The extreme stress of the last nine months (and counting) is resulting in a significantly higher rate of hair loss in racially diverse communities, new research in the Journal of the American Academy of Dermatology shows. A study on two hospitals in low-income, diverse communities in New York City, which had high COVID-19 death rates, found there’s been a 400% uptick in a hair-shedding disorder among some people of color.
Pandemic Hair Loss in Diverse Communities
In a study released by the Journal of the American Academy of Dermatology on December 10, five doctors took a look at the rates of telogen effluvium, a reversible condition that causes hair shedding after a stressful experience, in dermatology departments at Metropolitan Hospital in Manhattan and Coney Island Hospital in Brooklyn. The two “safety-net” hospitals serve racially diverse neighborhoods that have suffered some of New York City’s highest COVID-19 death rates. The researchers discovered a more than 400% increase in telogen effluvium between March 1 and August 31, compared with pre-pandemic cases between September 1, 2019 and February 29, 2020. The study showed a particularly significant rise in cases of telogen effluvium between July and August—about three to four months after New York City experienced its first major surge of COVID-19 and implemented lockdowns. “Telogen effluvium usually does not show up at the beginning of a stressor. Three to four months after the stress is pretty typical for telogen effluvium,” explains Allison Britt Kimmins, MD, MPH, a board-certified dermatologist specializing in both medical and cosmetic dermatology at Advanced Dermatology in Chadds Ford, Pennsylvania. The increase in telogen effluvium was most prevalent in Hispanic and Latino people, who have faced more than four times the rates of hospitalization from COVID-19 compared with white people. The researchers also found five cases of the condition among men during the pandemic. In the previous year, they had counted no cases of telogen effluvium among men.
Limitations of the Hair-Loss Study
While early research offers important insights during a public health emergency, this study has some limitations. It had a relatively small sample size of about 3,000 total patients, 50 of whom had telogen effluvium during the pandemic. It also focused on just two hospitals in New York City, so the results may not be generalizable to the population at large. Interestingly, the researchers noticed almost no increase in telogen effluvium among Black people, even though they’ve endured a disproportionate amount of cases, hospitalization, deaths, and other stressors during the pandemic. “That finding doesn’t make sense to me. African Americans do experience telogen effluvium, so the findings might be due to limitations in the study populations,” says Dr. Britt Kimmins, who has seen African American patients with the condition in her office over the last few months. Dr. Britt Kimmins also pointed out that popular hairstyles among Black people and African Americans, such as dreadlocks or braids, may make it difficult to notice hair loss. “Access to healthcare might be another problem,” she adds. “Sometimes when people in the African American population do show up at clinics, hair loss might not be as important to them as high blood pressure or their blood sugar going haywire.” What’s more, the vast majority of participants in this research had not been tested for COVID-19 due to shortages of supplies, making it impossible to determine if the disease itself was causing telogen effluvium. Despite its limitations, the study helps quantify anecdotal reports from dermatologists who’ve seen an uptick in telogen effluvium during the pandemic. It also adds more insight into the results of an informal survey of more than 1,500 COVID-19 long-haulers, which found more than 400 reports of hair loss. “What you can glean from this study is that telogen effluvium is real and it is on the rise because of COVID-19,” says Dr. Britt Kimmins.
Understanding Telogen Effluvium
Up to 90% of a person’s hair is typically in the growing phase at any giving time, while the rest is in the telogen (or resting) phase. Hairs in the telogen phase fall out after a few months, which explains the strands we usually find in our brushes and bathtub drains. A stressful event, such as a severe illness, childbirth, or emotional trauma, can be a shock to the system. That can result in telogen effluvium, a condition in which about 30% of hairs enter the resting phase and fall out a few months later. There are still a lot of unknowns about the specific cause of telogen effluvium during the pandemic, says Scott Paviol, MD, a board-certified dermatologist at Paviol Dermatology in Charlotte, North Carolina. “Does the COVID virus actually cause hair loss, or is what we’re seeing strictly another form of a life stressor triggering hair loss? That may need time to be figured out,” says Dr. Paviol. Doctors say that seeing excess strands of hair falling out, day after day, can be a crushing experience that may ultimately exacerbate the condition. “Noticing hair thinning can be a very devastating experience for men and women of every race. It becomes a daily and hourly struggle,” explains Dr. Paviol. “When it’s stress-related hair loss, it becomes a stress about being stressed.” On the bright side, telogen effluvium is a temporary condition that typically lasts about six months. While there are no treatments for telogen effluvium, the condition is unlikely to make you go bald and the hair will eventually grow back on its own. If you’re noticing hair shedding, make an appointment with your primary care physician or a dermatologist to investigate the cause. They’ll usually ask you about any major life events, like stressors or diseases, from the past few months. They may also run a blood test to eliminate other potential causes of hair loss, like a thyroid issue. Doctors recommend avoiding excessive brushing, combing, shampooing, and other activities that could lead to unnecessary hair shedding while you have telogen effluvium. They also encourage patients to find ways to cope with emotional stress to boost their overall wellbeing. “I remind patients with telogen effluvium that any kind of ongoing mental stress can be physically harmful. Once you modify your reaction to stress, you will notice less hairs on your pillow,” says Dr. Britt Kimmins. “There’s hope because once you know what you have, you can change things to try and fix it.” 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. The good news is that this disorder is temporary and the hair will grow back. Finding ways to cope with stress in a healthy way could help prevent physical symptoms, like hair loss, and improve your overall well-being.
