Can covid-19 cause hair loss?

We sat down with our Medical Director and Consultant Dermatologist, Dr Martin Wade to share more about Covid-19 and the effects it has on hair loss. This is an emotionally-rich topic that has affected many people across the globe. After Alyssa Milano shared her personal story and struggles with Coronavirus and hair-loss, the conversation started trending on social media, with people asking the Question, “Can covid-19 cause hair loss?” 

We wanted to share more on why and how this could occour.

Q

I suppose the first question is, is it possible to experience hair loss as a result of Covid-19, and how or why would this happen? 

Dr Martin Wade: 

Yes, it is possible and we are seeing this with the patients in our own clinic. The mechanism is referred to as Telogen effluvium. If a patient gets sick, or experiences any trauma or stress, for example, that could cause a shock to the body and result in a period of hair shedding. There is not enough evidence at this stage to prove that it is specifically related to coronavirus, however, if someone has been unwell and has had a high temperature, or has experienced any weight loss, as is the case with some Covid-19 patients, then this could certainly be considered a trigger for hair loss. 

Post the infection or the trauma, there is typically a lag that ocours. The shedding would then begin about 3 months later, and continue for another 3 months, at which time, it would cease. 

It is important to note and understand that this is just an alternation of the hair cycle, so the hair follicles themselves are not being destroyed or damaged, they are simply falling out. 

With the hair cycle you normally have 87% of the hairs in the growing phase, 12% in the resting phase, and 1% transition between the two phases. When a resting hair comes out, it comes out with gentle pressure, so when you are washing or brushing your hair. If that 12% resting hair, goes up to 15 or 16%, although it may not seem like a high amount, it would be enough to notice dramatic shedding of the hair. That is when people begin to notice that they may be losing some of their hair, and haven’t managed to put two and two together because there has been that lag between the time of infection and the start of the shedding. 

Q. Who would this typically affect? 

Any person of any age could be affected. Women do tend to notice it more than men because they have longer hair so they pick it up quickly, but with men, who may generally have shorter hair, might not notice it straight away. 

We have had patients who have never had a hair loss problem and are all of a sudden losing their hair, causing a lot of distress and anxiety. 

And then on the flip side, we have had patients who are managing existing hair loss problems and are now experiencing a further insult to injury. 

Q. Has there been any research into this condition? 

There is a bit of research in the US about the link between Covid-19 and Androgenetic alopecia, but it’s all quite experimental at this stage. We would need time to further investigate the matter and study the link between the two. 

Q: 

Could there be any possible link with Anaemia- the low iron disorder?

There is insufficient evidence to assertively confirm that anemia has a direct link to hair loss, but having low iron, lacking certain nutrients or generally being unwell as mentioned, can cause hair loss to some extent. Anaemia and low iron can cause hair loss – it would cause a telogen effluvium.

Q

When a patient comes to visit the clinic, can you explain a little bit about the process and what he/ she could expect from the Dermatology consultation? 

The first point of call is to thoroughly check their medical history and make sure we are fully aware of any medical concerns and the history of the presenting condition. Then we would examine the scalp, and take a full set of baseline photographs. This would be our reference point to track and monitor results and be able to compare them to other images in the future. 

One of the tests we would carry out is the hair pull test, whereby I would pull on one or two of the hair strands and assess whether I’m getting one or two strands out, which would be normal, or whether I’m managing to pull a lot of hair out with gentle traction only, which would be considered to be a positive hair-pull test. 

We would then discuss and assess the next steps. 

Q. 

What would you say for people trying to treat the hair loss at home, as a potential result of covid-19?

The good news is that this type of hair shedding is usually completely recoverable. It is what we call self-limiting, meaning that it can resolve without any form of treatment. It may be distressing at the time, and appear rather dramatic, but it will usually resolve on it own.  

We know that people start to become afraid to wash or brush their hair, for fears their hair may fall out further, but the truth is that any hair that comes out, would’ve come out anyway on its own. So my advice would be to carry on as you were, use your regular shampoo, and wash as and when is required to cleanse the scalp. 

For any homecare advice, I would say to ensure that you are getting enough protein in the diet. You may also want to explore Viviscal supplements, upon recommendations by a healthcare professional, to assist in giving the hair follicles everything they need in order to fully recover. 

Q. Do you ever recommend Biotin a good supplement to strengthen hair and nails? 

There is not enough clinical evidence to prove the efficacy of Biotin unless you are Biotin-deficient, which would not present in people with a well-balanced nutritional diet. 

Q. What if the shedding persisted?

In some cases, the shedding can be prolonged. And if it persisted, then we would recommend consulting with an experienced Dermatologist to discuss possible treatments and product plans. This could include using topical minoxidil, oral minoxidil or platelet rich plasma injections to try and treat the condition. PRP injections can also help speed up the recovery.

Q. Any final advice or recommendations you would give to people experiencing this? 

Try to maintain a stable weight, avoid yo-yo dieting, eat a nutrient-rich diet, and find ways to manage the stress. Patients should feel assured that their hair will eventually grow back, and should avoid using any products on the market that claim to be able to solve the condition and that are not properly prescribed or recommended by a Healthcare Professional. 

Time and patience is really what is needed at this point.