Telogen effluvium after COVID-19 vaccination among public in Saudi Arabia

Abstract

Background: Number of reports linked Telogen effluvium to coronavirus disease 2019 (COVID-19) infection. However, data about Telogen effluvium after COVID-19 vaccination are limited. Objectives: To estimate prevalence of Telogen effluvium among those who received COVID-19 vaccination. Methods: A cross-sectional study was performed during July 2021. Adults who received one of recognized COVID-19 vaccine irrespective of previous COVID-19 infection were asked to fill a questionnaire. Results: The majority of participants were females (90.3%). The most common age group was between 21 and 30 years (51.9%). Out of 991 participants who were included in the current analysis, 670 (67.6%) reported post-vaccination hair fall. The probable causes of post-vaccination hair fall were vaccine-related in 185 (27.6%) participants, other causes in 326 (48.7%) participants, and unclear in 326 (48.7%) participants. Post-vaccination hair fall was significantly higher among females compared with males (68.5% versus 57.9%, P = 0.036), those who did not suffer compared with those who suffered from hair fall before vaccination (72.1% versus 63.4%, P = 0.003), and those who did not report compared with those who reported preexisting conditions that might be related to hair fall (74.5% versus 57.3%, P < 0.001). Conclusion: We are reporting a high prevalence of post-vaccination hair fall, which affected approximately two-thirds of participants who received COVID-19 vaccines. Only 28% of these participants were apparently vaccine related. The role of COVID-19 infection and stress caused by infection and vaccine cannot be excluded. Primary care physician and dermatologist need to consider the possibility of COVID-19 vaccine as a potential cause of hair loss.

Dermoscopy-assisted prevalence of hair loss after COVID-19 vaccination among an Egyptian population: a cross-sectional study

“…Another study that assessed the prevalence of TE following COVID 19 vaccination demonstrated that out of 991 participants, 670 (67.6%) reported post-vaccination hair fall. The probable causes of post-vaccination hair fall were vaccine-related in 185 (27.6%) participants, other causes in 326 (48.7%) participants, and unclear in 326 (48.7%) participants [ 8 ].…”

COVID-19-induced hair shedding and related risk factors: A Saudi perspective

“…Hair loss is not a disabling consequence of SARS-CoV-2 infection; however, it causes psychological stress that affects the patients' quality of life and may initiate a viscous cycle of hair shedding. [ 7 10 16 ] Therefore, it is important for primary care physicians and dermatologists to not underestimate patient complaints. [ 7 17 ] Although alopecia areata and AGA have been reported as related conditions to COVID-19, TE remains the most common trichologic disease in these patients,[ 18 ] in both acute (≤6 months) or chronic (>6 months) forms.…”

“…[ 7 10 16 ] Therefore, it is important for primary care physicians and dermatologists to not underestimate patient complaints. [ 7 17 ] Although alopecia areata and AGA have been reported as related conditions to COVID-19, TE remains the most common trichologic disease in these patients,[ 18 ] in both acute (≤6 months) or chronic (>6 months) forms.…”

“…[ 5 6 ] Hair loss is a common complaint in primary care clinics, seen in females more than males and almost in all different age groups. [ 7 ] During the pandemic, many cases of acute hair shedding following COVID-19 have been reported. [ 8 ] In fact, it is assumed that SARS-CoV-2 infection provokes telogen effluvium (TE),[ 9 10 ] which is defined as diffuse hair shedding following stress triggers, such as systemic diseases, stressful events, drugs, nutritional deficiencies, febrile illnesses, major surgery, or any disturbance of the body's normal physiology.…”

“…[ 13 ] Physiologically, approximately 90% of the scalp hair should be in the anagen phase and 10% in the telogen phase. [ 7 14 ] In this study, we aimed to assess the relationship between COVID-19 and TE and raise awareness of this phenomenon in Saudi Arabia. To the best of our knowledge, this topic has not yet been addressed, and it could be a valuable contribution to the growing medical literature on COVID-19.…”