Hair Shedding Related to COVID-19 Doesn't Last Long

By Reuters Staff

August 03, 2021

NEW YORK (Reuters Health) - Acute telogen effluvium (TE) following COVID-19 appears to occur sooner, with quicker resolution, than when TE is triggered by other events, clinicians have observed.

TE is form of alopecia characterized by diffuse hair shedding, often with an acute onset. TE is a reactive process caused by physical or emotional stress, high fever, illness or substantial weight loss - symptoms common with SARS-CoV-2 infection.

Cases of acute hair shedding have been reported during the COVID-19 pandemic. One report described a 400% surge in cases of TE related to SARS-CoV-2 infection among Hispanic/Latinx population of New York City (https://bit.ly/2Vi8sAS).

In the Journal of the American Academy of Dermatology, Dr. Carlos Wambier of Rhode Island Hospital, in Providence, and colleagues describe the onset and duration of acute TE after COVID-19 in 30 patients from the U.S., Brazil and Spain.

The median age of the cohort was 40.5 years and 21 were women.

All patients had monthly follow-up until recovery of hair loss. Diagnosis of TE was based on dermatologist evaluation, using mainly trichoscopy and pull test, with one patient confirmed by biopsy.

Acute TE occurred at a median of 45 days (1.5 months) after a RT-PCR positive test for SARS-CoV-2. In contrast, TE typically occurs two to three months after a triggering event.

Acute TE after COVID-19 lasted a median of 47.5 days, whereas typical acute TE generally takes three to six months to recover, the authors note.

One patient presented with patchy alopecia in the occipital area, diagnosed as pressure alopecia from a prolonged stay in the intensive-care unit. More than half (53%) of patients reported concomitant medication use.

Trichoscopy showed empty hair follicles, as expected for TE.

"These cases depict an intense TE with shorter duration, potentially reducing hair density or unmasking previous androgenetic alopecia," Dr. Wambier and colleagues write.

"Because patients may present with TE sometime after their COVID-19 illness, it is important for clinicians to consider a previous COVID-19 infection as a possible cause for their patient's TE in the context of this pandemic," they advise.

Limitations of the study include the possibility of other concomitant causes of TE and the small number of cases.

SOURCE: https://bit.ly/3i9FEnt Journal of the American Academy of Dermatology, online July 21, 2021.

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