Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management

Michela Starace, Matilde Iorizzo, Andrea Sechi, Aurora Maria Alessandrini, Miriam Carpanese, Francesca Bruni, Giulio Vara, Zoe Apalla, Daniel Asz-Sigall, Stefania Barruscotti, Francisco Camacho, Isabella Doche, Bruna Duque Estrada, Rachita Dhurat, Maria Fernanda Gavazzoni, Ramon Grimalt, Matthew Harries, Dimitrios Ioannidis, Amy McMichael, Daniel Fernandes MeloRui Oliveira, Yuliya Ovcharenko, Rodrigo Pirmez, Yuval Ramot, Lidia Rudnicka, Jerry Shapiro, Tatiana Silyuk, Rodney Sinclair, Antonella Tosti, Sergio Vano-Galvan, Bianca Maria Piraccini

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


Background: The cutaneous manifestations of COVID-19 may be useful disease markers and prognostic indicators. Recently, postinfectious telogen effluvium and trichodynia have also been reported. Objective: To evaluate the presence of trichodynia and telogen effluvium in patients with COVID-19 and describe their characteristics in relation to the other signs and symptoms of the disease. Methods: Patients with a history of COVID-19 presenting to the clinics of a group of hair experts because of telogen effluvium and/or scalp symptoms were questioned about their hair signs and symptoms in relation to the severity of COVID-19 and associated symptoms. Results: Data from 128 patients were collected. Telogen effluvium was observed in 66.3% of the patients and trichodynia in 58.4%. Trichodynia was associated with telogen effluvium in 42.4% of the cases and anosmia and ageusia in 66.1% and 44.1% of the cases, respectively. In majority (62.5%) of the patients, the hair signs and symptoms started within the first month after COVID-19 diagnosis, and in 47.8% of the patients, these started after 12 weeks or more. Limitations: The recruitment of patients in specialized hair clinics, lack of a control group, and lack of recording of patient comorbidities. Conclusion: The severity of postviral telogen effluvium observed in patients with a history of COVID-19 infection may be influenced by COVID-19 severity. We identified early-onset (<4 weeks) and late-onset (>12 weeks) telogen effluvium.

Original languageEnglish (US)
Pages (from-to)11-18
Number of pages8
JournalJAAD International
StatePublished - Dec 2021
Externally publishedYes


  • COVID-19
  • SARS-CoV-2
  • hair loss
  • hair shedding
  • multicentric study
  • scalp allodynia
  • telogen effluvium
  • trichodynia

ASJC Scopus subject areas

  • Dermatology


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