Telogen Effluvium: Hair Loss In Response to Trauma

If you are losing hair suddenly, at a rapid rate, and you’ve suffered from COVID-19, you likely are experiencing telogen effluvium (TE). This is a type of hair loss that is usually temporary, but common in the wake of physiological or psychological stress – perhaps not just from exposure to the coronavirus, but to the fear that goes with it.

The medical records of 552 patients at the Henry Ford Health System, collected between February 2020 and September 2020, seems to prove this out. Ten patients reporting hair loss were identified; on average, the shedding of their hair started about 50 days after the onset of COVID-19 symptoms, and 70% of them had been hospitalized (note this was earlier in the epidemic, before the vaccines were developed).

Another study (Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management, JAAD International, Starace, et al., August 2, 2021), conducted later in the pandemic and published in the Journal of the American Academy of Dermatology (JAAD), found that TE was experienced by 66.3% of 128 patients. The majority of those patients, 62.5%, experienced hair loss symptoms within a month of their diagnosis; the remainder experienced hair loss after 12 weeks after their diagnosis.

In the conclusions of the JAAD study, the severity of hair loss correlated with the severity of the COVID-19 infection. Important to note is these patients self identified for having hair loss as they were seeing hair loss treatment specialists, therefore the incidence of hair loss is likely higher among this group than the general population of Covid patients. There was no control group in this study.

Many illnesses involving fevers are often associated with telogen effluvium. Another contributing factor is psychological stress, which can easily coincide with the physical illness. Other causes are a poor diet (lacking in protein, iron, B vitamins, and zinc), sudden weight loss, pregnancy and childbirth, menopause, some medications, and use of some recreational drugs (cocaine, methamphetamine, adderall). Telogen Effluvium is the type of hair loss condition necessitating a physician before consulting the local hair loss clinic.

In all TE cases, hair loss is characterized by an acute or chronic shedding of hair. In some cases there is pain in the scalp that patients experience when touching it or brushing their hair. Essentially, all hair sheds at some point (technically, it’s the third of three phases of hair growth, also known as the “resting phase”), but stressful conditions can prematurely hasten its onset. It is more common in women than men from any cause; this was the case with the COVID-19 patients as well (although clinicians suspect men experience TE more frequently than reported but because of shorter hair styles they are unaware of it).

The fix for TE? Time is mostly the great healer, as new hair grows in to replace what was lost. But reducing stress, eating healthier (protein, iron, B vitamins, zinc), and getting a little bit of good circulation-stimulating exercise all work together for general health and hair health.