Hair Loss After COVID-19: Why It Happens and How to Treat It

The list of possible COVID-19 side effects is as lengthy and diverse as the list of potential symptoms. Among those possible lingering issues is hair loss after COVID-19, a troubling side effect that emerged early on in the pandemic, leaving many people confused and concerned.

Even though many things about COVID-19 are still shrouded in mystery, our understanding of the illness that completely changed life as we know it is growing, postvirus hair loss included.

According to dermatologists and an evolving body of scientific research, we now not only know that hair loss after COVID-19 is, in fact, a very real thing, but we’re continuing to learn more and more about the mechanisms behind it.¹ The good news is that, for most people, hair loss after COVID-19 is not permanent.

Here, dermatologists explain the connection between COVID-19 and hair loss—and what you can do if you’re experiencing this unique type of shedding.

What causes hair loss? | How can COVID-19 cause hair loss? | What does COVID-19 hair loss look like? | How long does hair loss after COVID-19 last? | Have any COVID-19 vaccines been linked to hair loss? | How to stop hair loss after COVID-19

First, what causes hair loss or thinning in general?

There are many different types of hair loss and a multitude of factors that can contribute to the issue. The hair loss that’s seen post-COVID-19 is usually telogen effluvium, a condition in which hair sheds in response to a stressor. Telogen effluvium—the most common type of generalized hair loss—is not only triggered by viruses, it can also be a side effect of certain medications, nutritional deficiencies, hormonal abnormalities, and stressful events (more on that soon).

Androgenetic alopecia and alopecia areata are other common forms of hair loss, but they both show up differently than the general shedding seen in telogen effluvium. Androgenic alopecia typically manifests as hairline recession or thinning on the crown, specifically. “This is the most common cause of localized hair loss and is often referred to as male or female pattern baldness,” Craig Ziering, MD, a board-certified dermatologist, hair transplant surgeon, and hair restoration specialist, tells SELF. According to the Cleveland Clinic, 50 million people assigned male at birth and 30 million people assigned female at birth in the U.S. experience this type of hair loss, which is largely genetic, although hormones also play a role.

Alopecia areata, on the other hand, is an autoimmune condition that causes the body to send a misguided directive to attack the hair follicles, which leads to patchy or overall baldness, explains Dr. Ziering. Alopecia areata can be exacerbated by other health conditions, including COVID-19, but this is not the type of hair loss most people are experiencing after the virus.

Certain causes of inflammation in the scalp can also lead to hair loss. For example, the inflammation in scalp psoriasis—which shows up as red, scaly, plaques—can damage the hair follicles. Scalp psoriasis can also be itchy, and scratching and picking the scalp can exacerbate follicle damage and increase hair loss.

Then, there’s certain hair-care practices to be cautious of. “Traction alopecia affects those who have chronic follicular tension from wearing high-tension hairstyles, such as braids and tight ponytails, for long periods of time,” Dr. Ziering adds. Constantly subjecting your hair to harsh chemical treatments (such as coloring, relaxers, and perms) can also cause damage that can eventually lead to hair loss.

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How can COVID-19 cause hair loss?

According to one 2020 study in the Journal of the European Academy of Dermatology and Venereology, approximately 1 in 10 people infected with COVID-19 experienced hair shedding after the fact; other data in JAAD International found that it occurred in more than 66% of those who contracted the virus.² ³

However, it’s not SARS-CoV-2, the coronavirus that causes COVID-19, that’s causing the hair loss, but rather the stress your body is under when fighting it, Helena Kuhn, MD, assistant professor of dermatology at the Warren Alpert Medical School of Brown University, tells SELF. Again, “the type of hair loss caused by COVID-19 is called telogen effluvium, a prolonged hair shedding that occurs in response to a sudden stressor,” she says.

In order to understand what’s happening, it’s important to first have a basic understanding of the hair growth cycle. Hair follicles go through three phases: anagen, catagen, and telogen, also known as the growth, transitional, and resting or shedding phases.⁴ At any given point in time, all of the hairs on your head are in different phases.

“What happens in telogen effluvium is that a systemic change in the body abruptly pushes a large percentage of the hair that’s in the growth phase into the resting phase,” Dr. Ziering explains. Under normal conditions, anywhere from 5 to 10% of the hair on the scalp is in the resting phase. But with telogen effluvium, more than 30% of the follicles are in the resting phase, after which all of those “resting” hairs fall out at the same time, resulting in widespread shedding or hair loss.⁵

Stress that triggers telogen effluvium can be either physical—in the case of a car accident or major surgery, or after other illnesses such as the flu—or emotional, such as a particularly difficult breakup or the death of a loved one, Dr. Kuhn notes. Postpartum hair loss in people who have given birth is another example of telogen effluvium, in this case caused by hormonal changes.

COVID-19 presents a bit of a double whammy because people are dealing with not only the physical stress the illness puts on the body, but also the mental anxiety that can come with being diagnosed with the virus, Dhaval G. Bhanusali, MD, a board-certified dermatologist in New York City specializing in hair loss, tells SELF. In fact, a 2020 study in the Journal of the American Academy of Dermatology found that the instance of telogen effluvium in a New York City neighborhood with a high number of COVID-19 cases increased by over 400% in the neighborhood as a whole during the first few months of the pandemic.⁶

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What does COVID-19 hair loss look like?

Telogen effluvium is defined by a few key factors. Initially, you may notice hair all over your bathroom floor or an excessive amount in your hairbrush. After a few weeks, the hair on your head may seem thinner or finer. Telogen effluvium usually doesn’t occur at the same time as the triggering event, though—it starts approximately three months after, Dr. Ziering says. (Although one study found that the onset of COVID-related telogen effluvium can be a bit faster, sometimes within two months after the initial infection.)³ So you may be completely recovered from your COVID-19 infection, feeling back to normal, and then a few months later your hair may start falling out.

When telogen effluvium occurs, the hair loss is rapid. “We all lose about 100 hairs per day on average, but in the case of telogen effluvium, you’re suddenly losing way more than that,” Dr. Bhanusali says. He adds that people tend to notice it when they see large clumps in their hands after washing their hair, see lots of hair in the shower drain, or notice that their brush or comb is filling up much faster than normal. This isn’t a gradual type of hair loss or subtle hair thinning—it’s an acute, intense, sudden shedding that can leave your hair feeling less full overall and often manifests as noticeable thinness and sparseness along the sides of the temples.⁵

It’s unclear if hair loss after COVID-19 correlates with any other specific symptoms of the virus or how sick you get. “The American Academy of Dermatology has a COVID-19 registry and we hope over time we will be able to extrapolate some data to find associations, but so far there are no clear relationships,” Dr. Kuhn says. “I have seen severe shedding following a mild case of COVID, and mild shedding following severe illness.”

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How long does hair loss after COVID-19 last?

Telogen effluvium, whether it’s caused by COVID-19 or another trigger, usually isn’t permanent. “Shedding can occur, however, for three to six months before it stops,” Dr. Kuhn says. With telogen effluvium the hair growth cycle eventually normalizes and, because there is no damage to the scalp or hair follicles, all of the hair should grow back.

According to the American Academy of Dermatology, your hair will likely regain normal fullness after telogen effluvium within six to nine months. Although Dr. Kuhn says, in her experience, it often takes even longer—anywhere from one to two years—for someone’s hair to reach its pre-shed status.

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Have any of the COVID-19 vaccines been linked to hair loss?

“There’s no research to indicate that the COVID vaccines trigger hair shedding,” Dr. Kuhn says, adding that, in her experience, she hasn’t seen any people dealing with hair loss postvaccine. Dr. Bhanusali underscores the fact that there’s currently no direct data to connect the two.

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How to stop hair loss after COVID-19

Most importantly, be patient. “Though losing hair can be scary, I always reassure patients that they won’t go bald from COVID-related shedding,” Dr. Kuhn says. “Typically, the best thing to do is simply wait it out.” In the meantime, practicing healthy hair habits is paramount.

You want to make sure that you’re doing everything you can to minimize the risk of losing any more hair, Dr. Bhanusali notes. That means avoiding heat styling and/or using the lowest temperature whenever you do, minimizing intense chemical processes such as highlighting and straightening, and avoiding tight hairstyles that put tension on the hair.

You can also consider getting tested for nutrient deficiencies to ensure that’s not exacerbating the situation. If you are, in fact, lacking in a certain vitamin or mineral that’s associated with hair health—Dr. Bhanusali notes that vitamin D and iron deficiencies are common—talk to your doctor about how to incorporate more of it into your diet and/or if you’ll need to try a supplement (and if so, what the dosage should be).

And while it’s always easier said than done, lowering your stress levels may also help. “Practicing self-care and engaging in things such as meditation and breathing exercises can be helpful as you deal with COVID-related hair loss,” Dr. Ziering suggests. “Breaking long-term stress can be helpful in helping normal hair function resume more consistently.” That said, lowering stress levels may feel nearly impossible given what’s going on in the world or in your personal life, so if self-care isn’t cutting it, consider talking to a therapist if you’re able.

However, if your shedding persists beyond six months, Dr. Kuhn suggests consulting a board-certified dermatologist if you can. If you don’t see a dermatologist regularly, see your primary care doctor, who can give you a referral for an expert in your area. Chronic telogen effluvium, where the shedding continues for months, is possible. While its causes remain somewhat unknown, it can occur in people with long COVID, she says. “Even if it is chronic telogen effluvium, there are medical therapies we can use to reduce shedding and augment hair growth,” she explains.

Overall, the connection between COVID-19 and dermatologic symptoms, those that affect the skin and hair, remains somewhat unclear. “We’re still learning in real time about things that occur after the virus or the vaccine, and it’s hard to delineate when things are definitive versus theoretical,” Dr. Bhanusali says. In other words, our understanding of the virus, including what we can do to mitigate its side effects, is constantly evolving.

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