Some COVID-19 patients report hair loss months later

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Some recovered coronavirus patients are experiencing hair loss and looking for help, Canadian dermatologists say.

“I have seen it in some of my patients who have had coronavirus,” said Dr. Julia Carroll, a Toronto-based dermatologist, who estimates that she’s seen a handful of such cases.

People who suddenly experience hair loss are “very disturbed” by it, Carroll said.

“We get a lot of panicked phone calls or texts to the office because their fear is, when it starts to happen, then they’re going to lose all of their hair. And I think for a lot of people hair is an important part of confidence and how you present yourself to the world.”

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Dr. Jeff Donovan, a hair loss specialist in Whistler, B.C., and president of the Canadian Hair Loss Foundation, also says he’s seen some cases in his clinic, though he’s not sure how common this is overall. “Certainly we are realizing now that it is part of the spectrum of conditions, but we don’t yet have the numbers.”

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The problem patients are reporting is called telogen effluvium, Carroll said. It’s a well-known condition that is often a reaction to a high-stress situation, whether it be severe illness, or even strong emotional stress. It generally causes an overall thinning of hair all over the scalp, rather than bald patches, she said.

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“Your hair is always in different phases,” she said. “It’s in a growing phase, a resting phase and finally a dropping-out phase. Luckily for most people, about 80 per cent of our hair lives in that growing phase. But when you have a stress on your body, there can be a shift and a higher percentage of the hair goes into the dropping-out phase.”

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“It is almost like a safety measure in some ways,” Donovan said.

“What we find whenever there is a stress on the body, or an illness, or weight loss, or viral infections, is a large proportion of the hairs on the scalp say, ‘You know what, it’s time to fall out. We can’t dedicate all our resources right now to growing these hairs. We’ve got to focus on other parts of the body, making sure they’re doing well. The heart, lungs, liver, the kidneys. And we’re going to devote our resources elsewhere and we’re going to shed these hairs.’”

It doesn’t fall out all at once though, Donovan said. The hair generally remains in place for roughly three months before dropping.

Tying this kind of hair loss specifically to the SARS-CoV-2 virus is tricky though, he said, as many things could cause increased “shedding” of hair.

Hair loss was reported among patients who caught the Spanish Flu in 1918, he said. High fevers and other severe symptoms seem to contribute to developing the condition.

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But the emotional stress of living through a pandemic can take a toll too, even among people who had mild symptoms of COVID-19, he said, or even people who haven’t had the disease at all.

“It’s a very stressful time right now, and we’re seeing rates of shedding like we’ve never seen before.”

While Carroll believes that this phenomenon is due mostly to stress, Donovan thinks it may also be directly tied to the virus.

“I think it would be a mistake to say that these people are shedding simply because of stress. This is a complex virus. It does many things to every organ in the body that we don’t yet understand.”

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There’s good news though, both Carroll and Donovan say: the hair will probably grow back.

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“Say you have a shedding phase of about four to six weeks,” Carroll said. “Then, the hair will start to repopulate.” If you have shoulder-length hair or longer, though, it will be a while before the new hairs catch up, she said.

“The prognosis is good for a lot of people,” Donovan said. “The recommendation for most is just to see through it and just continue without formally treating it. Patients always want to do something. But the reality is this is self-resolving by definition.”

There are treatments available for particularly bad or prolonged cases, he said, like Minoxidil — commonly known by the brand name Rogaine.

Seeing your hair fall out is alarming, Donovan said, but for this condition it is probably not permanent.

“It’s hard for people to understand that eventually this will stop. And it’s unfortunately a long process, but it does resolve in most.”

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