Study: COVID-19 Stress Might Be Causing Uptick in Temporary Hair Loss

In a paper published earlier this month, board-certified dermatologists from New York City reported a 400% increase in telogen effluvium (TE) cases, also known as hair shedding, in the city's Hispanic and Latinx population this past summer. Because this phenomenon can be triggered in the months following extreme stress, researchers suggest it's a new indication that the pandemic hit specific populations especially hard after ravaging New York in March.

The study, which was published in the Journal of the American Academy of Dermatology, looked at the number of hair shedding cases in dermatology clinics serving two safety-net hospitals in Brooklyn and Manhattan.

The clinics typically treated low-income, non-White populations. The researchers noted that the neighborhoods served by the clinics experienced some of the highest COVID-19 death and infection rates in NYC.

“It’s clear that minority predominant communities have been disproportionately affected by this pandemic,” study author Shoshana Marmon, MD, PhD, FAAD, board-certified dermatologist and and director of clinical research in the department of dermatology at New York Medical College, tells Verywell. “Since this type of hair shedding is related to extreme physiological and/or emotional stress, I would expect that the number of cases of TE would be higher in these hard-hit areas than in the general population.”

What Is TE?

TE is a type of medically induced hair loss that occurs two to four months after a major stressful event such as childbirth, prolonged illness, major surgery, or serious infection.

A person with TE may begin to notice larger amounts of hair on their pillow, in the tub, or on a hairbrush. The hair on the scalp might appear thinner, but TE rarely causes bald spots.

“A severe stressor or illness like COVID-19 can cause a shock to the system that shunts more hairs into telogen,” Marmon says. “Because of the lag time (two to four months) people are often unaware that the stressful event and hair shedding are related.”

TE is usually diagnosed with a physical exam and medical history. Marmon says that a technique called a “hair pull” test, where the clinician observes the number of hairs that come loose by gently tugging on a bundle of hair, is also used.

As for possible long-term effects, while some medical hair loss conditions can cause scarring, inflammation, or bald patches, Marmon says that these effects typically do not occur with TE.

How Common Is TE?

A 2020 study from Sampson Regional Medical Center in North Carolina reports that TE can occur in people of any age, gender, or racial background. While the exact prevalence is unknown, many adults will develop TE at some point in their life. Women are more likely to be diagnosed because they are more likely to seek treatment.

In pre-pandemic years, the NYC clinics in the recent study would only report about 7.5 cases of TE every two months—and never in men. However, in July and August of 2020 (four months after the first surge of COVID-19 cases hit the U.S.), the clinics reported 43 cases of TE—5 of which were in men. The majority of the cases were in the Hispanic/Latinx communities.

“Patients typically notice the condition when they are washing or styling their hair,” Marmon says. She adds that patients sometimes report that their hair comes out in clumps, which can be very distressing.

Can COVID-19 Cause TE?

TE can be caused by an illness or infection, meaning that it could possibly be a side effect of the COVID-19 recovery process. However, more data is needed to confirm if there is a direct correlation between COVID-19 and TE.

“It is a difficult question because there was a severe lack of testing in NYC at the start of the pandemic,” Marmon says. “However, based on what we are seeing now, it does look like infection with COVID-19 significantly increases your risk of developing telogen effluvium."

The Centers for Disease Control and Prevention (CDC) does not list hair shedding as a COVID-19 symptom. Dermatologists at the Cleveland Clinic are seeing TE both in people who have been infected with COVID-19 as well as people who have not infected.

Stressors other than actually getting sick with COVID-19—such as financial worries, concern for loved ones, social isolation, fear of contracting the virus, and changes in work and school, could also cause hair shedding.

Can TE Be Treated?

TE will usually go away on its own in about six months as long as the cause has resolved. In the meantime, people should keep with their regular hair care routine including styling and washing. 

According to the Cleveland Clinic, eating a healthy, well-balanced diet can help with TE management. Studies also indicate that taking a multivitamin that contains iron and using minoxidil 5%, which is approved by the Food and Drug Administration (FDA), can also help relieve symptoms.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.