Hair Loss After COVID: Should You Be Concerned?

Physical appearance is probably the last thing you thought of during the past few years when it comes to COVID-related symptoms. Whether it is respiratory distress or inflammation that can lead to a loss of smell from COVID, most complications from the contagious viral infection remain invisible to others.

As the coronavirus has continued to infect people around the world, patients have been surprised to notice clumps of hair falling from their scalp months after coming down with COVID. This development has led many people to wonder if COVID can cause hair loss. The answer is yes, although the more pressing topic is if people should be concerned about the long-term impact of these hair changes.

Hair loss after COVID

The human body has about 5 million hair follicles that cycle through a three-step process. First, hair grows and pushes through the skin in the anagen stage. Then, hair dies during the catagen stage. Finally, hair falls out and regenerates during the telogen stage. Each day, you lose about 50 to 100 hairs.

Hair follicles remain in the anagen (growth) stage 85 to 90 percent of the time, which can take anywhere from two to four years. By comparison, the telogen (rest) stage may only last two to four months.

In certain cases, the physical and emotional stress created by COVID can lead to what is perceived as hair loss. You aren’t losing hair, rather, COVID causes hair to shed more than normal.

Telogen effluvium and COVID

The medical term for this type of temporary hair shedding is known as acute telogen effluvium. The stressors created from COVID shock your body and disrupt the growth-rest cycle. The result is increased shedding of hair – as much as 30 to 50 percent of hair follicles are in the telogen stage compared to 5 to 10 percent – several months after becoming infected with COVID.

Telogen effluvium isn’t just limited to COVID. It can occur for many reasons, including viral infections, after a surgery, hospitalization, hormonal changes, and stress. COVID is a viral infection that can lead to stress and hospitalization, which explains why hair loss may occur in some people.

For COVID patients, physical stressors can be as mild as a high fever or having to be placed on a ventilator due to moderate to severe respiratory complications.

As for mental stressors, the toll of dealing with COVID can impact how you think and feel. These changes can produce stress hormones that place hair follicle stem cells into an extended resting phase. More specifically, stress can alter cells at the base of hair follicles called dermal papilla and inhibit molecules needed for hair growth. 

The severity of hair loss isn’t necessarily directly tied to the severity of illness – some people with mild COVID symptoms may experience severe hair loss, while people with severe COVID symptoms may have mild hair loss.

How soon does hair shedding begin?

Unlike most COVID symptoms that appear days or weeks after infection, you’ll typically notice hair shedding two to three months later. In general, non-COVID cases of telogen effluvium causes hair to begin shedding in about three months. 

However, research during the past several years has shown an expedited timeline due to COVID. One small study of 30 COVID patients found the median average onset of telogen effluvium to be 45 days. The delayed nature of these symptoms is what makes it such a head-scratcher for most people.

Since more hair follicles than normal are in the dormant stage and have begun to shed, people usually see changes to their hair whenever agitating the scalp. Initially, hair clumps will appear when brushing your hair or after you shower. Your hair will then start thinning out within a few weeks of seeing hair clumps.

It’s important to remember hair shedding is due to a disruption in the growth-regeneration process, not actual damage to hair. Hair will regrow over time because the follicles are still present.

How long does COVID hair loss last?

For those concerned, the good news is that COVID-related hair loss is generally an acute issue and will grow back eventually. Patience is needed, though, as regrowth can take anywhere from six to nine months and possibly as many as 18 months to become full again.

Don’t be alarmed if your hair remains thin for quite some time. Hair grows about a centimeter per month. You’ll first notice short, baby hairs on your scalp that get thicker and fuller over time. For women with longer hair, it may take two years or more to regrow hair long enough for a ponytail to feel “full” again.

As for treatment, no medications are recommended to help with acute cases of hair shedding. Other than patience, the best way to avoid further hair shedding is to handle your hair with care. Don’t tug on your hair when combing it and be sure to use a conditioner when showering to reduce tangles. Curling irons, hair straighteners or other devices that heat your hair may damage or weaken hair follicles.

In the summer, wearing a hat can reduce damage from strong ultraviolet rays. As comfortable as it may be to wear hair in a tight-fitting ponytail or headband, the stress on the hair can break down hair and make it more prone to falling out. Avoid any hairstyles that place tension on your hair.

It’s also beneficial to practice stress-relieving techniques, such as yoga, meditation or another form of exercise. The relationship between acute hair loss and stress is cyclical in many cases. Losing your hair can create unwanted stress, and that stress can make hair loss even worse.

While a majority of cases are short-term, COVID can cause chronic telogen effluvium that lasts several years. People who experience long COVID symptoms are most likely to be affected by chronic hair shedding.

If you notice your hair loss after COVID isn’t improving after several months, contact your primary care physician and ask for a referral to a dermatologist. They can evaluate your condition and provide treatments to reduce hair loss and help regrow hair. Find a dermatologist near you today.