COVID Hair Loss (Why It Happens and How To Treat It)

Close-up of the face of a person with dreadlocks wearing a surgical mask

COVID-19 is a traumatic global event, changing life as we knew it and causing high levels of stress for almost everyone. Individuals who experienced high levels of physiological or mental stress during this time have been more susceptible to hair loss. Stress-related hair loss causes rapid hair loss after a physically or emotionally stressful event. (1,2) 

A variety of medical treatments, vaccines, and behavioral changes related to COVID have also caused hair loss for some people. In some cases, this is also stress-related hair loss, with the body being stressed by a new medication, while in others, the hair loss is due to lifestyle changes, like using personal protective equipment (PPE) on a daily basis.

The COVID pandemic has also affected people with pre-existing types of hair loss. The most common cause of hair loss, androgenic alopecia (pattern hair loss) affects about 80 million people in America alone. Other causes of hair loss include autoimmune conditions like alopecia areata, where the body’s immune system attacks its own hair follicles.

Are COVID and Hair Loss Related?

The COVID pandemic has led to an increased number of people experiencing hair loss. This has occurred in both COVID patients and people experiencing increased stress as a result of living through the pandemic. 

Hair loss due to COVID is primarily caused by telogen effluvium (stress-related hair loss). However, hair loss can also be caused by an autoimmune response as a result of the COVID infection, among other factors. (2)

Does COVID Cause Hair Loss?

COVID can lead to hair loss in a variety of ways, but it’s not usually a direct cause. COVID is typically a secondary cause. It plays a part, but the infection itself isn’t causing loss of hair. (2) 

Telogen effluvium is estimated to occur in up to 60 percent of patients who have been diagnosed with coronavirus. It can happen during the infection or in the weeks to months immediately afterward, while the patient is recovering. Doctors have begun to refer to this specific type of stress-related hair loss as COVID-19-associated telogen effluvium. (2) 

The experience of having COVID and the fear, stress, and worry during the infection can be enough to cause telogen effluvium. Stress-related hair loss can also be caused by the experience of being hospitalized, weight loss during the infection, loss of nutrients, lack of sleep, fever, and even some medications used to treat the infection. (2) 

When stress-related hair loss occurs, hairs move from the growth phase into the resting phase of the hair growth cycle. The next growth phase doesn’t start, so when hair strands begin to fall out, new hairs don’t replace them. This causes hair thinning in a diffuse pattern. (2) 

Some people may experience an autoimmune response as a result of having COVID, in which their body mistakenly attacks its own cells. Hair follicles can be attacked as part of this response, causing hair loss. COVID infections are specifically thought to cause a hyperimmune reaction that attacks the patient’s hair follicles. (2) 

Hyperimmune COVID reactions can also influence pre-existing autoimmune forms of hair loss. Alopecia areata is one of the more common autoimmune hair loss conditions in COVID patients. Anagen effluvium (similar to telogen effluvium, but affecting a different phase of the hair growth cycle) and fibrosing alopecia are other autoimmune-based conditions that affect COVID patients, although these are less common. (2) 

Treatment of COVID may also influence hair loss. For example, some of the medications used to treat or manage COVID can cause alopecia as a side effect. These include antiviral, antimalarial, anticoagulant, and immunosuppressant medications. (2,3)

Patients who have been hospitalized, have been lying down for long periods on their back, or are placed in a prone position can also end up with pressure-induced alopecia. Being in any single position for a long period can cause pressure on the skin. This is known to cause skin problems, like pressure ulcers (more commonly known as bed sores), but can also result in hair loss. This is due to reduced blood flow to the area, which can damage the layers of skin and in some cases, the hair follicles. (2,4) 

Is Hair Loss a Symptom of COVID?

Hair loss is very unlikely to be a symptom of COVID-19. Instead, it’s likely a secondary symptom, caused indirectly by something related to COVID. (2) 

But when it comes to post-COVID-19 syndrome (also known as long COVID), research suggests hair loss may be one of many ongoing symptoms. In fact, hair loss can continue for months after recovery. (2,3) 

People with underlying medical conditions are typically most susceptible to experiencing severe or long COVID symptoms. Those with underlying health conditions and certain genetic predispositions may also be more likely to experience hair loss along with a COVID infection. (3,5) 

Research has found that the severity of the COVID infection is linked to hair shedding. Those who experience severe COVID symptoms are far more likely to experience hair loss. Likewise, those who experience milder symptoms are less likely to experience hair loss. (3,6) 

What About Post-COVID Hair Loss?

Hair loss from COVID can occur in the weeks or months after the patient has recovered. Some patients also notice a hair texture change after COVID. 

Hair loss after COVID-19 can happen for a variety of reasons, one of the main causes being telogen effluvium. Since going through COVID puts a great amount of strain on the body and can be really worrying, it’s understandable that it can lead to this type of hair loss. (2,7) 

The treatments provided to help patients overcome COVID can also cause hair loss after they recover. Treatments such as antiviral, antimalarial, or immunosuppressive medications, which are used in more severe cases of COVID, can cause hair loss as a side effect. (2,3) 

Anticoagulants are also used in 80 percent of hospitalized COVID patients and are significantly linked to hair loss. However, the exact reason why this occurs is not yet known. (7) 

Long COVID is a condition causing ongoing symptoms in patients after the active infection is passed. There are a wide variety of long COVID symptoms, including fatigue, palpitations, breathing difficulties, cognitive issues, and hair loss. More research is needed to fully understand why long COVID causes hair loss in many people. (2)

Does the COVID Vaccine Cause Hair Loss?

Many people wonder, is hair loss a side effect of COVID vaccines? In some cases, it’s possible for the vaccine to cause hair loss. The COVID vaccine can cause an autoimmune or inflammatory response in the body, which can lead to hair loss. The most common type of hair loss the vaccine can cause is alopecia areata. (2)  

It’s crucial to note that COVID vaccine hair loss is mostly seen in patients with a genetic predisposition to autoimmune reactions. And this side effect isn’t specific to the COVID vaccine – other vaccines have also been shown to cause alopecia areata.

Vaccine-related hair loss is more likely to occur in people who have previously had a hair loss condition. It’s also important to remember that the COVID infection itself can also cause hair loss (along with a host of dangerous symptoms), so this potential side effect shouldn’t deter you from getting this – or any other – vaccine. (2) 

Other Ways COVID and Hair Loss Are Related

Since the start of the pandemic, there’s been an increased rate of people experiencing skin issues, including forms of psoriasis and dermatitis. These issues can cause localized hair loss on the body or scalp. (2) 

In health care professionals in particular, the long term use of protective personal equipment (PPE) can cause friction and skin irritation. This can break down the skin’s protective barrier (known as the epidermal barrier), which can cause irritation, discomfort, rashes, and hair loss. (2) 

Some forms of dermatitis, such as seborrheic dermatitis, can be caused or aggravated by stress. This can contribute to hair loss, among other symptoms. Since the pandemic has caused high levels of stress for most of us, it’s easy to see how this has affected so many people. (2) 

Scalp psoriasis has also been reported in some COVID patients. This causes raised, scaly patches that can lead to hair loss. It can be caused by an immune reaction or skin irritation. (2) 

Some of the protective measures people have taken (such as showering and washing hair more frequently, wearing face masks, and using hand sanitizer) have caused skin conditions and in some cases, hair loss. (8) In some cases, these protective measures can compound skin issues like psoriasis or dermatitis, particularly if people already have sensitive skin.  

Pattern Hair Loss and COVID

Some studies have proposed that COVID and androgenetic alopecia (pattern hair loss) are linked. Androgens, hormones that are integral to the development of male traits and sexual development, play a part in the development of androgenetic alopecia. Androgens are present in both males and females, although they are present at higher rates in males. (8,9) 

Some studies suggest that androgens are linked to an increased risk for COVID. They hypothesize that men with androgenetic alopecia have a greater risk of catching COVID. Men are already known to have a higher risk for COVID than women, which drives this theory. 

Other studies have linked androgenic alopecia to increased risk of severe COVID and more prone to side effects. In fact, everyone who experienced alopecia areata after COVID had a pre-existing diagnosis of androgenic alopecia. (9)    

How Long Does COVID Hair Loss Last?

Most hair loss associated with COVID is temporary. Once the stressful event or infection has passed, hair will gradually regrow. But if hair loss persists past the six-month mark, additional treatment may be needed. For patients with long COVID, hair loss will likely last as long as symptoms do, but this can vary. (2) 

People who experience an autoimmune form of hair loss, like alopecia areata, should know that this issue can reoccur in the future. Fibrosing alopecia, another autoimmune condition, can cause permanent hair loss in its advanced stages. If it’s caught early, treatment can help stop its progression. (2) 

Hair loss due to dermatological issues, like dermatitis and psoriasis, will last as long as the cause persists. Once the trigger is identified and a treatment’s been started, hair will usually regrow. (8) 

How To Stop Hair Loss After COVID

A lot of hair loss will resolve on its own once patients recover from COVID. Therefore, much of the post-COVID hair loss treatment is simply being patient, letting the hair growth cycle restart, and helping people deal with the emotional impact of hair loss. (2)

Patients with telogen effluvium may be offered help to cope with emotional stress. Some people might be given iron or zinc supplements to encourage quicker regrowth of hair. (7)

If telogen effluvium becomes chronic (lasting more than six months), other treatments, like topical minoxidil, may be offered. If telogen effluvium is exacerbating an existing form of hair loss, like androgenic alopecia, a much wider range of treatments may be offered, including DHT blockers, laser hair therapy, or even hair transplants in severe cases. (2)

For people with alopecia areata, hair loss treatments typically involve corticosteroids or topical immunotherapy medications.(2) Sometimes, a combination of topical treatments and lifestyle changes can help ease symptoms. (8) 

Why Has Hair Loss Increased During the COVID-19 Pandemic?

There are many reasons hair loss has increased during the pandemic. Everyone has been under a great amount of stress. For some people, this stress has led to a type of hair loss known as telogen effluvium. And stress isn’t only psychological. The vaccine and medications used to treat COVID also caused physical stress – and hair loss – in some individuals. 

But stress isn’t the only cause of COVID hair loss. An autoimmune response called alopecia areata caused hair loss in a number of patients. And for those who experienced more severe COVID, prolonged periods in bed during recovery sometimes also contributed to hair loss. Even now, some long COVID patients are experiencing hair loss during their recovery. 

Even healthy individuals like healthcare practitioners struggled with COVID hair loss. Wearing PPE and frequent cleaning habits have caused an increase in skin problems, which has also resulted in hair loss.

Thankfully, most of the hair loss experienced as a result of these causes will resolve over time. Hair will regrow, and treatments like minoxidil, corticosteroids, and even nutrient supplements can help people restore their hair’s health.

References

  1. Cleveland Clinic, (2021), Hair Loss
  2. Aryanian, Z., Balighi, K., Hatami, P., Afshar, Z. M., & Mohandesi, N. A. (2022). The role of SARS‐CoV‐2 infection and its vaccines in various types of hair loss. Dermatologic Therapy, e15433.
  3. Guarnieri, G., Bertagna De Marchi, L., Marcon, A., Panunzi, S., Batani, V., Caminati, M., Furci, F., Senna, G., Alaibac, M. & Vianello, A. (2022). Relationship between hair shedding and systemic inflammation in COVID-19 pneumonia. Annals of Medicine, 54(1), 869-874.
  4. Perry 2nd, T., Rosen, H., Pettit, C., & Trinidad, J. C. (2021). Pressure-induced alopecia due to proning in COVID-19. Dermatologic Therapy, e14764-e14764.
  5. Ramos, P. M., Ianhez, M., & Miot, H. A. (2020). Alopecia and Gray Hair Are Associated with COVID-19 Severity. Experimental dermatology.
  6. Sattur, S. S., & Sattur, I. S. (2021). COVID-19 Infection: Impact on Hair. Indian Journal of Plastic Surgery.
  7. Qasid, A. (2021). Hair, nail, and skin changes during COVID 19 era. Egyptian Journal of Medical Microbiology, 30(4), 169-173.
  8. Goren, A., Vaño-Galván, S., Wambier, C.G., McCoy, J., Gomez-Zubiaur, A., Moreno-Arrones, O.M., Shapiro, J., Sinclair, R.D., Gold, M.H., Kovacevic, M. and Mesinkovska, N.A., 2020. A preliminary observation: Male pattern hair loss among hospitalized COVID-19 patients in Spain-A potential clue to the role of androgens in COVID-19 severity.
  9. Nguyen, B., & Tosti, A. (2022). Alopecia in patients with COVID-19: A systematic review and meta-analysis. JAAD International, 7, 67.
Published on August 26, 2022

Last updated August 2022

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