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Actress Alyssa Milano took to social media earlier this month to reveal a lesser-known effect of COVID-19: hair loss.
On a video posted on Twitter, the “Charmed” star showed large clumps of strands coming out of her brush after running it through her wet hair.
“This is my hair loss from COVID-19. Wear a damn mask,” said Milano, who recently tested positive for coronavirus antibodies after having symptoms of the disease in April.
While the Centers for Disease Control and Prevention (CDC) does not include hair loss on its list of COVID-19 symptoms, doctors say there’s compelling evidence that it can be a long-term effect from the illness.
Here’s what we know so far about COVID-19 and hair loss.
Hair loss among ‘long-haulers’
Milano isn’t the only COVID-19 survivor who is now experiencing hair loss. On the Survivor Corps Facebook group, there are dozens of posts about hair loss among people who’ve recovered from COVID-19 and still have lingering effects months later, also known as “long-haulers.”
A survey created by the group’s founder, Diana Berrent, revealed that more than a third of the 1,700 respondents say they’ve had hair loss after enduring COVID-19.
Dr. Dendy Engelman, a dermatologist at Manhattan Dermatology & Cosmetic Surgery, said she started seeing an uptick in patients with hair loss about 6 weeks after the initial stay-at-home orders were implemented in New York in mid-March.
“There’s been at least a 25 percent increase in people coming in with hair loss, and that’s from a place of already being busy dealing with hair disorders,” said Engelman. “It’s not yet documented on major medical sites as a symptom, but patients show me their positive test results.”
Stress may be to blame
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 a reversible hair loss condition called telogen effluvium.
The condition is known to occur a few months after a stressful event such as emotional distress, major surgery, or high fever. It shifts more of a person’s hair to the telogen, or resting phase, of the hair growth cycle, which ultimately leads to losing hair.
“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, so you end up with hair shedding,” explained Dr. Susan Massick, a dermatologist at the Ohio State University Wexner Medical Center.
Stress-induced telogen effluvium is typically diagnosed through the process of elimination of other potential causes of hair loss. Doctors may do a blood test to rule out a thyroid issue or nutritional deficiency, both of which can also cause hair loss.
They may also look at what’s been going on in a patient’s life over the last few months to nail down the stressful event that triggered the condition, such as a hospitalization from COVID-19.
“We want to make sure we’re relieving whatever the stressor is,” said Massick.
Coping with hair loss
People typically lose up to 100 hairs per day. Telogen effluvium can cause around 300 strands to fall out every day for up to 6 months — an experience that can cause a lot of distress and anxiety.
“Hair loss is super emotional,” said Engelman. “People shed more tears over hair loss than any other condition I treat, including skin cancer.”
The good news is that telogen effluvium is temporary, and the hair will eventually grow back. However, it may take a while for your hair to achieve its original fullness and length.
“Hair grows slowly, so you may not necessarily have voluptuous regrowth the first couple months after telogen effluvium is resolving. It’s not a quick fix; the timeline is 6 months to a year,” said Massick.
While people with telogen effluvium may be tempted to try hair regrowth supplements and products they see on drugstore shelves, Engelman warns that they probably won’t lead to the results they’re looking for.
“There aren’t many hair supplements that are vetted in science, and these companies know people are desperate, so they’ll make crazy claims,” she said.
Instead, focus on developing a healthy lifestyle. Finding ways to manage stress can be helpful in beginning hair regrowth, as can eating a nutrient-rich diet and avoiding smoking, added Massick.
Understanding the outlook of telogen effluvium — and the fact that the hair will grow back — is also critical for patients.
“The stress of the hair loss can actually become part of the problem again. The most important thing is to reassure patients that it will get better and they won’t go bald,” said Massick.