Rational Evaluation of Patients with COVID-19-Related Hair Loss

Hair loss is a common complaint during or after COVID-19 infection, often manifesting as telogen effluvium (TE), a diffuse but self-limited hair shedding likely due to the impact of cytokines on the hair follicle cycle. However, not all cases of diffuse hair loss after COVID-19 are TE. Other conditions such as trichotillomania (TTM), alopecia areata, and androgenetic alopecia have been linked to COVID-19 infection. For example, a case of a woman with acute and diffuse hair loss was initially treated for TE for over 8 months with no response, but further examination revealed the diagnosis of diffuse alopecia areata. Dermoscopy and blood screening can help differentiate the cause of hair loss, especially when associated with other conditions like androgenetic alopecia, syphilis, diffuse alopecia areata, or TTM. Therefore, hair loss following COVID-19 infection should not be evaluated solely on clinical grounds and may require specialized dermatological help.