Hair Loss After Covid-19
Unexpected Side Effects
Long-term side effects following COVID-19 infection have caused many devastating symptoms, from loss of taste and smell to brain fog and persistent fatigue. Hair loss has also been reported as a common symptom and is something we are seeing quite frequently at Connected Health & Skin. Months after recovering from COVID-19, many people find
that their hair is falling out in large clumps.
While this side effect can be one of the most alarming, it is short lived in most circumstances.
Why do some people experience hair loss after having Covid-19 or other infections?
Patients who experience hair loss from Covid-19 infection may notice clumps of hair shedding while washing their hair in the shower or when brushing or combing their hair. This phenomenon is known as telogen effluvium.
About 90 percent of hairs on our scalp are in a growth phase, called anagen, and about 10 percent of hairs are in a resting phase, called telogen. On our scalp, the anagen phase lasts for about three years, and then hairs begin transitioning into the telogen phase, which lasts between two to six months. At the end of the telogen phase, our hairs are shed from their follicles and gradually replaced by new anagen hairs. Then, the growth cycle continues.
On average, you should shed about 100 to 150 hairs a day. But when an individual experiences a stressful event, such as COVID-19 infection, our bodies can prematurely shift a greater than normal proportion of hairs into a resting telogen state. Instead of the usual 10 percent of hairs that are in the resting and shedding phase, up to 50 percent of hairs are resting and shedding, which is much more than normal.
Hair Loss Triggers:
- Viral infections (including Covid-19)
- Medications, especially hormonal medications
- Thyroid dysfunction
- Entering menopause
- Significant emotional stress
- Nutrient deficiencies or excesses
- Hormonal shifts
- Elevated androgens
How long does hair shedding typically last?
Most people typically see noticeable hair shedding two to three months after having a fever or illness. Handfuls of hair can come out when you shower or brush your hair. This hair shedding can last for six to nine months before it stops. Luckily, telogen effluvium does not cause permanent damage or loss of the follicle. While hair may not temporarily grow, the hair follicles are still present, and hair will eventually regrow.
Even after the shedding has stopped, patients may notice their hair is not as thick as it once was - that’s because of how slowly the hair grows on average, which is about a centimeter a month. For example, if someone has shoulder length hair, it can take over two years for the new hairs to reach that length again and for a ponytail to feel full again
In some cases, patients may experience a condition called chronic telogen effluvium, where excessive hair shedding can persist beyond six months. This can last for a couple months to a couple years, and usually no obvious cause can be found. In this situation, we treat the symptoms the best we can with various interventions like microneedling with growth factors, topicals and targeted nutrients.
Chronic telogen effluvium can be a frustrating and traumatic symptom for long COVID patients. This is likely because their bodies are undergoing a significant amount of stress and are still not fully healed.
Treating a condition like hair shedding takes time and patience.
Medications can be tricky, especially for patients with acute telogen effluvium. Once you start a medication or supplement for hair growth, it’s hard to know when to stop taking it and there can be associated fear that discontinuation will cause hair to start shedding again. We often do not recommend medication or supplements for hair growth during an acute phase. However, targeted medication or other therapies make sense for those patients who are still experiencing shedding four to six months after onset.
Any kind of hair loss can be a significant emotional stressor, which in and of itself can contribute to hair shedding if it’s not managed. While it’s completely understandable to be distressed, we find it critical to empower patients to monitor their own progress at home and communicate the importance of stress management for successful recovery.
At Connected, we recommend that patients struggling with hair loss consult with a Naturopathic Doctor to create an appropriate plan for overall recovery and to address the underlying causes.