As the Covid-19 pandemic rages on, disturbing every aspect of life, from physical health, mental health, and social or financial affairs, we are becoming more and more aware of its impact on infected patients. In fact, although the most common symptoms remain high-grade fever, shortness of breath, and cough, various new signs and symptoms are being identified as time goes by. One of which is hair loss.
Although the CDC has yet to add hair loss to the confirmed symptoms associated with Covid-19, we have seen a global increase in reports mentioning it as a complaint. Although, an exact association between Coronavirus and hair loss is yet to be established, let’s go through some of the most accepted theories.
Post-Covid syndrome
‘Post-Covid syndrome’ is the new term that has been coined by the scientific community as more and more long term effects of the virus get reported. These symptoms, which include chronic fatigue, joint pain, shortness of breath, vision and taste problem, are known to persist in patients long after they have recovered from the infection and tested negative. Most recently hair loss has been added to this list, with a survey revealing that more than a third of respondents experienced hair loss after recovering from the Covid-19 infection.
The pattern of hair loss
The most common pattern observed in Post-Covid patients, is hair loss that occurs in large clumps, involving the whole head. Other types include male and female pattern hair loss that is associated with the virus targeting the androgen receptors that are associated with hair growth.
Hair fall is commonly observed after 2-3 months post-infection, and is known to persist for a duration of 4-6 months.
In addition, the male population was found to be affected at a higher frequency than females, according to a preliminary study conducted in Spain.
Covid-19 and Telogen Effluvium
The human hair growth cycle comprises of three phases of follicular development and maturation. These include the Anagen or the growth phase, Catagen or the resting phase, and Telogen or the shedding phase. Usually, 90% of the hair at a given time is present in the Anagen phase, with 5% each in the Catagen and Telogen phase, respectively. It is the reason why normally 50-100 hairs are lost daily.
One of the proposed pathologies associated with the virus is Telogen Effluvium (TE), a non-scarring type of hair loss that results from a dysregulation of this hair cycle. Here, an early entry into the Telogen phase is seen as the cause of premature shedding of hair in larger numbers than the average daily loss. This phenomenon is often seen to be triggered by stressful conditions such as post-surgery, severe infections, extreme weight loss, certain medications, physical or psychological trauma. Certain medical conditions and nutritional disorders are also proposed to be associated with Telogen Effluvium.
The shedding of hair generally starts two to three months after the traumatic event and affects all parts of the scalp. As stress and severe infections are already two well-established risk factors for the development of Telogen Effluvium, researchers believe it to be a culprit behind Covid-19 hair loss.
Fortunately, TE is a reversible phenomenon that usually resolves itself after the triggering stimulus is removed or the nutritional deficiency fixed. In this case, soon after health is restored to its previous strength. In rare instances, TE can progress to become a chronic condition if an underlying condition persists. Therefore, a thorough investigation and consultation may help an individual to manage their hair loss, as the treatment modalities differ in both cases.
Covid-19 and other risk factors for hair loss
Novel Coronavirus, similar to other systemic infections, can aggravate the already existing risk factors for hair loss, which include:
- A genetic predisposition to early hair loss that was bound to cause premature shedding of hair in an individual.
- A pre-existing hair condition such as androgenic alopecia or seborrheic dermatitis can worsen after infection with Covid-19.
- Similarly, nutritional deficiencies especially, iron, biotin,and vitamin D, can also contribute to a significant hair loss Post-Covid. This happens because the body utilizes the nutrients that the virus targets and depletes, for hair growth. Lower levels of both iron and vitamin D are in fact frequently reported in Covid-19 positive patients.
- Too little or too much thyroid hormone can also lead the body into an overdrive mode which results in hair loss.
- Last but not least, physical and mental stress, as it again, may trigger Telogen Effluvium or directly cause hair loss.
How to tackle this problem:
While hair loss can further add to the misery of the ongoing pandemic, experts believe that similar to the prevailing illness, it should be temporary. Affectees are encouraged not to lose hope and self-confidence and seek professional help as soon as they notice any new symptoms post-recovery.
Meanwhile, special attention should be paid to restoring a healthy mind and body by ensuring a balanced diet, along with adequate sleep and exercising routines. Meditation, yoga, or any other relaxing therapies should also be employed to tackle the stress and anxiety caused by the pandemic. In the majority of cases, simple reassurance from a healthcare provider is effective enough in comforting the patient.
Again, the people suffering from hair loss need to understand that this condition is temporary and usually improves with time, which is 4-6 months on average. For more rapid results, one can add foods rich in iron and vitamin D, along with various other hair loss supplements to their daily routine. Frequent oiling with essential hair oils and the use of hair growth serums can also help reduce the duration of hair loss.
References:
Goren A, Va ±o Galv¡n S, Wambier CG, McCoy J, Gomez Zubiaur A, Moreno Arrones OM, Shapiro J, Sinclair RD, Gold MH, Kovacevic M, Mesinkovska NA. A preliminary observation: Male pattern hair loss among hospitalized COVID 19 patients in Spain A potential clue to the role of androgens in COVID19 severity. Journal of Cosmetic Dermatology. 2020 Apr 16.
Lee J, Yousaf A, Fang W, Kolodney MS. Male balding is a major risk factor for severe COVID-19. Journal of the American Academy of Dermatology. 2020 Jul 21.
Wollina U, Karada AS, Rowland Payne C, Chiriac A, Lotti T. Cutaneous Signs in COVIDâ€19 Patients: A Review. Dermatologic therapy. 2020 May 10.
Wambier CG, Va±o-Galván S, McCoy J, Gomez-Zubiaur A, Herrera S, Hermosa-Gelbard , Moreno-Arrones OM, Jiménez-Gómez N, Gonzalez-Cantero A, Pascual PF, Segurado-Miravalles G. Androgenetic Alopecia Present in the Majority of Hospitalized COVID-19 Patientsthe Gabrin sign. Journal of the American Academy of Dermatology. 2020 May 22.