Does COVID 19 Infection Worsen Alopecia Areata?

COVID 19 Does not Usually Worsen Disease in Patients with Alopecia Areata

COVID 19 is well recognized to cause hair shedding or “telogen effluvium” and this typically occurs 1-3 months after the COVID 19 infection

For patients dealing with the autoimmune disease alopecia areata, COVID 19 infection is additionally stressful for many due to fears that the COVID 19 could worsen the underlying alopecia areata. Although there are some studies that suggest that COVID 19 infection can worsen AA and even induce alopecia areata, the majority of patients with alopecia areata are not expected to experience additional hair loss from the COVID 19 infection.

Rudnicka et al, 2021

In 2021, authors from Poland performed a retrospective study to evaluate whether or not patients mild to moderate alopecia areata experienced additional hair loss after acquiring a mild to moderate COVID 19 infection.

32 consecutive patients with alopecia areata who had COVID 19 were evaluated. The patients had received the following treatment at the time of developing COVID-19 : intralesional triamcinolone (12 patients), oral glucocorticosteroids (10 patients), cyclosporine (10 patients), methotrexate (6 patients), azathioprine (1 patient). 4 patients were not receiving any type of treatment. In 10 (31.3%) of the 32 patients, the treatment was discontinued for 7-28 days on account of the COVID-19.

Three Month Follow Up Evaluations Show No Worsening

Follow up evaluations at the 3 month mark showed that patients with alopecia areata did not experience additional hair loss on account of having COVID 19. Specifically, the SALT score was 40.8 before COVID-19 and 36.3 after COVID-19. The difference was not statistically significant.

Conclusion

This is a nice study that adds to a growing body of knowledge about how to best manage alopecia areata during the COVID 19 pandemic. Most patients wth mild COVID can continue their medications and most patients are not expected to experience a worsening of the alopecia areata on account of having the COVID 19.

REFERENCE

Rudnicka et al. Mild-to-moderate COVID-19 is not associated with worsening of alopecia areata: A retrospective analysis of 32 patients. J Am Acad Dermatol. 2021 Sep;85(3):723-725.