The COVID-19 pandemic, unfortunately, continues to take its devastating toll. While vaccine introductions offer hope of relief, the virus remains a threat. Many who survive report physically debilitating long-term effects that prevent them from resuming the activities of their pre-coronavirus life. Yet even many among those who do make a complete recovery are reporting a baffling effect: hair loss.
As an industry-recognized leader in hair restoration surgery, Dr. Marco Barusco, MD – Founder and Chief Medical Officer of Tempus Hair Restoration – has recently seen a marked increase in the number of patients who survived COVID-19 now experiencing a significant amount of hair loss. Almost every discipline in the medical community is searching for answers about this puzzling development. Hair loss is not on the CDC’s list of known COVID-19 symptoms.
A Medical Mystery Emerges
“We don’t know exactly how COVID-19 influences hair loss,” says Dr. Barusco in his YouTube video series, “Hair’s the Truth.” In the episode – “Hair Loss After Covid-19 Infection” – Dr. Barusco discusses what he has learned based upon his examination of patients who have sought their own answers about why they’re suffering sharp, accelerated hair loss after recovery, as well as his ongoing research and review of medical literature covering this rapidly developing condition.
“It is not yet known if the virus damages hair follicles, or if the hair loss is secondary to the body’s reaction to the viral infection and the healing process. We are getting more and more questions about that.”
Based upon reports from other specialists as well as Dr. Barusco’s observations, hair loss typically begins two to four months post-COVID. However “hair loss” is a general term that covers several specific types. Telogen effluvium (TE) is a common form of hair loss characterized by diffuse hair shedding caused by an abnormal shift in follicular cycling. These early indications tend to implicate telogen effluvium in post-COVID hair loss.
In plain language, there are three phases in the hair follicle growth cycle: anagen (growth), catagen (resting) and telogen (shedding). At any given time, about 90% of hairs are in anagen, with 5% in catagen and 5% in telogen. In telogen effluvium, the proportion of hair follicles in the telogen phase significantly increases as much as 50%, leading to mass shedding. Most people shed between 50 to 100 hairs each day.
Unlike male pattern baldness, telogen effluvium involves shedding all over the head. With this condition, the scalp appears normal, with no rash or other symptoms, such as itching, burning, pain or flaking.
The afore-mentioned abnormal cycling shift has several common trigger events, such as the following:
- Infection or high fever
- Major physical or psychological trauma
- Surgery
- Extreme weight loss/change in diet
- Drugs
- Nutritional deficiencies
- Hormonal changes
Considering that COVID-19 is a viral infection and high fever is among its symptoms – and that many patients experience significant weight loss – telogen effluvium has the optimum opportunity to occur.
Shilpi Khetarpal, MD – a dermatologist at Cleveland Clinic – reports that there may also be a genetic component in determining who experiences post-COVID telogen effluvium.
“Experts say it is hard to know why some patients recovering from COVID lose hair and others do not,” she said in an interview with Healio. “It may be related to genetics. We know that hair loss happens to people who are predisposed, but we do not know who or why. There are specifics about one’s hair cycle and genetics that make them prone or predisposed to developing TE.”
Pandemic Stress May Also Trigger Telogen Effluvium
As Dr. Barusco and other medical experts note, telogen effluvium is affecting people who have not had COVID-19. He has seen patients who cared for a family member with COVID-19 who also experienced hair loss, noting that stress is a common trigger event.
Says Dr. Khetarpal, “We are also seeing people dealing with TE who did not have COVID. There is immense stress around the pandemic itself. People are stressed regarding finances, child care, homeschooling and fears about contracting COVID, along with everyday life stressors. In my practice, I have seen a rise in patients with TE since early June and continue to see new patients every week complaining about excessive hair shedding.”
Can Hair Loss Related to COVID-19 Be Treated?
Dermatologist Sara Hogan, MD, tells WebMD that she is seeing an increasing number of coronavirus patients who have hair loss for the first time.
“Hair loss can occupy a large amount of someone’s mind share because our hair is something we see. It’s often part of our identity and how others perceive us. So when patients start losing hair, especially for the first time, they often come to me very upset.”
Based upon his examination of patients seeking treatment, Dr. Barusco says that as frightening as it is to have hair come out in handfuls – as was the case with an anonymous patient he features in his video – the hair follicles remain intact, meaning that regrowth can occur. This agrees with what is known about telogen effluvium, in which hair typically starts growing back in four to nine months. Initial regrowth may occur in patchy areas of the scalp, rather than evenly.
As for treatment, each person – whether a COVID-19 survivor or one who is experiencing the stress of COVID’s impact on their family or other areas of life – is different. Your individual case involves numerous factors, such as genetic predisposition. For this reason, it is very important to not try to diagnose and treat yourself. Making an appointment with a licensed medical specialist is essential to determine your state of health and its relationship to your hair loss. Based upon an examination, a specialist can recommend and/or prescribe the appropriate actions and/or medications required to promote hair growth.
Dr. Barusco is a board-certified hair transplant surgeon, trichologist and hair loss specialist with more than 20 years of experience. He is Assistant Professor of Surgery at University of Central Florida School of Medicine, and has dedicated his career to helping thousands of patients worldwide overcome their hair loss challenges using the latest medical and surgical procedures.
Contact us to schedule your free virtual consultation. Dr. Barusco conducts every consultation himself, giving you the opportunity to learn your options in the comfort of your home – or any location, on any internet-enabled device.
Dr. Barusco conducts consultations in English, Spanish and Portuguese. For your greater convenience, Tempus Hair Restoration offers a two-night complimentary hotel stay to out-of-town clients who travel 100 miles or more.
As a COVID-19 survivor or one who is experiencing long-term stress from additional responsibilities and hardships resulting from the pandemic, you deserve to return to feeling whole and healthy, with the tools you need to promote your own sense of well-being. We would be honored to help you achieve your hair restoration goals. It may now sound clichéd, but we truly are all in this together – and we are here for you.