Stress factor: New multicentre study links COVID-related hair loss with stress

The study was conducted by a team of researchers from various medical institutions in Turkey and aimed to study the type and frequency of hair and nail disorders after COVID-19 infection.

It involved 2,171 post-COVID-19 patients, including those who developed hair and nail disorders and did not. They were recruited as subject and control groups respectively.

According to this study, the symptoms of COVID-19, including fever, fatigue, loss of taste and smell, cough, nausea, and vomiting were more frequent in the hair loss group compared to the control group.

The rate of the previous admission in hospital due to COVID-19 was more common in patients who developed hair loss after getting infected with COVID-19.

Telogen effluvium (TE) was the most common (85%) hair loss type (85%) followed by worsening of androgenetic alopecia (AA) after COVID-19 infection (7%).

Some studies have suggested that hair loss was an effect of pandemic-related emotional stress in addition to COVID-19-related proinflammatory cytokines.

The study recorded that there was a 16% history of hospitalisation due to COVID-19 in the hair loss group compared to 10.3% in the control group.

The researchers also observed the mean stressed scores during and after COVID-related hospitalisation.

For those with hair loss, mean stress scores during and after hospitalisation were 6.88 and 3.65. On the other hand, mean stress scores were 5.77 and 2.81 for those that did not experience hair loss.

The intensive care admission was 2.2% in the hair loss group and 1.3% in the control group.

This would suggest that the severity of stress during the COVID-19 infection could influence hair loss.

However, the researchers highlighted: “The fact that the level of stress in patients with hair loss is relatively lower than in hospitalised patients may indicate that stress is a priority for individual psychological susceptibility rather than COVID-19- related cytokine storm in hair loss.”​

Furthermore, the study found that stress level after COVID-19 was most commonly associated with an increase in TE followed by AA and a worsening of androgenetic alopecia (AGA).

Nailing the issue​

In addition to hair loss, the researchers also studied nail disorders related to COVID-19 infection.

The most common nail disorders were leukonychia, onycholysis, Beau’s lines, onychomadesis, and onychoschisis.

The symptoms of COVID-19 were more common in patients having nail disorders after getting infected with COVID-19 compared to the control group.

The researchers concluded that the development of both nail and hair disorders after COVID-19 seemed related to severe COVID-19.

“In conclusion, as we are about to leave behind the second year of COVID-19, there are still multiple gaps regarding the post-COVID-19 manifestations of hair and nail disorders. There are numerous types of hair and nail disorders that appeared after COVID-19. It seems that the development of both nail and hair disorders after COVID-19 may be related to a history of severe COVID-19.”​

The researchers said they encouraged further research in order to better understand the relationship between COVID-19 and hair and nail disorders.

Furthermore, they said they were currently conducting additional clinical investigations, such as long-term follow-ups, to observe the progress of diseases.

The effect of COVID-19 on development of hair and nail disorders: a Turkish multicenter, controlled study​
Source: International Journal of Dermatology

 ​

Kutlu et al.

https://doi.org/10.1111/ijd.16454​