Derm Topics

Patient Buzz: COVID-19 & Telogen Effluvium

VeryWell Health recently posted an article about a study that showed stress from COVID-19 — and perhaps the virus itself – may be leading to an increase in hair loss cases.

For an expert opinion, I contacted Chesahna Kindred, MD, MBA, FAAD, a dermatologist in practice in Columbia, Md.

Has the pandemic led to an increase in telogen effluvium? 

Absolutely. I noticed an increase in telogen effluvium cases last fall and suspect the cases have not peaked yet.

Embarrassingly, I was not the first to recognize the increase – the natural hairstylist in my practice did (I’m the only dermatologist with a full-service hair salon in my practice for hair loss patients). The reason is that hair loss patients are able to schedule an appointment with her much sooner than with me.

Have you noticed any similarities among the patients, such as ethnicity, gender, or COVID diagnosis?

So far, “COVID hair loss” (the term used by the lay) seems to affect more women than men. However, this may simply be a reflection of the social pressures on women about hair loss, the greater likelihood of women seeking medical care in general, or the demographics seen in my practice.

On the other hand, I see more patients with telogen effluvium who were never diagnosed with COVID than those who contracted the virus. This former group admits to experiencing greater than normal stress despite never having COVID. I am suspicious that those with telogen effluvium directly caused by COVID-19 may eventually come into the office but have other pressing health issues to address first.

Why is hair susceptible to severe stress and illness?

During severe stress and illness, micronutrients are diverted from the follicles to other organs. Hair simply is not a priority during those times.

What advice do you have for dermatologists who are treating patients with telogen effluvium related to COVID-19?

Remember that telogen effluvium sometimes unmasks other alopecias, particularly androgenetic alopecia and central centrifugal cicatricial alopecia (CCCA). I recommend that dermatologists counsel patients accordingly. Nutraceuticals, minoxidil, and platelet-rich plasma/platelet-rich fibrin matrix are treatment options I commonly use to treat telogen effluvium.

Photo Credit: Clinical image used with permission from the Journal of Drugs in Dermatology.

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