By now, it is safe to say that the main symptoms of COVID 19 are well known – a persistent cough, a high temperature and loss of taste or smell – but what is less well known is that some people who have been infected are also reporting a new long-term effect: hair loss.

Nick Allen, owner of Banbury Postiche, talks to Neil Harvey MIT, current director of The Institute of Trichologists (London), about the issue, to help ensure hairdressers are fully equipped to deal with any clients who may be suffering from hair loss.

How do you define hair loss?

To put it in very simple terms, as far as I am concerned, if someone is worried about their hair getting thinner or if there is less hair today than there was yesterday, then that is hair loss.

What can be the reasons behind people reporting hair loss during and after suffering from COVID 19?

Currently, no published research exists to suggest that COVID 19 attacks hair follicles, but we do know that fever is one of the common symptoms. Often at around 3 – 4 months after having a high fever or illness, people can experience noticeable hair loss, which can be as dramatic as handfuls of hair coming out when you shower or after brushing your hair. For some, this can last for up to 6 – 9 months before it stops, and a gradual recovery process begins. Quite often, after suffering from a fever, we are actually feeling better and on the mend and then when hair does start to fall out they aren’t necessarily putting it down to the illness.

Going through COVID 19 can be a stressful time for some people – does stress have an impact on hair loss as well?

We see it a lot in the clinic and I always feel a little patronising when I advise people to de- stress – but stress can really be the beginning of a very complex cause and effect relationship. Stress can impact your hormone levels, the adrenal glands produce cortisol and adrenaline and that raises testosterone levels and if you have a genetic predisposition to follicle sensitivity this can cause your hair to thin. The body’s ability to digest food and absorb nutrients can also be affected by stress, as can your immune system, which can leave you susceptible to illness. When your body is under a lot of strain it will divert energy to your vital organs, bypassing the energy it needs for healthy hair growth.

COVID 19 obviously affects anyone – regardless of age or gender – have you seen anyone that it affects more?

The term for hair loss that we explained a moment ago related to the fever and stress element is Telogen Effluvium and there are two forms of this – acute and chronic. The acute form, which is a short sharp shock that may occur after a physical or emotional trauma can affect any age group, any gender, any hair type or any ethnic background. The chronic form – which can last for years – usually affects women between the age of 30 – 60, who will generally have a good head of hair. I use the term generally, as we do see people who are exceptions to these textbook rules.

Is it a certain type of hair that is affected?

Generally, I would say that it can affect any hair type, but if you have thin hair to begin with then you will unfortunately probably notice the effects of thinning hair and hair loss perhaps more than someone with a very thick head of hair. Also, if you have hair follicles that are sensitive to hormonal changes – then you are starting with a disadvantage.

If you have had COVID 19, is there anything that you can do to avoid going through the trauma of hair loss?

The first thing to say is that it’s important not to worry, as any hair loss will only be temporary – but I know that is much easier said than done. For those who are worrying about it though then the first port of call should be a trichologist, who will be able to confirm the diagnosis, so that you know exactly what you’re dealing with. In some cases, once the diagnosis has been confirmed then there may be nothing that needs to be done in order to combat the issue, as the trichologist may see signs of active hair re-growth and be able to reassure you that you are in a recovery mode. However, if someone wanted to be pro-active in taking control of the issue, or you have the misfortune of having the chronic form of Telogen Effluvium then a trichologist may have a treatment that they could recommend – such as dietary or lifestyle changes, supplementation or medications (which will need to be discussed with your GP) or topical solutions or layers of phototherapy that can help to stimulate cell production and give the emerging hair the best chance for healthy hair growth.

What might hairdressers notice with their clients?

The short answer is – they will notice more hair loss than usual. The first sign will be that a client is sitting in their chair and they actually confide in them that they are worried about their hair getting thinner and if they are saying this then it’s important to listen.

The hairdresser may notice:

• A lot of shorter hair amongst the longer hair lengths which may look like broken hair but
can be indicative of hair shedding and new hair growing through.
• There may be a receding hair line or receding temples
• Thinner hair on the crown or entire top of the head
• Wispy ends on the length of someone’s hair
• Hair that doesn’t seem to grow past a certain length
• Hair that is easily broken
• There may even be someone’s who’s hair smells odd. This will be very rare, but if the
person hasn’t changed to a weird and wonderful shampoo, then it could be
indicative of something happening within the hair shaft or illness.
• Someone’s eyebrows getting shorter
• Pink or red patches on the scalp
• Someone who mentions that their nails are brittle or easily breaking
• Maybe even someone with sudden weight loss or sudden weight gain
All of these are signs that may make the hairdresser want to look again at the person’s hair
to see if they notice anything different from when they last came in.

Discussing a client’s thinning hair is a delicate issue for hairdressers to raise, do you have
any advice on how best to broach the subject?

It is obviously a very sensitive issue and a difficult one to discuss, but I think the main thing to do when discussing it is to use terms like thinning hair or hair loss and never use the words bald or balding. I think one of the most delicate ways of broaching the subject would be to ask them to tell you what they like and what they dislike about their hair – starting with the positive is always good. If they don’t say anything about their thinning hair then it is OK not to bring it up with them. If they say that they wished they had thicker hair, or more hair, then that is your chance to give them tips to help make their hair look thicker. If during the conversation it comes to light that they are genuinely worried about their hair getting thinner, then as a professional hair stylist I would encourage them to have strong links with a professional trichologist in their area and refer clients to them. What I want to stress is that “don’t try to offer any tips of your own to combat hair loss”.

What resources are available for hairdressers if they want to learn more?

There are many registered organisations that offer trichology training within the UK and if a hairdresser is genuinely interested in learning more about the subject then an online search will give you a number of trichological institutions. Alternatively, you could reach out to a local trichologist and ask their advice on where they trained and who you should go to in order to learn more. Learning about the common hair loss issues and how best to cope with them would be a real benefit not only to the hairdresser, but clients and even the salon in which they work.

The Institute of Trichologists’ and Trichocare both have courses in Trichology, which gives the hairdresser enough knowledge and insight into some of the most commonly seen hair loss issues. This would be a real benefit for both the client and the hairdresser – and if you enjoy this, then you may wish to go on to study further – and gain your qualifications in Trichology.

For more info, visit Banbury Postiche here.