Stress-Induced Hair Loss: It Can Happen

While it’s not considered a symptom of COVID-19 infection, hair loss is a concern among many COVID-19 survivors. More than 27% of 1,100 poll respondents in the Survivor Corps Facebook group (of which there are 91,000 members currently) report hair loss tied to the virus. Losing your hair can be emotionally traumatic, especially during increased stress, depression, and isolation.

“I have personally seen 60 to 70 cases of severe alopecia following COVID-19 infection,” said Antonella Tosti, M.D., a dermatologist with the University of Miami Health System. “I also see patients in Italy, so I had the opportunity to follow up with these patients months later, as the pandemic in Italy began earlier than in the U.S. (end of February 2020). Most of the patients I saw lost 50 to 70% of their hair following COVID-19 infection.”

What causes hair loss following COVID-19 infection?

The Centers for Disease Control and Prevention does not list hair loss among the symptoms or signs of COVID-19 infection. “That’s because the hair loss doesn’t start at the time of the infection,” said Dr. Tosti, who is a Fredric Brandt Endowed Professor at the University of Miami Miller School of Medicine. “Patients start to notice it two to three months later.”

This kind of hair loss, called telogen effluvium, is part of the body’s response to a traumatic event, such as a period of intense psychological stress, sleeplessness, change of diet, high fever, a car accident, surgery, or other stressors to the body and mind.

Telogen effluvium isn’t typically a sign of premature baldness. It’s a temporary shedding of hair follicles. Some have reported hair loss even without COVID-19 infection, which may be triggered by the immense social, professional, and financial pressures caused by the pandemic.

While physical and psychological stress are known causes of hair shedding and loss, Dr. Tosti believes stress is not the only factor.

“Many patients experiencing telogen effluvium with visible alopecia had the drug Heparin as part of their COVID-19 treatment. This drug can cause telogen effluvium. Following COVID-19 infection, this hair loss tends to last four to six months. I saw several patients who developed either female pattern baldness or male pattern baldness as a consequence of it,” Dr. Tosti reported.

Can stress-induced hair loss be treated or reversed?

For most people suffering from telogen effluvium, the hair regrows – without treatment – within six months after the physical or psychological stress passes. “However, for those predisposed to baldness, the hair might grow back thinner than before,” Dr. Tosti said. “Those with ongoing intense stress may also experience long-term or worsening hair shedding over time.”

There isn’t a prescription cure nor treatment for telogen effluvium. “But, there are treatments to prevent hair thinning after telogen effluvium resolves,” Dr. Tosti said. Over-the-counter and prescription topical products containing the ingredient minoxidil may stimulate the growth of new hair and prevent new hair from growing back thinner. This treatment can be helpful for those with premature balding or a family history of baldness.

“I think that patients with severe hair loss – or decreased hair density – should consult a dermatologist, even via telehealth, to decide if they want to start treatment,” she said.

Get your stress under control.

The best advice for those experiencing stress-induced hair loss is to reduce stress.

Physical activity, speaking openly with friends and family, spending time outdoors, eating a well-balanced diet, and avoiding excessive alcohol and drugs can help manage physical and psychological stress. If you need additional resources to address your stress, anxiety, and/or depression, speak with your primary care physician. You can arrange for a telehealth consultation, and you may be referred to a specialist.

Dana Kantrowitz is a contributing writer for UMiami Health News.

Tags: COVID-19, Dr. Antonella Tosti, hair loss, stress