If there is anything to learn from the COVID-19 pandemic, it's that we are constantly discovering new things about the virus and its associated infection. Now new findings suggest hair loss may be a common long-term health consequence for patients who had severe COVID-19 that required hospitalization.

The findings, published in The Lancet, also suggest women may be at greater risk of suffering from long-term health consequences. 

Previous research has found 1 in 10 people may have persistent health consequences up to three months after their COVID-19 infection has passed. People that have long COVID commonly report symptoms of fatigue, loss of taste and smell, nausea, diarrhea, and abdominal, joint, and muscle pains.

The new study confirms that some of those commonly reported long COVID symptoms such as fatigue and joint pains could be considered as primary long-term health consequences of the virus, as their findings showed they were still reported six months after patients hospitalized with COVID-19 had recovered. Furthermore, an additional health concern was revealed: hair loss. 

The study investigated 1,655 patients that had been discharged from the Jin Yin-tan Hospital in Wuhan, China between Jan 7, 2020, and May 29, 2020, after being treated for COVID-19.

Six months later patients were examined again with blood tests, a physical exercise test that consisted of a six-minute walk, and a questionnaire to assess whether they had any long-term symptoms after their COVID-19 experience. 

The results indicated that 63 percent of patients had reported fatigue or muscle weakness, 27 percent reported sleep difficulties, and 22 percent reported they had experienced hair loss during the last six-month period since having COVID-19.

"At 6 months after acute infection, COVID-19 survivors were mainly troubled with fatigue or muscle weakness, sleep difficulties, and anxiety or depression," the authors wrote in the study. However, hair loss was also one of the highest reported symptoms six months on.

It's worth noting that hair loss is not uncommon during infections, and may occur for short periods of time after recovering from a regular cold. The American Academy of Dermatology Association (AAD) explains: "Temporary hair loss is normal after a fever or illness. Fever is a common symptom of COVID-19. A few months after having a high fever or recovering from an illness, many people see noticeable hair loss."

The AAD also says losing hair after infection could continue for up to six to nine months and that this could be made worst by stress, which is prevalent during a pandemic with all the health, social, and economic challenges it presents. Furthermore, worrying about losing hair could cause more stress, which can result in a vicious feedback loop, so learning ways to mitigate stress is important.
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Your hair should return to normal on its own over time, but if you are concerned speak to your health care provider or a dermatologist.

That moisturizer your friends swear by left your face red and scaly. The cleaner you've been using for years to make your bathroom sparkle made your hands itch and burn.

For some people, the chemicals in shampoos, cosmetics, and detergents can trigger allergic skin reactions.

Causes

These reactions -- what your doctor calls allergic contact dermatitis -- happen when your immune system overreacts to chemicals that are normally harmless. They can be in products you're exposed to over and over, like cleaners, colognes, hair dyes, and personal care items.

Even if you've used them before, you can still have a reaction.

Cosmetics and personal care products have a lot of potential allergens, things you could be allergic to:

• Fragrances in soaps, colognes, deodorants, body creams, cosmetics, detergents, and tissues
• Preservatives and antibacterials, added to many liquids to keep them from spoiling
• Substances added to thicken, color, or lubricate a product
• Chemicals in permanent hair dyes and other hair products
• Formaldehyde resin, an ingredient in many nail care products
• Sunscreens, often found in cosmetic moisturizers, lip balms, and foundations

Symptoms

Your skin is one of the first places where the warning signs can show up. They often appear 24 to 48 hours later, but can start as late as a week after you come in contact with the irritating chemical.

Each person may have different chemical allergy symptoms. Some of the most common are:

• Red skin
• Scaly patches
• Blisters that ooze
• Burning or itching, which may be intense
• Swelling of the eyes, face, and genital area
• Hives
• Sun sensitivity
• Darkened, "leathery," and cracked skin

The symptoms tend to be worst where you touched the thing you're allergic to. If you get the allergen on your finger and then touch another part of your body, like your face or neck, you can set off an allergic reaction there.

Other conditions can cause similar symptoms, so see your doctor to find out what the problem is.

Diagnosis

Often your doctor may be able to diagnose your allergy by doing a physical exam and asking you about your symptoms.

Sometimes, they may suggest you see an allergist for a skin test, also called a patch test. The allergist places small samples of chemicals on your back and checks to see if you get a rash.

Keep track of your symptoms. It will help your doctor make a diagnosis. Note details such as:

• What you were doing in the 24 to 48 hours before your outbreak
• Any products you were using before the reaction
• How much of the product you were using and how often
• Where it touched your skin (even places with no symptoms)
• Symptoms you have or had
• Any previous skin reactions

Treatment

You'll want to identify and avoid the chemical that seems to cause your allergic reaction.

If you do come into contact with it, wash your skin with soap and water as soon as possible. If you have the allergen on your hands, don't touch other parts of your body until you've washed your hands.

It may help to take off and wash any clothes or jewelry that might have come in contact with the irritating chemical.

If you use nail care products, make sure the product has dried before you touch your skin.

Got a mild reaction? You can sometimes treat symptoms yourself with over-the-counter medications such as calamine lotion, antihistamines, or cortisone ointments.
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See your doctor if you have frequent or severe outbreaks. They can help you find out why it happens and give you prescription medications if you need them.

As a BosleyMD-certified trichologist and hairstylist/salon director at Foushee SalonSpa (@fousheesalonspa) in Littleton, Colorado, Gretchen Friese has her hands (and eyes) on everything related to hair and scalp health. Here, she shares the key characteristics, causes and best remedies behind four of clients’ most common scalp concerns.

Psoriasis appears as bumpy red patches covered with white scales—caused by the immune system attacking healthy skin cells. If the client is sick or battling an infection (strep throat is a common trigger), her immune system will go into overdrive to fight the infection, kicking off a psoriasis flare-up. Psoriasis is usually cleared up by doctor-prescribed medications.

With dermatitis, the skin will typically look dry, swollen and red. But there are several different kinds: Atopic dermatitis (eczema) begins at infancy and is usually caused by dry skin, genetics, an immune system disorder, a skin infection, exposure to certain foods, or contact with allergens—or a combination of these. Contact dermatitis is typically caused by contact with a skin irritant, inciting an allergic reaction (think poison ivy, perfumes, jewelry containing nickel, cleaning products, or creams/lotions). Seborrheic dermatitis is caused by a yeast that’s present in oil secretions on the skin. Follicular dermatitis is essentially atopic dermatitis that affects hair follicles. Control dermatitis by moisturizing regularly, or using medicated ointment, creams or dermatitis-specific shampoos.

Alopecia leads to thinning hair and also comes in various forms. Androgenetic alopecia (pattern baldness, usually genetic) occurs with a sensitivity to the hormone dihydrotestosterone. Alopecia areata, an autoimmune disorder, is typically caused by trauma or stress. And traction alopecia happens when hair is pulled too tightly, stressing the follicle and eventually leading to hair loss. These may not have complete cures, but retail products can help fill out the appearance of thinning areas.

Finally, dandruff appears as white flakes on the scalp, which shed into the hair and fall from the head (perhaps accompanied by mild itchiness). Here, a fungus feeds on the oils on the scalp, which can have many causes: irritated or oily skin, not shampooing enough, age (it’s common in teens and young adults), weather, stress levels, medical conditions and some hair products. The condition can usually be remedied with an anti-dandruff shampoo.

Talking Points

How can a stylist sensitively broach scalp issues with clients? “It can be an embarrassing topic, so ask a benign question like, ‘How is your scalp feeling?’ or ‘Have you had any itching on your scalp lately?’” Friese advises. “Questions like this will usually open up a conversation about the issue.”
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Similarly, Brandon Johns (@diplobrandon), an educator with Malibu C and owner of Dallas-based Studio2020, asks clients if they’ve experienced any changes to their diet or medications, then recommends therapeutic treatments to remove any mineral buildup on the hair and scalp (followed by related retail suggestions). “Clients often are looking for the stylist to bring these issues up,” Johns notes. “But it could be caused by something really simple—like if they’re using the same shampoo for six months or more, overwashing, or not washing hair often enough. They may just need a simple switch!”

What is a ‘Mallen streak’?

A white/grey streak is known as a Mallen streak and it is an example of poliosis – which in short means an absence of melanin in the hair which results in a white streak.

Throughout history, the streak has become synonymous with evil – think X Men’s Rogue or the Bride of Frankenstein. The term ‘Mallen streak’ came into common parlance in the 1970s.

Originally coming from the Latin word ‘malignus’ (meaning ‘bad kind’) it was first used by novelist Catherine Cookson in her ‘Mallen’ trilogy. The novels follow the lives of a doomed family who all share the hereditary white/grey streak in their hair. Cookson writes of the pejorative associations of the streak, “nothing good ever came of a Mallen.” But times are a-changing…

Embracing ‘Mallen streaks’

Hopefully attitudes are changing as figures in the public eye now wear their streaks with pride.

“Personally, I would always encourage a client to embrace a streak and work with it as a feature,” says Paul Dennison, colour director at Ken Picton. “It’s incredibly unique and striking and if you cover it, you’ll constantly be fighting the regrowth and trying to cover it up.”

Other notable celebrities with a Mallen streak include politician Ed Milliband, TV presenter George Lamb and author Caitlin Moran.

Paul is a fan of the look and has some tips on how to work with a Mallen streak as a colourist. “It’s a very strong look and because white hair is so clean, it can look really dramatic when sitting next to the darker, natural hair,” he says.
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“I’d aim to enhance that by covering any other greys, so that the front section becomes even more apparent and really stands out. If a client has covered their white hair previously and wants to grow it out and embrace it, I suggest you pre-lighten the ends as much as possible, then tone to the natural colour with a nice ash or clean blonde.”

A grey/white streak has also featured in Tony Haresign’s ‘Mallen Madness’ collection (image to the left). The owner of Esquire Barbershop says of the inspiration behind his collection: “My influences for this collection included 1970s sports presenters, Batman, Catherine Cookson and Film Noir. I was keen to include a Mallen streak in the collection to highlight how striking the grey/white streak can look.”





​Collection image credit:
Hair: Tony Haresign
Assistants: Kayti Dickinson, Blayre Turnbull, Daina Renton
Make-up and styling: Michelle Watson
Suits: Chester Barrie and Richard James, Savile Row
Photography: Matt Marcus