(NEW YORK) — Since the onset of the coronavirus pandemic over two years ago, people have reported lingering effects of COVID-19, including hair loss.

Dr. Jennifer Ashton, a board-certified OBGYN and ABC News’ chief medical correspondent, is among them, experiencing lingering hair loss after testing positive for COVID-19 in January.

“Now that it’s just over three months, roughly, later is really when I started to notice a major change,” Ashton said. “The two things that I noticed were loss of volume, really really like almost nothing for me to hold onto when I put my hair up in a ponytail, and then breakage.”

Ashton, who was vaccinated and boosted when she tested positive for COVID-19, has shared her hair loss journey on Instagram, where commenters thanked her for bringing awareness to the issue.

According to Ashton, it’s estimated that over 20% of people who have COVID-19 experience some form of hair loss.

Here are some questions answered about COVID-related hair loss, from why it happens to how it can be treated:

Why does COVID-19 hair loss happen?

It is not uncommon for people to experience noticeable hair loss a few months after recovering from a high fever or an illness, according to the American Academy of Dermatology (AAD).

While researchers are still looking into exactly how having COVID-19 can impact a person’s hair, the early research shows that the virus somehow infects and affects hair follicles, according to Ashton.

Hair follicles anchor hair into the skin, and each one goes through three phases: The anagen phase, when the hair grows; the catagen phase, when hair growth slows and the follicle shrinks; and the telogen, or shedding, phase, when old hair falls out and new hair begins to grow.

While most hair loss, or hair shedding, occurs in the telogen phase, COVID-19-related hair loss appears in the anagen phase, when the hair is beginning to grow, according to Ashton.

“This is relevant because it affects what the timeline is by which someone could start to notice hair loss following COVID-19,” Ashton said. “Hair loss after COVID can begin as early as 18 to 47 days after infection.”

With the more common type of hair shedding, telogen effluvium, most people start to see shedding two to three months after an illness, according to the AAD.

Is anyone more susceptible to COVID-19 hair loss?

The risk factors for COVID-19 hair loss are still unknown, and there is also no known way to specifically prevent this type of hair loss, according to Ashton.

“We don’t know yet who is more at risk,” she said. “It does appear that if you experienced more severe COVID-19, you are more likely to experience this, but you can experience this with mild COVID-19 illness as well.”

Does COVID-19 cause permanent hair loss?

Ashton said it remains to be seen whether hair loss due to COVID-19 is permanent.

She added that it looks “promising and encouraging” that most people will see hair regrowth and correction.

“We still don’t know what percentage breakdown will regain, or regrow, their hair, but the bottom line is it takes time,” Ashton said, noting that people should expect a timeline for regrowth of anywhere from three months to one year.

What are treatment options for COVID-19 hair loss?

While there are no known ways to prevent hair loss with COVID-19, there are many ways to treat it, according to Ashton.

She recommends first “resting your hair,” which means taking a break from stressors like heavy-handed brushing and pulling and not using tools like hair dryers and curling and straightening irons.

Ashton said that, for her, resting her hair also means wearing more hats and headscarves.

“I just think it’s super easy,” she said. “No one cares how dirty your hair is. No one cares what your hair looks like.”

Ashton also recommends limiting the use of hair products that contain alcohol as an ingredient because alcohol will dry out hair further. Instead, she recommends using a hair mask product, or going more natural by using coconut oil or olive oil to moisturize the hair.

Ashton has also been wearing hair extensions occasionally but stresses those can damage hair further.

“They can pull on your hair and actually forcibly detach your hair, so dermatologists are very kind of cautionary before they recommend that any woman use hair extensions,” she said. “I am experimenting with them, but we’ll see. I don’t foresee them as too heavy in my rotation.”

After her consulting with her dermatologist, Ashton said she began supplementing her diet with a protein powder to increase her daily protein intake, which will help lessen hair breakage.

While there are many supplements on the market promoting hair regrowth, Ashton said that, from a scientific standpoint, it’s unclear if those supplements get results any different than simply adding a daily prenatal vitamin or multivitamin to your diet.

And finally, Ashton stressed the importance of checking with a medical provider to rule out other medical causes of hair loss, like thyroid function.

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