A hair loss pandemic - Case series - 19 cases of COVID-19 induced telogen effluvium

Sep 27, 2026

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The COVID-19 pandemic increased the number of dermatology patients presenting with hair loss, yet the specific features of telogen effluvium in this setting remained unclear. This case series collected histories, physical examinations, and clinical images from patients at a rural Missouri dermatology clinic with COVID-induced telogen effluvium between July 2020 and March 2021. Nineteen patients were identified: 95% were female, mean age was 56, hair-loss onset averaged 2.73 months after diagnosis (range 2 weeks to 6 months), and 32% had been hospitalized. The study discusses possible pathogenesis and highlights distinct counseling and follow-up needs due to the combined psychological effects of COVID-19 and telogen effluvium, noting it can follow both severe and mild infection.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages4

Reading Time10 min

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Abstract

Introduction

Case series

Clinical assessment and diagnostic approach

Results

[www.jcimcr.org](www.jcimcr.org) Journal of Clinical Images and Medical Case Reports ISSN 2766-7820 Case Series Open Access, Volume 3 A hair loss pandemic: 19 cases of COVID-19 induced telogen effluvium Jazmine Nesvik ¹*; Colin Smith²; Jonathan Cleaver³; David Cleaver³; Lloyd Cleaver³ 1Northeast Regional Medical Center, 315 S Osteopathy, Kirksville, MO, 63501, USA. 2A.T. Still University, 800 W Jefferson St, Kirksville, MO, 63501, USA. 3Cleaver Dermatology, 1316 Country Club Drive, Kirksville, MO, 63501, USA. *Corresponding Author: Jazmine Nesvik Northeast Regional Medical Center, 315 S Osteopathy, Kirksville, MO, 63501, USA. Ph: (320) 491-0988, Fax: (660) 956-7097; [Email: jazminenesvik@atsu.edu](Email: jazminenesvik@atsu.edu) Received: Oct 19, 2022 Accepted: Nov 04, 2022 Published: Nov 11, 2022 [Archived: www.jcimcr.org](Archived: www.jcimcr.org) [Copyright:](Copyright:) © Nesvik J (2022) . [DOI: www.doi.org/10.52768/2766-7820/2152](DOI: www.doi.org/10.52768/2766-7820/2152) Abstract As the COVID-19 pandemic continues, the number of patients presenting to dermatology clinics with hair loss is increasing. Little is known about the specifics of telogen effluvium affecting this patient population. We aimed to discover patterns in patient characteristics and clinical course in those with telogen effluvium secondary to COVID-19 infection. We accomplished this by collecting patient history, physical exam, and images on patients presenting to our rural Missouri dermatology clinic with COVID-induced telogen effluvium from July 2020 through March 2021. Of the 19 patients identified, 95% were female, mean age was 56 years, mean onset of hair loss following COVID-19 diagnosis was 2.73 months with a range of 2 weeks to 6 months, and 32% of the patients had been hospitalized from COVID. Furthermore we explore possible pathogenesis behind and special considerations regarding counseling for COVID-induced telogen effluvium. We have concluded that telogen effluvium can occur following both severe and mild COVID-19 infections, may present earlier than TE associated with other causes, and requires unique patient counseling and followup given the psychological impact of both COVID-19 and telogen effluvium. Clinicians should be familiar with the unique characteristics of COVID-induced telogen effluvium and how to appropriately manage these patients. Keywords: Telogen effluvium; Hair loss; Alopecia; COVID-19; SARSCoV-2; Cytokine storm. Abbreviations: M: Male; F: Female; HPT: Hair Pull Test; Hair Prep: Trichoscopic evaluation. Introduction Telogen Effluvium (TE) is typically a self-limited diffuse nonscarring alopecia occurring three to four months after the premature transition of hairs from anagen to telogen phase [1] . Apart from the distressing amount of hair loss which can have significant psychosocial implications for patients, TE sufferers are generally asymptomatic and experience resumption of normal hair growth within 6 months. Known triggers for the transition from anagen to telogen include periods of intense physiologic or emotional stress, medications, infections, and ultraviolet light [1] . However, one-third of TE cases lack a definitive cause. A TE trigger with increasing incidence gaining public awareness is COVID-19 infection [2,3] . COVID-19 is caused by a novel RNA virus, SARS-CoV-2, that rapidly spread to pandemic Citation: Nesvik J, Smith C, Cleaver J, Cleaver D, Cleaver L, et al. A hair loss pandemic: 19 cases of COVID-19 induced telogen effluvium. J Clin Images Med Case Rep. 2022; 3(11): 2152. proportions in early 2020. It is the source of a great amount of physiologic and emotional stress that could explain the increasing incidence of telogen effluvium among this patient population [4] . Case series Beginning in July 2020, our physicians noticed an increase in the number of patients presenting to our rural Northeast Missouri dermatology clinic with the complaint of

FAQs

What is telogen effluvium and when does it typically occur after a trigger?

Telogen effluvium is a diffuse, nonscarring alopecia that usually develops three to four months after premature transition of hairs from anagen to telogen. Symptoms often resolve with resumption of normal hair growth within about 6 months.

How did the case series confirm COVID-19 as a trigger for telogen effluvium?

Each included patient had a positive COVID test 2 weeks to 6 months before the first signs of hair loss. The series used thorough history and physical examination to diagnose telogen effluvium secondary to COVID-19 infection and to screen for other possible causes.

What were the main characteristics of the 19 patients in the series?

Ninety-five percent were female with a mean age of 56 years. Hair loss became clinically noticeable about 2.73 months after COVID-19 diagnosis on average (range 2 weeks to 6 months), and 32% had been hospitalized. The study also notes that counseling should address the psychological impact of both COVID-19 and telogen effluvium.

Sep 27, 2026

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