferers per week who’ve reported hair loss after COVID-19.
“A day doesn’t go by that I don’t get asked about it,” Abittan advised MedPage Today.
Although extra sufferers are clearly reporting the symptom after COVID, there is not sturdy knowledge describing what number of sufferers expertise this phenomenon or what components put somebody in danger for it. While there are nonetheless many unanswered questions on COVID-related hair loss, specialists say the excellent news is that it seems to be short-term and clinicians ought to reassure sufferers that their hair will very seemingly develop again.
Some proof has proven that there’s an elevated danger of hair loss following COVID an infection. A research revealed in Nature Medicine final month discovered that hair loss was one of a wide range of symptoms that post-COVID sufferers reported to their major care physicians.
Patients with a historical past of COVID had been almost 4 instances as more likely to develop hair loss than those that weren’t contaminated, the researchers discovered.
Additionally, a research within the Lancet journal estimated that 22% of patients who were hospitalized with COVID experienced hair loss after their sickness.
The most typical kind of hair loss seen in post-COVID sufferers is telogen effluvium.
“The assumption is that COVID-related hair loss is very similar to stress-related hair loss,” Abittan mentioned.
Telogen effluvium happens when the expansion cycle of hair is disrupted, induced by traumas corresponding to surgical procedure, sickness, or any worrying life occasion, corresponding to transferring or a being pregnant. There are three phases that hair goes by means of throughout a progress cycle: anagen, catagen and telogen.
Anagen is the energetic progress section, catagen is the transitional section, and telogen is the resting section — during which hair sheds.
Telogen effluvium happens when a bigger proportion of hairs on the scalp shift into this resting section, leading to shedding at the next price. It’s regular for sufferers to lose about 100 hairs a day, Abittan mentioned.
But with telogen effluvium, sufferers may lose as much as 300, 500, and even 1,000 hairs every day, he added.
“A lot of times people don’t even notice that they shed,” Abittan mentioned. “But once they shed to a level where they notice, then they start to count every hair on their head.”
Hair might begin shedding as quickly as 2 or 3 months after an infection, mentioned Dr. Alexis Young, a dermatologist at Hackensack University Medical Center in New Jersey. That shedding may final for as much as six months, and it sometimes takes a few yr and a half for hair to develop again, she added.
There are a number of hypotheses about why an infection could also be inflicting hair loss in COVID sufferers, one in every of which being sufferers’ heightened state of irritation. Certain inflammatory markers, known as interleukins, turn out to be elevated throughout COVID, which might be inflicting a untimely shifting of the hairs into the telogen section, Young mentioned.
Because telogen effluvium is triggered by stress on the physique, it might be that sufferers who had been hospitalized with COVID or positioned on a mechanical ventilator expertise extra shedding than sufferers with gentle circumstances, she added.
“The more severe cases are probably having more severe hair loss,” Young mentioned. However, she added that the causes of hair loss in sufferers with extreme COVID might be multifactorial, linked to the drugs they took or the procedures they underwent.
More analysis is required to know what places a affected person susceptible to extra extreme hair shedding, Young acknowledged.
Other theories about what causes COVID-related hair loss embody a direct invasion of the virus into the hair follicles, which can interrupt the expansion cycle. Given that COVID causes blood clots, some have additionally raised the speculation that tiny microclots might intrude with the expansion cycle as effectively.
Abittan mentioned that to find out the perfect course of therapy, clinicians ought to consider sufferers to make sure there aren’t any different underlying causes of hair loss, corresponding to a thyroid difficulty.
Once COVID-19 is decided as a possible explanation for telogen effluvium, there are some oral drugs and topical therapies — none of that are FDA-approved for COVID-linked hair loss — that sufferers might flip to. However, light combing and hair care practices shall be best in permitting the hair to develop, Abittan mentioned.
Because telogen effluvium will not be a scarring course of, hair can — and sure will — develop again by itself, Young added. “There’s not really anything that can speed that along,” she mentioned.
Young advises her sufferers to eat a nutritious diet and attempt to scale back stress, which may worsen hair loss.
“The majority of people do, ultimately, grow their hair back,” Abittan mentioned. “It just takes time.”
There’s a broad vary of signs that sufferers with lengthy COVID can expertise, starting from coronary heart points to respiration issues and fatigue. Although hair loss might get misplaced within the combine with a few of these different signs, Abittan mentioned resolving the problem is necessary for sufferers’ psychological well being and well-being.
“When somebody does experience hair loss, it can be quite dramatic, and concerning to the patient,” Abittan mentioned. “It definitely can take a toll on people.”