{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T11:00:10Z","timestamp":1777978810836,"version":"3.51.4"},"reference-count":51,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,7,18]],"date-time":"2023-07-18T00:00:00Z","timestamp":1689638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Telogen effluvium post-COVID-19 is a condition characterized by the diffuse and reversible loss of scalp hair in the period following infection with SARS-CoV-2, and it is currently the second cause of alopecia in women. In the context of the COVID-19 infection, intense psychological stress contributes to alopecia appearance, along with systemic inflammation, autoimmune reactions, oxidative stress, and virally induced hypoxia. Cytokines with proinflammatory action and vasoactive substances negatively modulate the metabolism of some molecules, such as proteoglycans, involved in the hair follicle\u2019s growth cycle. Studies show that a large percentage of hairs will suddenly enter the catagen phase during a moderate to severe COVID-19 infection. In the present paper, we update the data from the literature with a clinical example. Our case highlighted that the telogen effluvium after infections with SARS-CoV-2 is reversible with appropriate dermatological treatment. For therapeutic success, informing the patient about this pathology\u2019s self-limited and reversible character is essential to reduce the emotional stress that may aggravate the disease.<\/jats:p>","DOI":"10.3390\/life13071576","type":"journal-article","created":{"date-parts":[[2023,7,19]],"date-time":"2023-07-19T00:47:38Z","timestamp":1689727658000},"page":"1576","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["SARS-CoV-2 Infection\u2014A Trigger Factor for Telogen Effluvium: Review of the Literature with a Case-Based Guidance for Clinical Evaluation"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9373-3670","authenticated-orcid":false,"given":"Gabriela Mariana","family":"Iancu","sequence":"first","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania"},{"name":"Clinic of Dermatology, County Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Estera","family":"Molnar","sequence":"additional","affiliation":[{"name":"Clinic of Dermatology, County Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8535-9677","authenticated-orcid":false,"given":"Loredana","family":"Ungureanu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"},{"name":"Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona Corina","family":"\u0218enil\u0103","sequence":"additional","affiliation":[{"name":"Department of Dermatology, \u201cIuliu Ha\u021bieganu\u201d University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania"},{"name":"Department of Dermatology, Emergency County Hospital, 400006 Cluj-Napoca, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian","family":"Ha\u0219egan","sequence":"additional","affiliation":[{"name":"Department of Urology, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania"},{"name":"Clinic of Urology, County Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Rotaru","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Lucian Blaga University of Sibiu, 550169 Sibiu, Romania"},{"name":"Clinic of Dermatology, County Emergency Hospital of Sibiu, 550245 Sibiu, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1111\/1346-8138.16475","article-title":"Management of hair loss after severe acute respiratory syndrome coronavirus 2 infection: Insight into the pathophysiology with implication for better management","volume":"49","author":"Ohyama","year":"2022","journal-title":"J. Dermatol."},{"key":"ref_2","first-page":"e29285","article-title":"Prevalence of Hair Loss after COVID-19 Infection in Makkah Region, Saudi Arabia","volume":"14","author":"Abdulwahab","year":"2022","journal-title":"Cureus"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"601","DOI":"10.1038\/s41591-021-01283-z","article-title":"Post-acute COVID-19 syndrome","volume":"27","author":"Nalbandian","year":"2021","journal-title":"Nat. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1159\/000517223","article-title":"Telogen Effluvium after SARS-CoV-2 Infection: A Series of Cases and Possible Pathogenetic Mechanisms","volume":"21","author":"Rossi","year":"2021","journal-title":"Skin. Appendage Disord."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e25352","DOI":"10.1097\/MD.0000000000025352","article-title":"Pityriasis rosea Gibert triggered by SARS-CoV-2 infection: A case report","volume":"100","author":"Birlutiu","year":"2021","journal-title":"Medicine"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.ijid.2021.04.058","article-title":"Cutaneous manifestations associated with anosmia, ageusia and enteritis in SARS-CoV-2 infection\u2014A possible pattern? Observational study and review of the literature","volume":"107","author":"Birlutiu","year":"2021","journal-title":"Int. J. Infect. Dis."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e21810","DOI":"10.1097\/MD.0000000000021810","article-title":"Viral exanthema as manifestation of SARS-CoV-2 infection: A case report","volume":"99","author":"Iancu","year":"2020","journal-title":"Medicine"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/S1473-3099(20)30986-5","article-title":"Long COVID in the skin: A registry analysis of COVID-19 dermatological duration","volume":"21","author":"McMahon","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1111\/bjd.19163","article-title":"Classification of the cutaneous manifestations of COVID-19: A rapid prospective nationwide consensus study in Spain with 375 cases","volume":"183","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"65","DOI":"10.31782\/IJCRR.2020.121312","article-title":"Dermatological Manifestations of COVID-19: A Review Based on Existing Reports","volume":"12","author":"Kumar","year":"2020","journal-title":"Int. J. Cur Res. Rev."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"441","DOI":"10.2169\/internalmedicine.8033-21","article-title":"Livedo reticularis associated with COVID-19","volume":"61","author":"Sahara","year":"2022","journal-title":"Intern. Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Bennardo, L., Nistic\u00f2, S.P., Dastoli, S., Provenzano, E., Napolitano, M., Silvestri, M., Passante, M., and Patruno, C. (2021). Erythema Multiforme and COVID-19: What Do We Know?. Medicina, 57.","DOI":"10.3390\/medicina57080828"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1016\/j.jaad.2020.04.044","article-title":"Varicella-like exanthem as a specific COVID-19-associated skin manifestation: Multicenter case series of 22 patients","volume":"83","author":"Marzano","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"e13986","DOI":"10.1111\/dth.13986","article-title":"Cutaneous manifestations and considerations in COVID-19 pandemic: A systematic review","volume":"33","author":"Seirafianpour","year":"2020","journal-title":"Dermatol. Ther."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1000","DOI":"10.1111\/ijd.15030","article-title":"Clinical characteristics of dermatologic manifestations of COVID-19 infection: Case series of 15 patients, review of literature, and proposed etiological classification","volume":"59","author":"Potekaev","year":"2020","journal-title":"Int. J. Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Masood, W., Ahmad, S., Khan, N.A., Shakir, A., Rokni, G.R., Gold, M.H., Cockerell, C.J., Schwartz, R.A., and Goldust, M. (2022). Pathobiology of Cutaneous Manifestations Associated with COVID-19 and Their Management. Viruses, 14.","DOI":"10.3390\/v14091972"},{"key":"ref_17","first-page":"1","article-title":"Cutaneous manifestations in COVID-19: A first perspective","volume":"34","author":"Recalcati","year":"2020","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"2198050","DOI":"10.1080\/09546634.2023.2198050","article-title":"New-onset and flares of psoriasis after COVID-19 infection or vaccination successfully treated with biologics: A case series","volume":"34","author":"Gargiulo","year":"2023","journal-title":"J. Dermatol. Treat."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1002\/jmv.27534","article-title":"A systematic review of acute telogen effluvium, a harrowing post-COVID-19 manifestation","volume":"94","author":"Hussain","year":"2022","journal-title":"J. Med. Virol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Monari, P., Gualdi, G., Bettoni, G., Costa, R., Ragni, G., Zani, F., Bianchi, G., Casella, S., Casella, E., and Crippa, M. (2022). Post-SARS-CoV-2 Acute Telogen Effluvium: An Expected Complication. J. Clin. Med., 11.","DOI":"10.3390\/jcm11051234"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"445","DOI":"10.4103\/idoj.idoj_139_22","article-title":"Covid Induced Telogen Effluvium (CITE): An Insight","volume":"13","author":"Inamadar","year":"2022","journal-title":"Indian. Dermatol. Online J."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Gentile, P. (2022). Hair Loss and Telogen Effluvium Related to COVID-19: The Potential Implication of Adipose-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma as Regenerative Strategies. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23169116"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1016\/j.ad.2022.08.018","article-title":"Trichoscopy in alopecia areata","volume":"114","year":"2023","journal-title":"Actas Dermo-Sifiliogr\u00e1ficas"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"17011","DOI":"10.1038\/nrdp.2017.11","article-title":"Alopecia areata","volume":"3","author":"Pratt","year":"2017","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"170","DOI":"10.4103\/0974-7753.130385","article-title":"Trichoscopy in alopecias: Diagnosis simplified","volume":"5","author":"Jain","year":"2013","journal-title":"Int. J. Trichol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.ijwd.2018.05.001","article-title":"Female pattern hair loss: A clinical, pathophysiologic, and therapeutic review","volume":"4","author":"Fabbrocini","year":"2018","journal-title":"Int. J. Womens Dermatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"890206","DOI":"10.3389\/fmed.2022.890206","article-title":"Epidemiological, Clinical, and Trichoscopic Features of Syphilitic Alopecia: A Retrospective Analysis and Systematic Review","volume":"9","author":"Pomsoong","year":"2022","journal-title":"Front. Med."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"6","DOI":"10.5070\/D3390280M2","article-title":"Alopecia syphilitica-report of a patient with secondary syphilis presenting as moth-eaten alopecia and a review of its common mimickers","volume":"15","author":"Bi","year":"2009","journal-title":"Dermatol. Online J."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"68","DOI":"10.4103\/ijt.ijt_30_20","article-title":"Trichoscopy as a Diagnostic Tool for Tinea Capitis: A Prospective, Observational Study","volume":"12","author":"Kumar","year":"2020","journal-title":"Int. J. Trichology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s11046-016-0058-8","article-title":"Tinea Capitis: Current Status","volume":"182","author":"Hay","year":"2017","journal-title":"Mycopathologia"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"327","DOI":"10.2217\/cpr.14.18","article-title":"An overview of management of drug-induced hair and nail disorders","volume":"11","author":"Pate","year":"2014","journal-title":"Clin. Pract."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"adv00565","DOI":"10.2340\/00015555-3859","article-title":"Diagnostic Accuracy of Trichoscopy in Trichotillomania: A Systematic Review","volume":"101","author":"Kaczorowska","year":"2021","journal-title":"Acta Derm. Venereol."},{"key":"ref_33","unstructured":"Pereyra, A.D., and Saadabadi, A. (2023, June 10). Trichotillomania, StatPearls, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK493186\/."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"631","DOI":"10.25122\/jml-2021-0380","article-title":"Prevalence of telogen effluvium hair loss in COVID-19 patients and its relationship with disease severity","volume":"15","author":"Seyfi","year":"2022","journal-title":"J. Med. Life"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/j.jaad.2021.07.021","article-title":"Time of onset and duration of post-COVID-19 acute telogen effluvium","volume":"85","author":"Abrantes","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_36","first-page":"e181","article-title":"SARS-CoV-2-induced telogen effluvium: A multicentric study","volume":"35","author":"Grimalt","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e2023036","DOI":"10.5826\/dpc.1301a36","article-title":"Effect of COVID-19 on Hair Diseases Observed by Health Care Providers: Analysis of 513 participants","volume":"13","author":"Bostan","year":"2023","journal-title":"Dermatol. Pract. Concept."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e15175","DOI":"10.1111\/dth.15175","article-title":"COVID-19 induced telogen effluvium","volume":"34","author":"Aksoy","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"3655","DOI":"10.1111\/jocd.15218","article-title":"Characteristics of hair loss after COVID-19: A systematic scoping review","volume":"21","author":"Czech","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"4068","DOI":"10.1038\/s41467-021-24342-y","article-title":"The antiandrogen enzalutamide downregulates TMPRSS2 and reduces cellular entry of SARS-CoV-2 in human lung cells","volume":"12","author":"Leach","year":"2021","journal-title":"Nat. Commun."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1809","DOI":"10.1111\/jocd.14883","article-title":"Evaluation of patients with telogen effluvium during the pandemic: May the monocytes be responsible for post COVID-19 telogen effluvium?","volume":"21","year":"2022","journal-title":"J. Cosmet. Dermatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.jdin.2021.07.006","article-title":"Trichodynia and telogen effluvium in COVID-19 patients: Results of an international expert opinion survey on diagnosis and management","volume":"5","author":"Starace","year":"2021","journal-title":"JAAD Int."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s40801-015-0056-z","article-title":"Traditional Anticoagulants and Hair Loss: A Role for Direct Oral Anticoagulants? A Review of the Literature","volume":"3","author":"Watras","year":"2016","journal-title":"Drugs Real World Outcomes"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"6056","DOI":"10.4103\/jfmpc.jfmpc_377_22","article-title":"Telogen effluvium after COVID-19 vaccination among public in Saudi Arabia","volume":"11","author":"Alharbi","year":"2022","journal-title":"J. Family Med. Prim. Care"},{"key":"ref_45","first-page":"51","article-title":"Androgenetic Alopecia: Predictive Factor for COVID-19 severity","volume":"9","author":"Rotaru","year":"2021","journal-title":"EMJ Dermatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"735","DOI":"10.2147\/CCID.S359052","article-title":"Complementary Strategies to Promote Hair Regrowth in Post-COVID-19 Telogen Effluvium","volume":"15","author":"Popescu","year":"2022","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"876561","DOI":"10.3389\/fmed.2022.876561","article-title":"Association between Hair Diseases and COVID-19 Pandemic-Related Stress: A Cross-Sectional Study Analysis","volume":"9","author":"Mahadi","year":"2022","journal-title":"Front. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"e14761","DOI":"10.1111\/dth.14761","article-title":"Telogen effluvium associated with COVID-19 infection","volume":"34","author":"Olds","year":"2021","journal-title":"Dermatol. Ther."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e6228","DOI":"10.1002\/ccr3.6228","article-title":"Intermittent chronic telogen effluvium with an unusual dermoscopic finding following COVID-19","volume":"10","author":"Saki","year":"2022","journal-title":"Clin. Case Rep."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"385","DOI":"10.2147\/CCID.S307982","article-title":"A Case of Acute Telogen Effluvium after SARS-CoV-2 Infection","volume":"14","author":"Lv","year":"2021","journal-title":"Clin. Cosmet. Investig. Dermatol."},{"key":"ref_51","first-page":"e14547","article-title":"Telogen effluvium related to post severe SARS-CoV-2 infection: Clinical aspects and our management experience","volume":"34","author":"Rizzeto","year":"2021","journal-title":"Dermatol. Ther."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/7\/1576\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:13:49Z","timestamp":1760127229000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/7\/1576"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,18]]},"references-count":51,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["life13071576"],"URL":"https:\/\/doi.org\/10.3390\/life13071576","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,18]]}}}