Characteristics of hair loss after COVID‐19: A systematic scoping review

Abstract

Objective While there are literature reporting increased incidence of hair loss in COVID‐19 patients, insufficient evidence exists on the topic to date. This review aims to identify the existing evidence and clinical characteristics of hair loss with COVID‐19 infection. Methods Following the PRISMA Extension for Scoping Reviews, MEDLINE and EMBASE were searched for all peer‐reviewed articles with relevant keywords including “Alopecia,” “Telogen Effluvium (TE),” and “COVID‐19” from their inception to November 20, 2021. Results A total of 26 articles, with 9 observational studies and 17 case reports or series (a total of 58 cases), were included. Most studies dealt with TE. There were no clear trends between COVID‐19 severity and the extent of hair loss. Analysis of the 58 cases also found similar results with most of the cases being female (82.8%), the median onset of hair loss of 2.0 months, and the median time to recovery of hair loss of 5.0 months with a resolution rate of 95%. Conclusion While this systematic review revealed uncertainty and a lack of strong evidence regarding the association of COVID‐19 and hair loss, hair loss in COVID‐19 may mainly include TE and be reversible in nature. Future studies are warranted to determine the detailed pathophysiology and risk factors of hair loss in COVID‐19, including possible roles of estrogen, progesterone, and pro‐inflammatory cytokines.

A prospective cross-sectional study on post COVID-19 hair loss at a tertiary care hospital

“…Meanwhile, Babaei et al in their study on TE following COVID-19 infection in Iran, found androgenetic alopecia as the most common concomitant pattern with TE [14]. Another study on hair loss post COVID-19 infection reported majority cases of TE and only few cases of alopecia areata and brosing alopecia [11]. We noted a relatively higher percentage of patterned hair loss, possibly because of high prevalence of pre-existing patterned hair loss in our study population.…”

“…Alopecia areata (including totalis and universalis) may be exacerbated or induced by COVID-19 infection. Fibrosing alopecia has also been reported as isolated cases [4,11]. The mechanisms of hair loss remain unclear, although autoimmune abnormalities, immune imbalances and prolonged residual infection of hair follicle may be involved [4].…”

Transitional Changes in Fatigue-Related Symptoms Due to Long COVID: A Single-Center Retrospective Observational Study in Japan

“…Hair loss is also a PCC symptom associated with autoimmune and acute diseases including various viral infections. Hair loss after COVID-19 appears after approximately two months, is often telogen effluvium, and resolves after approximately five months [ 27 , 28 ]. A proposed hypothesis is that interleukin (IL)-6, an inflammatory cytokine, is involved in hair loss by inhibiting elongation of hair shafts and promoting regression of hair follicles [ 29 ].…”

On the Potential Role of the Antioxidant Couple Vitamin E/Selenium Taken by the Oral Route in Skin and Hair Health

“…In the context of SARS-CoV-2 infection, it has been recently reported AGA may be a risk factor for severe COVID-19, whereas telogen effluvium (TE) presents as a sequela of COVID-19 [ 233 , 234 , 235 ]. In our recent studies [ 236 , 237 ], we have shown that 55.5% COVID-19 patients hospitalized in intensive care unit, 87.5% in ward units or 58.3% seen two months after their hospital discharge exhibited Se plasma concentration below normal range (73–110 µg/L).…”