Kristine Kucera, PA-C, MPAS, DHS
According to the most recent report from the CDC, COVID is still a national concern and over 152,500,000 vaccines have been given to the US population. A recent article published in Clinical Immunology discusses a potential link between immune-mediated alopecia areata and COVID-19 vaccinations.(1) It highlights reported cases and compares various immune markers between patients with alopecia and the control group, which they refer to as vaccine-tolerant individuals. The results showed variations in several immune factors, such as antinuclear antibodies, eosinophils, Total IgE, granulysin, and PARC/CCL18 levels. Although these differences indicated an immune response dysregulation in the patients with alopecia, further research is needed to establish a definitive connection between the two. As dermatology professionals we should be aware of this possible association and monitor patients for any signs of alopecia after vaccination.
Most of us are aware that telogen effluvium has been reported post-COVID infection in some patients. It is generally self-limited and hair will regrow over time. While stress has been implicated in many of these cases, researchers describe molecular mechanisms by which SARS-CoV-2 infection could induce hair loss(2):
“Pro-inflammatory cytokines in the context of severe inflammation, as well as the viral coagulopathy that causes the formation of microthrombi at the level of the capillary microcirculation of the hair follicle, but also the direct cytopathic effect of the virus on the hair follicles.”
Whether associated with vaccination or active infection, hair loss associated with COVID seems to be treatable and fortunately reversible. We should offer patients encouragement that will not lose all of their hair and we hope and optimistically expect that the hair will regrow.
You can read more about hair loss from my panel presentation with Adam Friedman, MD at DERM2023.
Kristine Kucera, PA-C, MPAS, DHS, is Assistant Clinical Professor, University of Texas Southwestern, Medical Center PA Program, Dallas, TX. She is a member of the DEF Advisory Council.
- https://www.sciencedirect.com/science/article/abs/pii/S1521661623005004
- Iancu GM, Molnar E, Ungureanu L, Șenilă SC, Hașegan A, Rotaru M. SARS-CoV-2 Infection-A Trigger Factor for Telogen Effluvium: Review of the Literature with a Case-Based Guidance for Clinical Evaluation. Life (Basel). 2023;13(7):1576. Published 2023 Jul 18. doi:10.3390/life13071576