Post-Covid impact on Skin Health and Hair

Covid-19 has not ended even after an entire year of dealing with the virus. But what’s even worse is that newer variants and more virulent ones are here now. The entire world is still in the process of understanding the disease and hoping that it would end. While we try to stay safe and continue to socially distance, here are a few things you must know about the post-covid impact. Covid is affecting individuals to varying degrees. Some are asymptomatic and others mild to moderately symptomatic and while some others are having it hard with severe infection. Even after recovery patients are now experiencing long-term side effects or post covid symptoms.  Fatigue, joint pain, breathlessness, brain fog and palpitation are being reported by patients even after weeks and months post-recovery from Covid-19. Apart from these, post-covid symptoms also include significant changes to the skin and hair.

Post covid effects on skin

Skin rashes are getting more common among people who are infected and/or have recovered from the virus. Rashes usually occur when the body has been through an infection, medication, allergen or even because of heat. This is the human immune system’s way of responding to diseases. Rashes are often common in several types of fever and flu apart from Covid-19. The viral infection from covid too triggers skin rashes that sometimes settle in a few days or weeks but others tend to stay longer than that. Researchers point to various reasons for these rashes, some say it is the body’s immune system responding to the infection, side-effect of high dose of medications including steroids, hormone-related changes post-infection and more. Some of the most common type of skin concerns reported include:

• Hives

In serious cases of Covid-19, hives or urticaria are characterized by red bumps on the skin that keeps recurring. These bumps could stay for a few minutes to hours but newer ones keep occurring in other parts of the body. This can be itchy and the bumps could be small or as large as a baseball. Hives clear themselves in a week or so under treatment.

• Atopic dermatitis

This type of skin rash appears as red or brownish patches and is often itchy. It commonly occurs on the arms and legs but can occur anywhere else on the body. This condition would remain quite persistent and patients could experience flare-ups. Scaly, flaky, red and extremely dry skin with severe itching are the main symptoms of this condition.

• Red bumps and patches

Flat red lesions on the skin referred to as maculopapular rashes are formed after severe infections. These type of rashes is commonly found in people who had to take strong medications.

• Conjunctivitis

The inner eyelid and the membranes of the eye become pinkish red due to the conjunctiva getting inflamed. Redness, itching and watering of the eyes are the most common symptoms. This is caused by the severe covid infection that the person has been through. It usually subsides in a week or two under proper care and treatment.

• Covid toes

Red patchy and discoloured skin in the feet and hands are common especially among children in the later stages of covid symptoms or much after recovery. This is referred to as covid toes and can also appear as blisters with fluid. The condition can also be itchy and painful. Most of the cases of covid toes subside in around two weeks’ time.

• Eczema

Extreme dry scaly and itchy skin is also noticed among a few percentage of the population who has been through covid-19. The condition is triggered as a result of infection or allergens. How fast the patient recovers from eczema depends upon how severe the symptoms are. Moisturization and following a care routine as suggested by the doctor can help reduce the severity.

• Water filled blisters

Some patients also experience water-filled blisters on their skin, especially in the palm region. This symptom usually occurs during the onset of the infection and in some cases, it can persist for a few days or weeks after recovery.

• Red blue patterns

Tiny bruises that are red or blue in colour occur in some patients and are considered to be due to the blockage in blood vessels. This occurs due to the body’s immune response to covid-19 infection.

• MIS or multisystem Inflammatory syndrome

Multisystem inflammatory syndrome in Children (MIS-C) occurs commonly in children who have been affected by covid-19. The condition can be severe with inflammation of the heart and blood vessels. Children exhibit skin rashes in the hands, feet and stomach and some can be severe with rashes all over the body. Other symptoms of MIS-C include red eyes, fever, aches and cracks in the lips. MIS-A is the same syndrome seen in adults who have been in the past infected with Covid-19. With proper medical attention, the condition can go down. Children and adults must take be aware that this condition could occur even months after the infection and must seek medical help.

• Pale skin

In some cases, patients also experience having pale skin while being infected or during the short period into recovery. This is mainly due to the person getting anemic, low oxygen levels, developing problems related to the heart or circulatory system, low blood sugar and due to longer duration of the infection.

• Skin Sensitivity

In severe cases, there are reports of skin sensitivity especially around the abdomen and upper abdominal region. Itchy skin and discomfort in wearing clothes are reported. This occurs due to the activation of cells for the production of immunoglobulins.

• Cracked lips

Dry and cracked lips is another symptom being observed among covid patients. Sore lips could be uncomfortable with no other signs of the fever and hence patients must make sure that the cracked lips are due to covid or not. Dry lips can also be due to dehydration, vitamin deficiency and others. It is important to make sure that the skin reaction is or not covid related.

How to know if your skin rash is due to the covid-19 infection?

A skin rash could be confusing to patients if it is not accompanied by any other symptoms of covid. Patients do tend to let it pass if the condition and severity is bearable. Now that there are reports of covid-19 and skin related changes in the second wave, anyone with the above types of skin issues must get consulted. A general physician or dermatologist could help with treatment for the concern. It is important to also take a covid-19 test and isolate oneself till the results are got. Do remember that timely intervention and care are important factors for treating and recovering from covid-19.

Post covid effects on the hair

Hair loss has been reported as a common side-effect of the covid-19 infection. Individuals experience covid triggered hair loss that sometimes settles in a few weeks, while for others it might take longer. With appropriate treatment, the condition can be brought under control and completely healed. Some major reasons for covid induced hair loss are:

• Telogen Effluvium

This type of hair loss occurs as a result of the body experiencing shock, trauma, stress or illness. The condition is temporary and one would recover completely in a couple of months’ time. This can also be triggered due to the lack of nutritional food to the patient while he/she was undergoing treatment. Our body is intelligent enough to cater to all the most important organs and help them completely recover after an infection. The hair is not considered as an essential part that requires care and hence there would hair loss. Once the body has completely recovered from the infection and replenished all the important organs of the person, telogen effluvium subsides on its own. This type of hair loss might persists for a duration of 3 months and usually subside in a period of 6 months.

• Iron deficiency hair loss

Low levels of ferritin, a protein that stores iron, can lead to iron deficiency hair loss. This condition would take several months to heal but commonly subside on its own without aggressive treatment. It is important to be patient about the hair growing back.

• Underlying hair disorders

If a person had conditions such as male or female pattern baldness, it could aggravate due to covid-19 induced hair loss. In such cases, consultation and treatment plan would be essential if there are lesser signs of recovery.

• Hormonal changes

Stress and medications could cause hormonal imbalance that can in turn lead to hair loss. Lower levels of estrogen and progesterone and increasing levels of androgen can trigger hair loss. Pregnancy and covid-19 could also trigger hormonal imbalance and cause hair loss related to it.

• Alopecia as a side-effect to certain medications

Some medications such as antibiotics, anticoagulant drugs, immunosuppressants can cause alopecia. In this type of hair loss, hair falls out in chunks leaving behind visible patches. The condition could in turn cause stress and anxiety to the patients. A dermatologist would be the right person to assess the condition and provide treatment.

Steps to recover from hair loss after a covid-19 infection:

• A diet rich in nutrients, iron and vitamins that can help the body recover from the infection
• A protein-rich diet with an increased intake of lentils, seafood, eggs, vegetables, nuts and more
• 8 hours of sleep on a daily basis
• Ample water intake and mild exercise for 30 minutes in a day
• Breathing exercises along with meditation and yoga
• Reduce stress and engage deeply in a hobby
• Avoid combing the hair rigorously

It is important to give enough time (up to a few months) after recovery from covid for the body to rebuild its old vigour. Appropriate care, medication and rest can be the best solution to heal from the side-effects of covid-19. Skin and hair-related concerns caused by covid-19 settle in a few months’ time and patients need not have to worry about long term side-effects in most cases.

As always, prevention is better than cure. It is important to use a mask, sanitize regularly and keep a healthy mind and body to beat the virus. Patients must take appropriate medical care at any symptom of the disease and not get delayed in starting treatment.