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Hair Falling Out After Covid? Illness-Related Stress Could be the Reason

Written by the Bosley Editorial Team

Reviewed by Dr. Ken Washenik, M.D., Ph.D

The COVID-19 pandemic (and more recently the omicron variant) has given us plenty to worry about. Between stay-at-home orders, mask mandates, and social distancing, we’ve done everything we can to avoid getting sick or infecting others with the highly contagious coronavirus. The uptick in stress is enough to make your hair fall out… literally!

If you are experiencing more hair shedding than normal, you might be wondering: Is hair loss a side effect of COVID?  You’re not alone. Researchers have found an unusual development stemming from the pandemic: excessive hair shedding. But don’t panic – it’s likely not permanent, and there are ways to treat post-covid hair loss.

Can Covid Cause Hair Loss?

Let’s be clear: Hair loss isn’t one of the primary symptoms of COVID-19, and, likely, it isn’t directly caused by the virus, but there is still a correlation between the two.

The correlation between COVID-19 and hair loss is illness- or infection-related stress. It’s long been known that physiologically high stress levels can lead to accelerated hair loss. With people battling elevated stress hormones in their bloodstream given the worldwide pandemic, it’s no wonder that more and more people have been experiencing stress-related hair shedding.  This type of hair loss is referred to as telogen effluvium.

Another interesting potential association between COVID and hair loss that has appeared in the medical literature is that men who carry the genes that are associated with androgenetic alopecia (commonly known as male pattern hair loss) may be more vulnerable to COVID-19 and/or more severe cases of the infection. Early observations by researchers at Brown University (among others) suggest this is worth researching further, and it is currently a subject of active clinical research [1].

Omicron and Hair Loss

While the omicron strain of COVID-19 appears to be milder than others – especially in vaccinated people – some people report hair shedding towards the end of the infection. It seems like there is a simple explanation for this. According to the American Academy of Dermatology Association, hair shedding is common after a high fever.

This means that hair loss can stem from COVID-19 in two ways:

  • The high fever associated with some cases of COVID infection with Omicron (or any variant) can also result in hair loss several weeks to three months post-infection [2, 3].
  • An indirect cause may even be the chronic stress from the COVID-19 pandemic which could lead to an increase in shedding in anyone, whether ever infected or not.

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Stress and Hair Loss

While hair loss is not considered a direct side effect from COVID-19, hair loss due to stress is a real condition that has been studied for decades [2]. Stress-related hair loss typically occurs through one of three conditions.  These conditions range from an occurrence at the molecular level all the way to the physical compulsion of pulling out your own hair on the other end of the spectrum.  Examples of stress-related hair loss types include:

  • Alopecia areata – This type of stress-related hair loss occurs when extreme stress activates the body’s immune system to attack the hair follicles.
  • Telogen effluvium – Stress, a high fever, as well as a number of other medical conditions can force your follicles into a phase of rest (also known as the telogen phase). Before long, follicles cycle out of their resting phase and hair shafts begin to shed at an increased rate.
  • Trichotillomania – The physical act of uncontrollably pulling out hair from your head or body when dealing with stress or a traumatic situation.

More than likely, COVID-19 is another stressor on your plate as we continue to navigate this new way of life. But there is good news: most stress-related hair loss is temporary and can be reversed through the resolution of the underlying medical condition and lifestyle changes [2].

Telogen Effluvium and Covid

One type of stress-related hair loss, as described above, is known as telogen effluvium (TE). TE is associated with the COVID-19 pandemic, fever from infection, and a number of other medical conditions.

TE differs from alopecia areata. In alopecia areata, your immune system attacks the hair follicles, whereas in TE your follicles prematurely go into their resting phase. Both result in hair loss, but the pathways are different [2, 4].

Stress-related hair loss occurs in men and women. Major life events, like childbirth or hospitalizations, can also cause hair loss. Stress is known to elevate stress hormones like cortisol in the bloodstream. Given the global pandemic, it’s no wonder that more and more people have been experiencing stress-related hair loss.

Hair Loss from Stress: How Long Does it Last?

Hair loss typically begins several weeks to three months after the inciting event such as a severe infection. It lasts six to nine months in most people [4]. Hair loss seems especially common in long-COVID patients [4].

Stress-related hair loss occurs due to inflammation that can affect the hair cycle. The hair cycle grows in four distinct phases [5, 6].

The Four Phases of Hair Growth

  1. Anagen – the growth phase. At any given point, 90% of the hair on your head is in growth phase [6].
  2. Catagen – the transition phase. At the end of hair’s growth phase, hair follicles shrink and growth slows. It begins to separate from the bottom of the hair follicle. This accounts for about 5% of the hairs on your head at any given moment.
  3. Telogen– the resting phase. Hair is neither falling out yet nor growing. Typically, anywhere from 10–15% of your hair is in this phase.
  4. Exogen – the shedding phase. New hair grows as the old hair falls out. Normal hair loss accounts for about 50-100 hairs lost each day.

Prolonged stress can cause hair to shift into the resting phase and subsequently fall out. If left unmanaged, long-term stress can cause chronic TE.

Solutions for Stress-Related Hair Loss

Fortunately, stress-related hair loss is temporary and can be reversed when the medical condition that caused it is addressed.  Stress management techniques, like exercise, meditation, and getting enough sleep, may help combat stress and its symptoms.

It’s also important to make sure you’re getting enough nutrients through your diet. Protein, vitamin D, and iron, as well as other vitamins and cofactors, are essential for hair growth.

Sometimes it’s difficult to track if you’re getting enough micronutrients to promote hair growth. This is why hair-growth-related nutrients––like biotin, niacin, zinc––are included in Bosley supplements.

How Bosley Can Help with Post-Covid Hair Loss

If the condition that led to your shedding has resolved and you are no longer experiencing symptoms of stress, but you’re still losing noticeable amounts of hair, it might be time to connect with one of our physicians.

At Bosley we’re doing everything we can to be there for our patients in a way that keeps everyone safe. We’re excited to announce that we now offer video consultations, making it easier than ever to discuss what you’re experiencing and the type of tailored plan we can offer to help you in your battle against hair loss.

Schedule your contactless video consultation today!

 


[1]Clark, B. (2020, April 8). Hypothesis: Is COVID-19 severity tied to hair loss? Retrieved July 21, 2020
[2]Daniel K. Hall-Flavin, M. (2019, April 05). Can stress make you lose your hair? Retrieved July 21, 2020

[3]Morris, C. (2022, January 14). COVID patients are seeing excessive hair loss after infection. Fortune. Retrieved 23 February, 2022.

[4]Sharquie, K. E., & Jabbar, R. I. (2021). COVID-19 infection is a major cause of acute telogen effluvium. Irish journal of medical science, 1–5. Advance online publication. Retrieved February 17, 2022. https://doi.org/10.1007/s11845-021-02754-5.

[5]Cobb, C. (2020, September 25). What Are the Four Stages of Hair Growth? Retrieved February 23, 2022. https://www.healthline.com/health/stages-of-hair-growth.

[6]Burg, D., Yamamoto, M., Namekata, M., Haklani, J., Koike, K., & Halasz, M. (2017). Promotion of anagen, increased hair density and reduction of hair fall in a clinical setting following identification of FGF5-inhibiting compounds via a novel 2-stage process. Clinical, cosmetic and investigational dermatology, 10, 71–85. Retrieved February 23, 2022. https://doi.org/10.2147/CCID.S123401.


What to do next?

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