It was about three months after she first got sick with COVID-19 that Heather Colton’s fiancé started noticing strands of her thick dark hair all around the house.

There would be clumps in the drain at the end of every shower.

Each time she brushed it, even more would fall.

“I’d run my fingers through my hair and I’d pull out a whole bunch,” said the 26-year-old. “I was worried I’d end up bald.”

The Belleville fast-food worker is not the only one experiencing this strange lingering impact of COVID-19. Called telogen effluvium, it often happens after a major illness or trauma. And it’s just one more sign, doctors say, that the strange new virus can impact the body beyond just the lungs, and, even in young people, trigger devastating impacts that last long beyond just 14 days.

Dr. Jeff Donovan, president of the Canadian Hair Loss Foundation, said he’s seen a “tremendous increase” in the number of people coming into his Whistler, B.C. clinic complaining about hair loss.

Most hair is in the growing or anagen phase, but a major stressor like COVID can flip more of it into the telogen or resting phase, as the body conserves energy for vital organs like the lungs and heart.

This takes about nine to 11 weeks after infection to show up, Donovan said, because “when a hair decides that it’s going to fall out it has to spend three months in this period where it gets ready.”

Over a hundred years ago, during the last great pandemic, survivors of the Spanish Flu also noticed hair loss.

When the novel coronavirus first surfaced in Canada this winter, Donovan watched closely.

“But I kind of figured that the hair loss issues are not going to be something that are going to be talked about until probably the summer of 2020, and sure enough that seems to be kind of when we’re hearing about it.”

A recent study from Dr. Natalie Lambert at the Indiana University School of Medicine and COVID patient Facebook group Survivor Corps that surveyed members on symptoms, found hair loss was a common one.

Many patients, called long-haulers, are also struggling with other, more debilitating symptoms, but say hair loss it just one more thing to deal with.

Nada Forbes, 37, first got sick in mid-March after a trip to see family in Egypt, and has been dealing with relapses ever since.

“My hair’s been falling out for three months,” said the Oakville resident, adding it’s starting to slow down now but she feels like it’s noticeable along the front of her hairline. The hair that’s growing back seems to be a different texture. She even ended up chopping several inches, just to give it a bit more volume.

“It’s just so shocking when you’re pulling handfuls of hair out. On top of everything else, now my hair is messed up,” she said. She’s found some solace in a Facebook group called COVID Long Haulers Support Group Canada, and wants people to know that hair loss, like her other symptoms, is just one more way COVID is showing it’s so much more than a bad cold or flu.

“It affects every single thing in the body and everyone’s just focused on it being some kind of respiratory illness when it’s not,” she said.

Lenore Alexander was “down and out for six weeks” with COVID around the same time. The 61-year old is still struggling with fatigue, and a few weeks ago started noticing hair loss.

“My hair has always been thick like a horse’s tail,” she said. Now every time she washes it “it looks like I’m holding a mouse.”

Lisa Pope, 47, survived both breast cancer and COVID. But was stunned to see her hair starting to fall out recently after beginning radiation.

Her doctor told her it’s chemo not radiation that usually causes hair loss, and at her three-month COVID-19 followup at Sunnybrook hospital she was told that’s probably what’s to blame.

“One day I was taking a shower and rinsing my hair and all of a sudden just chunks of hair were coming out,” she said.

“It was actually really scary. I literally was in tears because all these hair clumps kept coming out of my head.”

She also ended up chopping several inches off her hair to make it less obvious, and is otherwise fine aside from still not having her senses of smell and taste back completely.

“It was just really traumatic for me,” said Pope, who lives in Oakville.

“It’s literally so thin now. Hair is something, it’s who you are.”

Her physician, Dr. Julia Carroll, a dermatologist at Compass Dermatology who also teaches at the University of Toronto, said it seems like she’s hearing more about hair loss in COVID patients compared to other viral respiratory illnesses.

“That goes along with other things that we’ve seen, where this is not behaving obviously like a typical viral respiratory illness. It does affect more internal organs. It affects blood vessels. We saw a lot of COVID toes at the beginning,” she said. It just goes to show that the disease is “more serious and more of an assault to the body than a regular flu.”

The good news is the hair loss should be temporary for most people and resolve itself, Carroll said. But it could take a year or two before hair is completely back to normal. She advises being gentle with it, not chemically treating, perming or dyeing. Eating a healthy diet, and seeing a doctor or dermatologist to check for other underlying issues can also help.

For long haulers, it might take longer to resolve, said B.C.’s Donovan.

“If the body is experiencing some sort of ongoing symptoms, the possibility is there that the resolution of the telogen effluvium could be a lot slower,” he said. These patients might want to make sure that COVID medications aren’t responsible, and may consider treating with topical medication or lasers, if there’s no improvement within a few months.

Colton said her hair loss does seem to be slowing, after several weeks, but her hair is now noticeably thinner. She’s also still struggling with other symptoms like nerve pain, and shortness of breath, and is still not back to work.

She’s lost a few friends who just don’t believe she’s been so sick for so long. But she wants to warn Millennials and Gen Zers who feel a false sense of security just because there’s a low chance of dying of the disease. Maybe they will pay more attention to something like hair loss, which is easier to imagine than death or serious illness when you’re young and feel invincible.

“You don’t really know what it’s like unless you’ve been through it,” Colton said. “Younger people are still having issues long-term afterwards.”

Colton was very healthy before, aside from having asthma as a child, and only called in sick twice in the nine years she was at her job before COVID.

“Before I got sick I wasn’t too sure if it was anything worse than a flu and I thought my immune system was strong enough to fight it,” she said. “Clearly it can take anyone down.”

May Warren is a Toronto-based breaking news reporter for the Star. Follow her on Twitter: @maywarren11