When Stacey Maravola’s hair started falling out in clumps two months after she tested positive for Covid-19, she was not initially concerned.
“I washed my hair one day and I’m pulling handfuls upon handfuls. And I’m like, ‘Maybe because it was up in a scrunchie,’” Maravola, 44, of Leetsdale, Pennsylvania, said.
But nearly two months later, the hair loss has not stopped. Each time Maravola, a health and lifestyle coach, shampoos her hair, fistfuls come out, getting tangled around her fingers and sticking to her legs as she showers.
“I’ve had to limit hair washes because I’m terrified,” she said. “I’m not a big emotional person, but I can tell you, this has changed me. I cry every single time I take a shower.”
Maravola is one of many coronavirus survivors dealing with dramatic hair loss, something that experts say is not entirely unexpected following a serious illness — but can be jarring nonetheless.
“It is upsetting, especially for those who have gone through a significant clinical course of Covid, to then experience this as well,” said Dr. Sara Hogan, a dermatologist and health sciences clinical instructor at the David Geffen School of Medicine at the University of California, Los Angeles. "But oftentimes, patients, once they have a diagnosis and they understand that typically this will get better, they feel better."
Sudden hair loss can happen after any stressful event, including major surgery or even an emotional stressor such as starting a new job, Hogan said. The pandemic appears to have led to a large uptick in people who are seeing their hair thinning, she said: Hogan used to see an average of three to five hair loss patients a week and now sees up to seven a day.
Why severe assaults to the body or mind sometimes trigger hair loss is not entirely understood. In the majority of these cases, the patient is diagnosed with telogen effluvium, a temporary condition in which he or she sheds many more hairs than the typical 100 or so that people lose in a day. Telogen effluvium usually begins about three to six months after the stressor has happened, and in most patients, the problem will resolve within four to six months, according to Hogan. (In rare cases, unremitting stress can lead to chronic shedding, she added.)
Researchers do not believe Covid-19 attacks the hair follicles, meaning the hair loss is the body's reaction to the physiological and emotional stress that the disease caused, rather than a symptom of the disease itself. And many hair loss patients that Hogan and other dermatologists are currently seeing have never had the coronavirus to begin with.
“It’s just all the other tolls of the pandemic that are leading to the hair loss,” such as financial worries or grieving the death of a family member, said Dr. Lauren Kole, an assistant professor of dermatology at the University of Alabama at Birmingham School of Medicine.
Hair loss following Covid-19 came into the spotlight in August when the actress and activist Alyssa Milano shared a startling video of the amount of strands she was losing when she brushed her hair.
“Thought I’d show you what #Covid19 does to your hair,” she wrote. “Please take this seriously.”
Maravola was diagnosed with the coronavirus on July 5, and had a fever for a couple of days, plus a headache and loss of appetite. While the illness was fairly mild, she has had a constellation of enduring health issues since then, including debilitating fatigue, joint pain and rashes.
Seeing her thick, black hair coming out in bunches was one of the more upsetting developments.
In September, Maravola shared a picture of her hair loss with an online support group for so-called “long haulers” — coronavirus survivors struggling with lingering symptoms — and was surprised to receive nearly 200 comments from others who said they could relate.
“It was, for me, reassurance,” she said. “I thought, at first, I was going crazy.”
There are various treatments for telogen effluvium, including supplements and topical treatments like Rogaine, although some patients are hesitant to take Rogaine because it will initially cause hair to shed more, Hogan said.
Both she and Kole recommended that anyone with new or worsening hair loss go to a board-certified dermatologist to rule out other causes, such as thyroid problems or side effects from medications. A dermatologist can also decipher whether the hair loss is due to telogen effluvium or something else, such as alopecia areata, an autoimmune disorder.
Maravola said connecting with other people who have gone through the same thing has helped her to cope with her hair loss.
“It is heart-wrenching,” she said, her voice breaking. “You have to find your support system, whether it’s on Facebook, or family and friends, because it’s scary.”