Chronic Telogen Effluvium After COVID: PRP and Oral Minoxidil Treatment
A Case Report from Katy & Houston, Texas
Patient Presentation
A 61-year-old woman presented as a new patient to Reena Jogi, MD for evaluation of long-standing, generalized hair loss on the scalp. Her hair loss was described as moderate in severity, gradual in onset, and present for several years, with worsening diffuse shedding over the past year.
The patient reported a significant COVID-19 infection in 2025, after which she noticed a marked increase in hair shedding. She also endorsed several systemic stressors, including a recent gastrointestinal illness, unintentional 15-pound weight loss, and prior laboratory findings showing elevated white blood cell count and eosinophils, raising concern for an inflammatory or parasitic process. She was advised to follow up with a gastroenterologist for further evaluation.
She has been taking oral minoxidil 2.5 mg daily since 2023 without side effects and has a family history of hair loss in her mother.
Clinical Examination
A comprehensive dermatologic examination was performed, including detailed scalp and hair inspection, as well as examination of the head and face. The patient appeared well developed, well nourished, and in no acute distress.
Scalp examination demonstrated diffuse, non-scarring hair loss with increased shedding most notable at the mid-frontal scalp. A positive hair pull test confirmed active telogen shedding. No scarring or inflammatory alopecia was identified.
Diagnosis
Based on history and examination, the patient was diagnosed with:
Diffuse Non-Scarring Hair Shedding Following COVID-19 Infection
Post-viral telogen effluvium is a well-recognized cause of prolonged hair shedding, particularly in patients with additional medical, nutritional, or emotional stressors.
Treatment Discussion and Plan
The diagnosis of chronic telogen effluvium was reviewed in depth, including common triggers, expected course, and prognosis. Treatment options were discussed extensively and included:
Increasing oral minoxidil dosage
Adding an androgen blocker such as spironolactone
Low-level laser therapy
Nutraceutical supplementation
The patient was counseled that increasing oral minoxidil may result in increased generalized hair growth, which she understood. After reviewing risks, benefits, and alternatives, she elected to:
Increase oral minoxidil to 3.75 mg daily (1½ tablets of 2.5 mg)
Proceed with PRP therapy starting the same day
Baseline clinical photographs were obtained.
PRP Treatment Details
The patient underwent her first PRP treatment during the visit.
Indication: Hair loss
Treatment Number: 1
Total PRP Volume Injected: 7 cc
Written consent was obtained, and risks—including pain, infection, scarring, and incomplete improvement—were reviewed. Blood was drawn using sterile technique, centrifuged to isolate platelet-rich plasma, and injected into the scalp at the subdermal level. Pain control was achieved with Zimmer cooling, and the patient tolerated the procedure well without complications.
Post-Procedure Instructions
The patient was advised to:
Wash hair with warm water
Use sulfate-free shampoos
Continue oral and topical hair loss treatments
Avoid hair coloring for 2–3 days after PRP
She was scheduled to return in 1 month for PRP treatment #2.
Counseling and Expectations
The patient was counseled that:
Chronic telogen effluvium can take months to improve, especially when multiple triggers are present
Treating underlying systemic illness is critical for recovery
PRP may help reduce active shedding and support regrowth
Combination therapy often provides the best outcomes
She was instructed to contact the office if shedding worsens or new symptoms develop.
Expert Care for Post-COVID Hair Loss in Katy & Houston, TX
At Reena Jogi, MD, we specialize in treating complex hair loss conditions, including post-COVID telogen effluvium and chronic shedding in mature women. Our approach integrates medical therapy, advanced procedures like PRP, and careful systemic evaluation to optimize long-term hair health.
If you are experiencing persistent hair shedding after illness or COVID-19 and are looking for a hair loss specialist in Katy or Houston, Texas, our team is here to help.
