Management of Hair Loss After Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Insight Into the Pathophysiology With Implication for Better Management

Hair loss after SARS-CoV-2 infection (HLASCI) is a common long-term symptom of COVID-19, affecting 6% to 28.6% of patients, with Telogen Effluvium (TE) being the most common type. Pre-existing alopecia is a risk factor for COVID-19, and autoimmune alopecia, such as alopecia areata (AA), can worsen due to the virus. The onset of TE after COVID-19 typically occurs after a median of 2 months, lasting for a median duration of 5 months. Oral minoxidil is the most common treatment for hair loss, shown to be effective in 17 studies involving 634 patients for various types of alopecia, including TE and AA. Other potential treatments include biotin or iron supplementation, antioxidant and anti-inflammatory shampoo and lotion, vitamin D3 intake, microneedles, sandalwood, and photobiostimulation combined with microinjection, but these require further high-quality, randomized controlled trials to confirm their efficacy.