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COVID-19 Related Hair Loss

Telogen effluvium as a consequence of COVID-19 infection and pandemic stress

While the Centers for Disease Control and Prevention (CDC) does not include hair loss on it’s list of COVID-19 symptoms, there is compelling evidence to support this and not only is it a common occurrence following a serious illness, but we’ve seen an incredibly significant increase in clients coming to us with this condition.

The medical name for this type of hair loss is telogen effluvium however, it is often referred to as “shock loss”. It occurs when more hairs than normal enter the shedding (telogen) phase of the hair growth lifecycle at the same time in response to a shock to the system, such as the physical and emotional stress that accompanies a case of COVID-19.

There are several common triggers to this type of hair loss including:

Severe stress. Prolonged periods of stress can result in telogen effluvium. Hair loss typically occurs about 3 months after the stressful event.
Poor diet. Hair requires key nutrients including protein, iron, B-vitamins, and zinc to grow. A shortage of these nutrients may affect the quality and quantity of a person’s hair.
Sudden weight loss. Weight loss or chronic calorie restriction, such as in anorexia nervosa, can cause the hair to shed.
Pregnancy and childbirth. During pregnancy, more hair is in the growth phase for longer. Hormonal changes that occur 3 to 6 months after birth can cause hair to shed. This is called post-partum telogen effluvium.
Menopause. Hormonal changes that occur during the menopause may also cause telogen effluvium.
Certain drugs. Certain medications and recreational drugs can cause hair loss.
Underlying health conditions. These can include autoimmune disease, conditions that affect the thyroid gland, and alopecia areata.
Surgery. Depending on the type of procedure, length of stay in hospital, medications, and overall nutritional status.
Metal toxicity. Contact with toxic chemicals including heavy metals can lead to hair loss.

There are also other medical or nutritional conditions that can trigger this as well.

The hair growth cycle

There are three phases in the hair follicle growth cycle:

  1. Anagen or growth phase
  2. Catagen or transitional phase
  3. Telogen or resting phase

Generally speaking, about 90% of hairs are in anagen, with 5% in catagen and 5% in telogen. With telogen effluvium, the anagen phase slows down, meaning that fewer hairs enter the next two stages. With this condition, around 30% of hair follicles move into the telogen phase, which leads to excessive hair shedding occurs.

When you experience a significant physical or emotional stress the hairs that enter the telogen effluvium phase stay in this phase for approximately two to four months. This is why we tend to see these men and women seeking assistance with their hair loss several weeks after their COVID-19 symptoms resolve.

This hair loss can last for up to six to nine months. Generally, most cases resolve on their own (unless it’s related to medication or a nutritional deficiency) however, there are steps one can take to accelerate the recovery process.

Risk factors

There are several risk factors associated with telogen effluvium and COVID-19 related hair loss. The first is genetic predisposition.

We know some people can be extremely sick and not experience hair loss after, and others can have mild illness and have significant hair loss, so there is some genetic predisposition.

Nutrition also plays a role, especially iron, biotin and vitamin D.

There are certain nutrients the body requires to build hair. If you have high iron stores, your body is going be more capable of supporting the hair than if you’re anemic and/or are deficient in other nutrients. Again the body doesn’t see the hair as essential, so if you have low iron stores, the body will triage it’s stores to make your red blood cells, hormones. It’s not going to focus on making hair. Women are far more likely to be deficient in iron than men, especially teen girls and women who experience heavy periods.

Treatment for Telogen Effluvium related hair loss

Treatment for telogen effluvium depends on what is triggering the hair loss. Once the trigger has been established and addressed, the hair cycle should normalize and hair will typically begin to grow back.

That said, it’s best to see a trichologist / hair restoration specialist or dermatologist as soon as you start experiencing excessive shedding. Shock hair loss can be permanent if the hair loss is severe.

While, this type of hair loss does typically improve on its own over time, there are not only steps you can take to accelerate your hairs regrowth, and in the interim our Columbus Ohio hair loss specialist can offer hair loss treatments such as scalp microdermabrasion, Low Level Light Therapy (LLLT), as well as non-surgical hair replacement options including hair extensions, or hair pieces such as hairskeen,

Additional treatment options include:

  • addressing nutritional deficiencies through diet
  • hormone replacement therapy for people experiencing menopause
  • counseling support to manage stress or anxiety

A person should try to avoid chemical or heat treatments that could damage the hair. They should also avoid heat styling and heat treatment, such as curling or perming the hair.

Dietary considerations include the following:

  • Protein provides the building blocks for hair to grow. Make sure the diet includes plenty of protein-rich foods such as meat, eggs, fish, beans, grains, and nuts. The amino acid lysine may be particularly important for hair growth.
  • Iron deficiency may be linked to telogen effluvium. Making changes to the diet to include iron-rich foods may help with hair loss. These include red meat, liver, dark green leafy vegetables, beans, and lentils.
  • Supplementation can be considered for a short time while nutritional status is improved. We recommend a multi-vitamin such as Nutrient 950 Multi-Vitamin for general support, D3 5000 to boost vitamin D levels, Essential Aminos for protein support, OptiFerin-C to boost iron levels, and a biotin supplement such as Hair / Skin / Nails Ultra.

In terms of topical products and medications, the best over-the-counter treatment for telogen effluvium is Zenagen Revolve Hair Loss Shampoo and Conditioner.

Pandemic stress may lead to hair loss even in those who have not had COVID-19

There’s no evidence yet that the novel coronavirus itself directly causes hair loss. Instead, doctors believe that the physical and emotional stress that accompanies a case of COVID-19 can lead to the hair loss associated with telogen effluvium.

As mentioned, when there’s a shock to the system, the body goes into lockdown mode and only focuses on essential functions. Hair growth is not as essential as other functions, as a result your experience hair shedding.

There are so many pandemic-related stresses. There’s financial stress, concern for ill family members, anxiety about contracting the virus, social isolation and changes related to working and schooling from home.

While seeing your hair fall out in clumps can certainly add to your stress, it’s important to try to de-stress. It is by doing so we are able to take your body out of the sympathetic “fight or flight” state, and put it into the parasympathetic “rest, digest and heal” state thereby evoking the body’s innate ability of self-healing. Only when the stress ends will the excessive hair shedding stop.

Forms of Stress Relief

There are so many different ways to relieve stress that sometimes finding the right technique for your personality and situation may seem overwhelming, or at least like more work than you want to tackle when you’re already feeling stressed. Finding stress relievers that work for you, however, can be well worth the effort in that the work you do to try different techniques that work for you can ultimately change your whole experience of stress.

Following are six relaxation techniques that can help you evoke the relaxation response and reduce stress.

1. Cut out things that add to your stress. Sometimes, the best way to reduce your stress is to cut something out of your life. Get rid of the things that are adding to your stress so you can experience more peace. Watching the news, being constantly connected to your digital devices, drinking alcohol, and consuming too much caffeine are just a few of the things that may add more stress to your life. Making some changes to your daily habits could be instrumental in helping you feel better and allowing your body to start to heal.

2. Breath focus. In this simple, powerful technique, you take long, slow, deep breaths (also known as abdominal or belly breathing). As you breathe, you gently disengage your mind from distracting thoughts and sensations. Breath focus can be especially helpful for people with eating disorders to help them focus on their bodies in a more positive way. This technique is especially beneficial for those who recovering from COVID-19, as well as those looking to enhance the overall strength and health of their respiratory system.

2. Body scan. This technique blends breath focus with progressive muscle relaxation. After a few minutes of deep breathing, you focus on one part of the body or group of muscles at a time and mentally releasing any physical tension you feel there. A body scan can help boost your awareness of the mind-body connection. If you have had a recent surgery that affects your body image or other difficulties with body image, this technique may be less helpful for you.

3. Exercise. Physical activity is key to managing stress and improving mental health. And the best news is, there are many different kinds of activities that can reduce your stress. Join a gym, take a class, or exercise outside. Keep in mind that there are many different ways to get more physical activity in your day too. Walking, strength training, kayaking, hiking, and spin class are just a few different examples of ways you can get stress relief.

4. Mindfulness meditation. This practice involves sitting comfortably, focusing on your breathing, and bringing your mind’s attention to the present moment without drifting into concerns about the past or the future. This form of meditation has enjoyed increasing popularity in recent years. Research suggests it may be helpful for people with anxiety, depression, and pain.

5. Yoga, tai chi, and qigong. These three ancient arts combine rhythmic breathing with a series of postures or flowing movements. The physical aspects of these practices offer a mental focus that can help distract you from racing thoughts. They can also enhance your flexibility and balance. But if you are not normally active, have health problems, or a painful or disabling condition, these relaxation techniques might be too challenging. Check with your doctor before starting them.

Request a Hair Loss Consultation

To learn more about about the hair loss causes, prevention, and suitable solutions SCHEDULE A HAIR LOSS / RESTORATION CONSULTATION with one of our Trichologist / Hair Restoration Specialists.

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