Post-Covid hair loss

The Covid-19 is an ongoing global pandemic caused by the "Severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). The Covid-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes.
Since the emergence of the novel coronavirus SARS-CoV-2, the cause of Covid-19, much attention has been paid to its life-threatening pulmonary and cardiovascular manifestations. However, cutaneous signs and symptoms of disease have also been described and may significantly impact patients.
One of the most significant dermatological manifestations of Covid- 19 infection is hair loss disorder, specially telogen effluvium (TE).
Telogen effluvium (TE) is a common form of hair loss characterised by hair shedding, resulting from the early entry of the hair into the telogen phase. Inducing factors include systemic diseases, stressful events, drugs, nutritional deficiencies, and major surgery. Hair loss occurs 3 months after the causing event and is usually self-limiting, lasting for about 6 months (acute TE). A chronic form of TE also exists, when the duration of hair loss exceeds 6 months.
Stressors that can cause TE include pregnancy, psychological trauma, illness, hospitalisation, surgery, malnutrition, and medications. The Covid-19 pandemic is associated with these stressors; those who were infected with the virus were under immense psychosocial and physiologic stress.
Sars-Cov-2 infection can be associated with delayed TE.
The mainstay of treatment for TE is correcting the underlying cause and removing the inciting stressor.
To find out other underlying condition causing TE, following investigations should be done: Thyroid function test, Serum Vitamin D level, Serum Ferritin, Complete Blood Count, Serum Vitamin B12, Random Blood Sugar.
Telogen effluvium is self-correcting. Recommendations can be given:
l Gentle handling of the hair, avoiding over-vigorous combing, brushing and any type of scalp massage.
l Treat any underlying scalp disorder or hormonal problem determined, if any.
l Ensure a nutritious diet, with plenty of protein, fruit and vegetables.
l Correct any abnormality in thyroid function, or levels of iron, vitamin B12 and folic acid.
TE may have a profound impact on the patients' mind and would require attention, time, and empathy.
Dr Rubaiya Ali is a Consultant -- Dermatology of Evercare Hospital Dhaka