Hair loss after Covid: types, causes and treatment
Covid disease affects the whole body, including organs and vessels. Hair (or roots) are also affected. Since the Covid virus pandemic, we have seen an increasing number of patients suspecting hair loss due to Covid-19. But that's not all: even with the Covid vaccine, some patients experience hair loss.
Below is an overview of what we know about hair loss due to Covid and how we have been able to treat it successfully.
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Hair loss due to Coronavirus disease has so far been underestimated
Hair loss has often been observed in cases of Covid infection. As hair loss as a complication of Covid infection is not life threatening, little attention has been paid in studies so far to recording hair loss and its consequences. characteristics in patients who have been infected with Covid.
However, we are seeing more and more patients suffering from hair loss as a result of Covid illness or vaccination. It's not always obvious, but theories are multiplying.
It is not uncommon for fever, stress and physical exertion during illness to promote hair loss. However, the coronavirus does not stop there.
Types of hair loss due to Covid disease
The types of hair loss in Covid disease are similar to other types of hair loss. We observe these symptoms:
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Diffuse hair loss: hair falls all over the head. The hair thins and the scalp becomes visible.
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Circular alopecia: balding areas appear on the head and/or other body hair (beard, eyelashes, pubic hair).
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Cicatricial alopecia: sometimes severe inflammatory areas appear, associated with inflammation and redness at the hairline in the sense of perifollicular redness or hyperkeratosis at the hairline.
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Combination: These types of hair loss also occur in combination in the case of hair loss due to Covid disease.
Other comments:
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The degree of Covid disease does not necessarily correlate with the degree of hair loss in our patients.
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In most cases, hair loss begins 6-8 weeks after using Covid.
Prompt and targeted hair loss treatment is necessary because untreated hair loss can lead to complete hair loss.
Cause: Why does Covid cause hair loss?
Covid disease causes various forms of hair loss, often combined. According to initial findings, there are two causes for this disease:
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The vascular changes prevent the hair roots from being sufficiently supplied with nutrients and oxygen.
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Covid disease triggers autoimmune diseases or reactivates those that have appeared in the past. The immune system thus attacks the roots of the hair.
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More details on this topic can be found in the next section.
Destruction of vessels by the Covid
Covid damages vessels. According to current knowledge, autoantibodies attack the inner tissue of vessels (endothelium). As a result, the nutrition of cells and organs no longer works optimally. It also affects hair growth and appearance.
Due to the lack of oxygen and nutrition, the hair follicles are damaged and no longer function properly, or even die. As a result, the hair roots lack "fuel" for their growth, which leads to an interruption of the growth phase.
This situation leads to anagen effluvium (hair loss during the growth phase at different lengths). This results in diffuse hair loss, extending to the entire head.
Autoimmune diseases due to Covid
We regularly find that the coronavirus triggers or reactivates autoimmune diseases. We found that post-covid has all the signs of an autoimmune disease. Covid disease therefore leads, at least in some individuals, to an incorrect reaction of the immune system. Cells and organs in the body are considered foreign bodies or invaders that the immune system fights off.
It is also observed in the hair follicles, in the form of alopecia areata (circular hair loss). The hair roots are then attacked by the body's defenses. They no longer function properly and their growth cycle is interrupted.
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In the case of circular alopecia, hairless areas form on the scalp and in the beard area in men.
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In this case, the hair follicles often go into resting mode, without the hair roots dying.
Forms of Cicatricial and Non-Cicatricial Alopecia
How to distinguish scarring alopecia from non-scarring alopecia:
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In nonscarring alopecia, the hair roots usually do not die. They enter a state of rest. They "just" stop working.
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In the scar form of the autoimmune disease, the hair follicles and sometimes also the surrounding connective tissue (eg skin) are destroyed. This leads to the death and degradation of the hair root. These include scaling folliculitis, an inflammation of the scalp and hair roots that irreparably destroys hair follicles. In some cases, the disease is accompanied by redness of the scalp and the formation of eczema.
When does hair loss occur due to Covid?
Many people wonder when hair loss due to Covid occurs.
Most cases occur after Covid infection: a study in Wuhan showed that almost one in four patients suffered from increased hair loss. The study does not specify the severity of the progression of Covid disease and hair loss. Presumably the severity of Covid progression goes hand in hand with the severity of hair loss.
Hair loss can also occur after vaccination against Covid. We have observed that Covid vaccines can be associated with diseases causing hair loss. However, the hair loss is generally less pronounced than in the case of Covid infection.
The incubation period is about 4 to 6 weeks for non-scarring alopecia after infection or vaccination. In severe forms of cicatricial alopecia, the incubation period can also be around 3 months.
Treatment of hair loss caused by Covid
To put an end to hair loss caused by Covid, specific treatment must be started as soon as possible. It consists of the following elements:
Analysis: First, other influences must be excluded. That is why, during the interview with the patient, various questions are clarified and additional examinations are carried out (family history, blood tests, exclusion of deficiencies, examination of the scalp, hair, etc.)
Immunosuppressive therapy: this therapy involves suppressing the immune system so that the hair roots are no longer attacked by the body's defences. Cortisone or equivalent drugs are usually used. In this way, the immune system is regulated so that it no longer "overreacts".
Regenerative therapy: the injection of PRP (platelet-rich blood plasma) and cytokine-rich plasma is used to treat severe inflammatory reactions and to regenerate and reactivate hair roots. This means that the hair follicles receive specific support so that they can recover. This is done by injections into the scalp of the affected areas.
Hair transplants: When hair follicles die, balding areas may appear. If the follicles are already dead, hair can no longer grow in that area. A hair transplant operation can help the person regrow lost hair and fill in hair gaps to make them denser.
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