Welsh Investigation into Hair Loss in Critical Illness Survivors

When people are extremely ill, one of the side effects can be that they start losing their hair or noticing it thinning out diffusely.

Medical professionals have noted the negative psychological effects this aspect can have on both men and women and teams across Wales wanted to explore the topic in more detail.

An observational study was carried out to investigate the incidence and risk factors for hair loss in survivors of critical illness.

Hair loss reported in over one third of critical illness cases

A team from ten Welsh hospitals in various towns and cities across the country, including Newport, Swansea, Cardiff and Bridgend, carried out a 123-person, 'mixed method' study.

This involved monitoring all patients who stayed for at least five days in an intensive care unit (ICU) and were able to consent to taking part. Those patients were then sent a survey to complete three months after they were each discharged.

After taking into account the categorical and continuous variables, comparisons were drawn between those who said in their survey responses that they had developed hairloss within the three months after leaving hospital, and those who said they did not.

Researchers state that 'multivariate logistic regression analysis' was then used to determine the risk factors involved in critical illness patients developing hair loss.

Hair loss as a result of an underlying illness, side effect of medication or stress placed on the body by surgery, generally presents as thinning hair that sheds from the entire scalp. It is known as Telogen Effluvium or, when it lasts for longer than six months, Chronic Telogen Effluvium or Diffuse Thinning. In each case the shedding tends to appear around three months after being triggered and should be temporary, though it can exacerbate or trigger the permanent conditions Male or Female Pattern Hair Loss where the individual has an active or dormant genetic predisposition.

The findings, published in the Journal of Critical Care, showed that 36 per cent of the ICU patients studied reported hair loss (44 out of 123). The only risk factor the teams identified for triggering thinning hair was sepsis or septic shock.

Healthcare providers to make patients aware of risks

Sepsis is a serious complication which can be triggered following an infection in any part of the body. It is most likely to develop after surgery or a urethra catheter being fitted, or following a lengthy hospital stay, according to the NHS. Septic shock, also known as 'severe sepsis' causes dangerously low blood pressure and, in both instances, the hospital admittance is necessary given they can cause multiple organ failure and may even prove fatal.

Given the seriousness, it may seem churlish to some for survivors to worry about losing hair once they recover, however, seeing their hair fall out or dramatically thin can be extremely distressing.

As a result, the study authors state conclude that, although theirs was fairly small in scale and there is 'limited research' besides this, "The results of this study highlight the need to discuss the potential for alopecia with survivors of critical illness, who had sepsis / septic shock."

Finding out that the issue is likely to be temporary and hair regrowth should resume naturally once the body has recovered, although treatment is also available where patients are deemed medically suitable, should reassure patients that, even if they do lose up to 30 per cent of their hair after leaving hospital, it should not be a permanent problem.