Telogen effluvium (TE) is known as diffused shedding of hair two to three months post stressor such as infection from COVID-19. Due to this, anagen phase terminates prematurely following transition to catagen and telogen phases that result in shedding of hair. There is usually a delay as the hair cycle has different phases. Most commonly, around 85% hairs are in their growing phase, 10% are in shedding phase and 5% are in resting stage. When someone experiences stress or shocked events then up to 50% of hair might be pushed prematurely into this shedding phase that causes hair loss. When we talk about patients of COVID-19, we see that shedding of hair occurs in them after three to four months of the illness.
Telogen effluvium (TE) after infection of COVID-19 is typically self-limited i.e., acute TE usually resolves within the period of six months after the onset and does not cause any scars. TE causing stressors are pregnancy, illness, surgery, malnutrition and medications. COVID‐19 has associations with these stressors because virus infected patients are usually under physiological and psychological stress. Response of the body to SARS‐CoV‐2 infection usually creates a state of pro inflammation leading to tissue and other damages. Anticoagulation mechanisms are impaired by release of proinflammatory cytokines resulting in provoking of TE through systemic inflammatory response and/or micro thrombi in follicles of hair.
Post COVID-19Telogen effluvium (TE) is not only due to this viral infection but the stress of pandemic is very much itself. Despite daily life anxieties, there are stressed conditions in people due to financial issues, child care, schooling from home and fears of COVID-19 contracting. Doctors have seen THE patients since June and the number of patients is increasing day by day complaining shedding of their hair. In the body, fever or any other sickness causes stress. In TE patients, many illnesses are seen in which there is no exception of COVID-19.
Usually, various risk factors in patients with telogen effluvium after COVID-19 infection happen. Experts’ opinion in this regard is that it is unknown why in some coronavirus recovering patients, there is hair loss and in others it does not happen. They thought that it may be due to genetic factors. As we know hair fall in predisposed people occurs usually however its reasons are not known yet. One of the reasons for it might be some one’s hair care routine and hair cycle that make him or her susceptible to develop telogen effluvium. Then there is a question that comes into everyone’s mind that how to resolve this issue. In most cases, time is the major factor in recovery as it has been mentioned earlier that TE can be recovered by itself within the time period of six months after the infection. But in order to speed up the recovery and reduce this time limit, some medications can be used. Such as application of topical minoxidil one time in day in patients that are not pregnant or are in nursing services. Proper balanced diet should be taken with an adequate number of proteins in it. Multivitamins can also be used on a daily basis as these help in developing building blocks that are required for optimum growth of hair. Stress should be minimized which can be done by trying various activities for diverting mind such as exercises, yoga or use of medications. Infected patients should consult medical specialists because hair loss and TE are usually stressful. These affect some one’s life significantly. So, consulting a dermatologist is very important especially if there is no recovery or improvement within a time period of 6 months.
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