Coronavirus Long-Haulers: How will it change the practice of hair medicine?

Managing All types of Hair Loss in Coronavirus Long-Haulers

When evaluating patents with hair loss, I feel like I need to know a zillion things about the patient. Now, I put that number at a zillion and one. There’s one question I ask now that I didn’t ask 1 year ago: Have you had COVID 19?

For those that answer yes, the question that follows is the one that has the potential to dramatically affect how I treat them: do you think you’ve recovered from COVID 19 fully?

Considerations for the COVID Long-Hauler: What the hair doctor needs to know.

We are slowly coming to realize that not everyone with COVID-19 recovers quickly and not everyone recovers fully. Some patients have persistent symptoms of shortness of breath, fatigue, brain fog, racing heart and other symptoms as well. The term “long-hauler” has been applied to patients with chronic symptoms after COVID 19 infection. It’s still too early to know how long symptoms could last given that this is still the early days of the pandemic. It’s likely that a small proportion of COVID 19 patients will have chronic symptoms - some potentially lasting many years. I think that the medical community has yet to fully understand the magnitude of long term symptoms.

Many patients with COVID 19 will come to see the hair doctor about hair loss. Some are looking for advice about treatment hair loss that happened after they experienced COVID 19. But some are coming for advice on hair loss that happened before COVID 19 and they are now in your office looking for advice on how best to treat it. The hair doctor needs to understand everything they can about the COVID long-hauler. Many of the drugs used in the treatment of various types of hair loss have the potential to be poorly tolerated in the COVID long hauler. More studies are needed but I’m now starting to see the array of issues that can arise.

Should we be using minoxidil in a COVID long-hauler if the minoxidil worsens the dizziness and heart palpitations they already experience?

Should we be using anti-androgens in a COVID long-hauler if the anti-androgen has the potential to worsen fatigue they already experience?

FINAL THOUGHTS

There’s still an enormous amount to learn about how COVID 19 affects the body in the short term and the long term. It’s important for physicians treating hair loss to understand the issues that COVID long-haulers experience in order to better understand how best to to treat them.