Does Hair Density Come Back Fully After Telogen Effluvium From COVID 19 Resolves?

Hair Density Expected Return to Normal in Most But Not All Patients

We’ve reviewed in several previous articles that anywhere from 20-50 % of patients get increased hair shedding after COVID 19 infection. The type of hair loss seen in the weeks and months after COVID 19 is known as “telogen effluvium”.

I’m often asked if hair density returns to normal after COVID 19 infection resolves.

The answer that many give is … yes. However, this is not the correct answer. The answer is not yes. The precise answer is that the vast majority will get their full hair density back but some will find their hair is a little bit or a moderate amount thinner 6-12 months following resolution of COVID 19.

The following algorithm is taken from an earlier article I wrote where we discussed the many different things that go into evaluating whether or not a person is going to get their hair back. (see article : Telogen Effluvium: Am I going to get My Hair Density Back after Telogen Effluvium)

When it comes to COVID 19, we don’t have all the long term data yet. We presume that the hair loss is a typical telogen effluvium but the reality is that we don’t fully know if there are any other issues contributing to hair loss. SARS-COV-2 affects multiple organ systems, affects blood vessels and stimulates a variety of complex immune responses. Genetic material are known to persist in some organs long after the acute infection is over.

If hair loss after COVID 19 truly behaves like a typical “telogen effluvium”, then we expect that most patients will get their hair back. However, as we see with other cases of telogen effluvium, a small proportion of patients are going to find that their hair density does not quite return back to normal. Fortunately, it tends to be a small proportion only. Those with progressive (especially untreated) androgenetic alopecia and some other scarring alopecias (such as active untreated scarring alopecia) may find that the density doesn’t quite get back to the same density 6-12 months down the road in the future.

This phenomenon is well known to hair experts around the world. The phenomenon may not be well known to everyone.

To say that hair density always gets back to normal in everyone once a telogen effluvium resolves in inaccurate and incorrect. Fortunately, most people do get their hair density back which makes it seem liek the myth is correct.