One of the lesser discussed aspects of the COVID-19 pandemic is the intense hair loss which people experience during or soon after recovery. In some cases, hair can fall off in large quantities, resulting in deep distress for the patient. Additionally, due to lack of conversation around this particular situation left in the wake of the pandemic, the uncertainty and unawareness can worsen matters further.
According to Dr Soumya Jagadeesan, Clinical Associate Professor, Dermatology, Amrita Hospital, Kochi, about 30 percent (approximately one-third), COVID-19 patients may develop the complication. The condition has been seen across genders, though some studies noted that females are more affected or perhaps sought medical consultation for it more often.
The specific condition, in medical terms, that the pandemic caused or triggered in people is called telogen effluvium. Before going any further, let’s first unpack the meaning of these two words.
Explaining Hair Loss
Dr Sachin Dhawan, Senior Consultant, Department of Dermatology, Fortis Memorial Research Institute, Gurugram, explains that there are three main phases of the hair cycle:
Anagen or the growth phase
Telogen or the shedding phase
Catagen or the transition phase
“In a healthy scalp, 90 percent of the hair is in the anagen phase and approximately 9-10 percent of the hair is in the telogen phase. Telogen effluvium is the condition that is marked by a large proportion of the hair in the telogen phase, resulting in excessive hair loss. When it is due to COVID-19, it is most in the first one-two months after recovery from the infection.”Dr Sachin Dhawan
Dr Jagadeesan adds that the hair loss can be dramatic, and thus potentially very upsetting for the patient, resulting in severe psychological morbidity. The hair may fall in clumps, resulting in significant thinning and noticeable appearance of the scalp. Even though most cases might get resolved within the first three months, in some rare instances it may even persist for up to five to six months
Other than Hair Fall, What Other Symptoms Should You Watch Out For?
Dr Jagadeesan recommends to watch out for co-existent nutritional deficiencies, especially if the
hair becomes dry and brittle, which may be more common after a severe infection or hospitalization due to coronavirus. “Some patients have also experienced trichodynia, a painful/pull-like sensation around the hair follicles, along with COVID-related hair loss”, he adds.
It is of course wise to keep an eye out on the amount of hair fall, specifically after washing or combing them. Seeing an excess amount of hair on the floor or bed even without combing points towards the early phase of telogen effluvium which in some patients can even go up to losing almost 60-70 percent of their pre-COVID hair volume, says Dr Dhawan.
Who is Most Likely to be Affected by it?
Both doctors agree that there is no strict definition as to who may or may not be affected by it, yet there are a few factors to keep in mind.
“Any person who developed the COVID-19 infection is at risk of developing this complication; however it is more likely and more severe in those who had a moderate-severe infection (than a mild one) due to the resultant stress, inflammation and other complications which take longer to recover from.”Dr Jagadeesan
The severity of the infection has a direct correlation with the intensity of telogen effluvium and the consequent hair loss.
“Extent of shedding may depend on how long a patient has suffered from COVID-19 and was it mild or very severe. While all age groups are equally affected, we are commonly seeing more middle-aged people in our OPD,” says Dr Sachin Dhawan.
How Do We Manage This?
Fortunately, this is a self-limiting condition. Reassurance and education is key to managing it. The knowledge that the dramatic hair loss is due to a transient disruption of the hair cycle pattern, and that the person concerned will fully recover within a few months, can be comforting for a lot of patients, underlines Dr Jagadeesan.
A balanced diet is a prerequisite for overcoming it, emphasise both doctors. Under the guidance of a medical professional, supplements can also be explored as an option.
“One should take enough carbohydrates in all three meals, i.e either two chapatis/ two bowls of rice in each meal, and there shouldn’t be long intervals between them. Protein intake should also be adequate. Depending on your preference, soya, tofu, paneer, chicken and fish can be added to your diet. If tolerated by the body, you can also include nuts in your daily nutritional intake.”Dr Sachin Dhawan
In addition to all of this, please also remember that mild cases of telogen effluvium recover on their own within two to three months. In case the condition persists longer than that, an expert can be approached for professional guidance.
(Rosheena Zehra is a published author and media professional. You can find out more about her work here.)
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