PracticalDermatology

Dermatologists across the globe are reporting high rates of hair loss in patients who have recovered from COVID-19.

The most recent study found that 48 percent of infected people experience hair loss within three months following COVID-19 infection, and that hair loss is associated with disease length and presence of inflammatory symptoms, such as high fever, severe dyspnea, and myalgia.¹ These findings were published online last month in International Journal of Dermatology.

Telogen effluvium can occur after any stress or infection, and COVID-19 certainly ticks all the boxes. “Telogen effluvium instances have gone up exponentially for a combination of reasons, not just because of COVID-19 infection, but also because of the stress of living during a pandemic,” says Candace Spann, MD, a dermatologist in Las Vegas.

“With Telogen effluvium, a disproportionate amount of hair shifts into the shedding phase,” she explains. “It should be 90 percent in the anagen phase, seven percent in the resting phase, and three percent in the shedding, but there is a shift to 30 percent in the shedding phase,” she says. “This is alarming, because hair comes out in clumps and handfuls.”

Suneel Chilukuri, MD, director of Cosmetic Surgery, Refresh Dermatology in Houston, is also seeing an uptick of cases of hair loss following COVID-19 infection, especially as case numbers rise due to the highly contagious Omicron variant.

“There seems to be greater hair loss with those patients who had more severe disease, even though they were vaccinated,” he says. Dr. Chilukuri points out that he has not seen any direct correlation between the vaccine and reports of hair loss.

It’s not always telogen effluvium, says New York City dermatologist Neil Sadick, MD. “There are occasions when people have severe acute vascular syndromes and may develop vascular lesions in the scalp associated with hair loss, but that is much rarer,” he says.

Optional Interventions

Telogen effluvium is self-limiting and often resolves in six to 12 months, but some CSF faculty members are offering treatments to help facilitate a more rapid recovery.

“It bothers patients enough that they often ask if there is something they can do, and there is,” says Dr. Chilukuri. He recommends nutraceuticals and the use of the Revian Red System for hair growth.

“We can push those hairs that are in resting pause back into growth phase with this at-home device,” he says. The device emits dual colors of LED light in the 620nm and 660nm wavelength ranges to boost nitric oxide (NO) production in the scalp.

“NO is anti-inflammatory, increases blood flow to the scalp, and encourages the development of new blood vessels in the scalp to continue to improve blood flow,” he says. “It also blocks the conversion of testosterone to dihydrotestosterone (DHT), so it’s really working from multiple aspects to reverse illness-induced alopecia.”

Dr. Spann often suggests that patients try the Retress System that she developed. This system includes supplements with high-dose biotin, vitamin A, and zinc. “Anything that helps to calm scalp inflammation, even topical steroids or injections, can make a difference,” she says.

Dr. Sadick will accelerate the treatment program with high-dose minoxidil compounded with topical corticosteroids, red light, low-energy laser technology, plus platelet-rich plasma (PRP).

This article is based on a presentation from Cosmetic Surgery Forum 2021. For information on the 2022 meeting: CosmeticSurgeryForum.com.

Dr. Spann developed the Retress System.

Dr. Chilukuri has been an investigator and speaker for Nutrafol, Viviscal, Revian, Selphyl, Eclipse, and Crown Labs.

Dr. Sadick has no relevant disclosures.

1. Müller-Ramos P, et al. “Post-COVID-19 hair loss: prevalence and associated factors among 5,891 patients.” International Journal of Dermatology. E-pub. Jan 26, 2022.