The first time you noticed your hair falling out, maybe it was from seeing clumps in the shower drain or on your brush. Maybe you looked in the mirror and noticed that your hairstyle looked a little different. Maybe I made a ponytail and felt there was less volume.
If you’ve recovered from Covid in the last few months, this increase in hair loss may not be a coincidence. Some research estimates that 22% of people hospitalized with the condition have experienced temporary hair loss.
It’s more difficult to gauge the extent to which the problem affects people who have had the milder version of the disease, but studies suggest that hair loss is one of more than 60 persistent symptoms often associated with long-term Covid, some of which are better known. such as loss of smell, cognitive impairment and sexual dysfunction.
Doctors say they are seeing more patients seeking help for hair loss.
“I’ve never seen anything like it in my life,” said New York dermatologist Michele Green, from Lenox Hill Hospital, who specializes in hair loss. “I’m seeing more patients of both sexes, of all age groups and all professions. This problem is affecting people of all kinds.”
altered scalp
Sudden, temporary hair loss has a medical name: telogen effluvium. This occurs when stress or illness causes a much greater hair loss than normal, which is between 50 and 100 hairs a day.
The problem is not specific to Covid: Experts have known for centuries that serious illness, surgery, blood loss, hospitalization, childbirth, and very strong emotional events such as the loss of a loved one can trigger telogen effluvium. But researchers have found that people with a history of Covid-19 infection are four times more likely to experience hair loss than people who have not had the disease.
It is unclear exactly how these physical and emotional stressors cause telogen effluvium. Many dermatologists believe that cortisol, the stress hormone, may play a role in this process.
But for Dr Luis Garza, a professor of dermatology at the Johns Hopkins University School of Medicine, there may be other chemicals that tell hair follicles it’s time to shed hairs. And Covid has been a double whammy for many people, with the mental stress of living in a pandemic being accompanied by the physical stress of the disease itself.
In normal times, each hair shaft goes through three phases: a growth phase, known as the anagen phase, a transitional, or catagen phase, and a resting phase, also known as the telogen phase, after which the hair shaft falls off and the follicle repeats the entire process.
Hair strands go through different phases of the cycle at different times. Only 5% to 10% of our hair should be in the telogen phase at any given time (hair from other parts of the body enter the telogen phase in different proportions).
“Telogen effluvium short-circuits the cycle for many strands of hair,” Garza said. The result is that 30% to 50% of the hair on the head enters the shedding phase, and two or three months after a distressing event the person is likely to see clumps of hair falling out.
This hair loss can last for six to nine months, which can seem like an eternity. Then the shedding slows down, and new strands begin to grow.
What to do besides wait?
If you start to notice sudden hair loss or are concerned about how much hair you are losing, it may be a good idea to see a doctor right away. “Usually you’ll know if you’re losing hair a long time before anyone else can see it clinically,” Green said.
By intervening early, especially if your hair loss is linked to an underlying condition, you can properly treat it.
The doctor will take your history, order some blood tests, and will likely do a hair pulling test, in which he will take small clumps from different parts of your head and pull them out very gently. If six or more strands fall out without resistance, this is an indicator of active hair loss. In some cases, the doctor may order a biopsy to examine the hair follicles.
If the hair pulling test is positive and your scalp doesn’t show signs of redness or scarring, which are indicators of other types of hair loss, you likely have telogen effluvium.
Most doctors advise patients to wait for the hair to grow back on its own, because the phenomenon is known to be temporary. “A lot of what I do is offer information and advice to people when that happens and play the role of cheerleader for them, explaining that it’s going to get better,” said Arash Mostaghimi, director of dermatology at Brigham and Women’s Hospital, in Boston.
Some dermatologists recommend stimulating the hair regrowth process with a topical solution of minoxidil, a drug used to promote hair growth. It is also possible to take minoxidil in pill form if the patient is very anxious or has an event ahead that makes the situation seem more urgent, such as a wedding.
But for Mostaghimi, minoxidil can be a double-edged sword, as it sometimes causes hair loss when the patient starts taking it, as part of the process of normalizing cycles. In addition, according to him, the patient who stops taking the medicine because he thinks he has reached the desired volume may lose some hair until the situation stabilizes.
According to Garza, just managing stress may be a way to combat telogen effluvium. “One thing I say to patients who are experiencing hair loss is that it can be helpful to see a therapist, because we know that stress causes hair loss, and hair loss in turn intensifies the stress. Hair is a very important part of our lives. identity.”
Most dermatologists agree that betting on hair loss supplements and shampoos can be tempting, but it probably won’t solve the problem.
“People like to think they’re much more in control of their skin, hair and nails than they really are,” commented Mostaghimi.
Supplements, for example, are not rigorously tested and not well regulated. Most people already get the vitamins and minerals they need for good hair growth simply by eating a varied diet, he explained. “I don’t encourage patients to gamble too much on these items. They end up spending a lot of money, and the benefits, if any, will be minimal.”
Most patients will have some hair regrowth even before the hair loss has stopped completely. Treatments can help with a recovery within four to six months, Green said, but anyone who decides to wait will also experience a natural recovery. The difference is that it can take 12 months or more, especially if the haircut is shoulder length or longer, because hair growth is so slow — usually less than 1.20 centimeters per month.
Some people may find that their hair has never returned to its previous volume. According to doctors, sometimes telogen effluvium can trigger other, more permanent types of hair loss, such as male or female pattern baldness, although the reason for this is not known.
In other cases, telogen effluvium can be a sign of a health problem that is still present, such as a malfunctioning thyroid or an autoimmune disease, Green said.
While you are waiting for your hair to grow back, it is recommended that you treat it carefully. Avoid using heat styling aids or hairstyles that put too much tension on the hair, such as a tight ponytail, which can weaken the hair follicles further. And try to face the process with optimism.
“Most of the patients who came to me at the beginning of the pandemic are already improving,” said Mostaghimi.
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