“I am seeing tons of hair loss,” Mona Gohara says.
Patients come to Gohara, a dermatologist and professor at the Yale School of Medicine, for all kinds of reasons from skin cancer screenings to cosmetic procedures. But this year more than ever, they’re worried about their hair.
It’s not a coincidence. Stress — like, say, that brought on by living through a deadly pandemic — is known to cause hair loss. Ordinarily, “90 percent of the hairs on our head are in the growing cycle; 10 percent are in the shedding cycle,” Gohara explained. “But when we’re subject to some type of physiologic or emotional stress, that cycle shifts to where the shed outweighs the grow.” The result: “people notice a massive, massive shed.”
And those stray hairs are part of a bigger trend. At this point, millions of Americans have spent nine months living through a public health nightmare and an unprecedented economic crisis at the same time. They have also had to cope with all this while avoiding gatherings, limiting physical contact, and, when possible, staying inside their homes. Put together, the isolation and anxiety of life in 2020 have brought with them numerous side effects. For one, they might be doing weird things to our bodies.
If you’ve noticed your menstrual cycle is more irregular this year, for example, you’re not alone: More patients are reporting irregular periods since the pandemic began, Mary Jane Minkin, an OB-GYN who teaches at the Yale School of Medicine, told Vox. The likely culprit, as with hair loss, is the anxiety of living in such a difficult and uncertain time. “When stressors come into play,” Minkin said, “we end up with screwy periods.”
If you’ve spotted more gray hairs on Zoom calls, there may be a pandemic-related explanation for that too. And according to some, life in lockdown may even be changing people’s body odor.
Those are just some of the smaller effects. Some experts are also concerned because isolation has documented effects on health, increasing the risk of cardiovascular disease and even death. “Humans are considered a social species,” Julianne Holt-Lunstad, a professor of psychology and neuroscience at Brigham Young University who studies the impact of social relationships on health, told Vox. “When we lack proximity to others, and particularly trusted others, this creates a heightened state of alert or stress” — which, over time, can have harmful effects on our bodies.
To be clear, none of this is an argument for getting rid of pandemic-related restrictions — after all, the effects of Covid-19 on the body can be far more severe than the effects of isolation.
But the rise of pandemic periods, weird smells, and other bodily indignities are a reminder that Americans are going through something right now that most of us have never experienced before. And that takes its toll in a lot of ways — some of them stranger than others.
2020 is messing with people’s periods
Let’s talk about periods first. Trend pieces about menstrual changes — either irregularity or worsened symptoms like cramps — began popping up in the spring. “A couple of weeks into the stay-at-home order in Washington State, where I live, I woke up in the middle of the night with the worst cramps I’ve ever had,” Colleen Stinchcombe wrote at Self in May.
And while it’s likely too soon for any published research on the impact of the pandemic on menstruation, Minkin isn’t the only one to see increased reports of irregularity among her patients. “It’s common for us to see patients with changes in their menstrual cycle, but anecdotally, it seems like it’s been happening more over the last six months,” Beth Schwartz, an OB-GYN at Thomas Jefferson University Hospital in Philadelphia, told the Washington Post in August.
These changes aren’t necessarily surprising, Minkin told Vox. “Most people think that the ovaries and the uterus regulate periods,” she said. But actually, “the boss is sitting in our brain.”
Specifically, it’s the hypothalamus and the pituitary gland that control the ovaries, regulating their hormone production, which in turn regulates the menstrual cycle. “It’s our nice, regular hormonal activity from the hypothalamus and the pituitary which stimulate the ovaries to do their thing appropriately and get us nice, regular periods,” Minkin said.
And when we’re under stress, that can disrupt the functioning of the hypothalamus and pituitary, leading to irregularity. Researchers have noticed a similar effect among young people who go away to college — and often experience irregular periods as they adjust to a new environment and a new set of worries and pressures.
The good news, Minkin said, is having an irregular period generally isn’t dangerous. When her patients report irregularity, she’ll typically test their thyroid function and levels of certain hormones to rule out conditions like polycystic ovary syndrome, but as long as everything’s normal, no treatment is needed. If the irregularity is especially bothersome, people can take hormonal contraception to regulate their periods, Minkin said. “Once we get through things and people’s lives get back toward normal, most folks are probably going to regulate themselves just fine.”
The pandemic could also be changing people’s body odor
But irregular periods aren’t the only strange symptom people are reporting after months of reduced contact with others. Another is body odor — some say they’ve started to smell worse, or just different, since the pandemic began.
“I am a man who prides himself on smelling fresh and fancy free at all times,” Joseph Lamour wrote at Mic in July. But during the pandemic summer, he became “so limburger-esque that my own odor woke me up in the middle of the night.”
As with periods, there’s not yet published research on changes in body odor during the pandemic. But anecdotal reports of the issue have gotten back to Julie Horvath, head of the Genomics and Microbiology Research Lab at the North Carolina Museum of Natural Sciences and a professor at North Carolina Central University. An expert in primate genetics who expanded into studying microbes and odor (“I never thought I would be the armpit researcher,” she says), Horvath explains that a big factor in the way we smell is our skin microbiome, or the mix of bacteria, fungi, and viruses that live on our skin.
“When you’re in your home, you’re now coming into contact more with maybe your pets and your family, who you didn’t see as many hours a day,” she told Vox. This means we’re exchanging microbes with a different group of people (and animals) than usual, which could affect our smell. Spending more time indoors can also affect the microbiome, as can wearing different types of clothes — synthetic fabrics can host different kinds of microbes than cotton, for example. And a lot of people have changed their style (if you can call it that anymore) during the pandemic. “When I talk to people, maybe they’re wearing a nice shirt, but now they have jeans or sweatpants on,” Horvath said.
Stress can also affect the microbiome, Horvath said. A specific set of glands, the apocrine glands, release sweat when you’re nervous. That sweat contains different compounds from sweat that comes from the ecrine glands, which get to work when you’re too hot. And if your apocrine glands — found in the armpit and a few other places on the body — are highly active, then they are providing a “different food source to some of those microbes there, and maybe you’re promoting the growth of some that smell different than what they would’ve before,” Horvath said.
But the microbiome doesn’t just affect the way we smell. Beneficial bacteria on our skin create a “protective barrier,” Horvath explained. “If you have these good, beneficial microorganisms that are on your skin, eating oil or sweat and living there happily, they’re taking up residence,” she said. Then, if something lands on your skin that can make you sick — a staph bacterium, for example — “then it can’t take hold very quickly, because your beneficial organisms are going to outcompete it for resources.”
Washing your hands with soap and water just washes away the lop layer of microbes, potentially allowing some of the good ones to stick around. But hand sanitizer kills the microorganisms on your skin, the good along with the bad, Horvath said. Thus, using too much hand sanitizer during the pandemic could leave us more vulnerable to staph, acne, or other infections down the road.
Airborne spread of the coronavirus in close contact is the main danger in the pandemic, but we still need to wash our hands, too. Horvath recommends using soap and water when possible to help maintain a healthy microbiome. Beyond that, habits like eating a healthy diet could be good for your microbial balance, though they may or may not help you smell better. Spending time outside if you can is also a good idea, Horvath said. “Certain organisms that are outside in the soil are actually beneficial for your overall body.”
Stress is affecting our hair and skin
Beyond weird smells and irregular periods, the isolation of this year has brought with it other physical changes for many. In addition to hair loss, a proliferation of gray hair is a common complaint — one that can also likely be pinned on stress, as Deanna Pai reports at Medium. While the mechanism by which stress causes graying isn’t fully understood, one recent study in mice found that stress led to the death of stem cells that produce melanocytes, the cells in hair follicles that produce pigment.
Gray hair isn’t reversible (except with dye), Pai points out, but managing stress — as much as anyone can during a pandemic — can help slow the process.
Stress could also be making our skin look worse, Gohara, the dermatologist, said. It causes an increase in the hormone cortisol, which “wreaks cosmetic havoc on your skin” and can lead to anything from dryness to puffy eyes, she explained. “Everything just looks worse with a surge in cortisol.”
An increase in stress can also lead to more acne, something also exacerbated by the friction of wearing a mask (hence the 2020 neologism “maskne,” or breakouts on the lower part of the face linked to mask-wearing). Luckily, unlike gray hair, much of this is reversible — you can combat maskne by washing masks in the same gentle cleanser you use for your face, Gohara said, and using a product with salicylic acid or benzoyl peroxide. For hair loss, meanwhile, she sometimes prescribes supplements, but also reassures patients that when it comes to shedding, “eventually the cycle is going to re-equilibrate itself and your hair will be back on track.”
Loneliness could cause more severe physical effects
While things like hair loss are typically harmless, if annoying, the way we live in 2020 could be causing more serious issues too.
Researchers have long known that isolation — the condition of having little or no contact with other people — and loneliness — the subjective feeling of being alone, regardless of how much contact with people one has — can be harmful, Holt-Lunstad, the psychologist, said. For example, in one 2015 analysis, she and her coauthors found that isolation was associated with a 29 percent increased likelihood of mortality, while loneliness was associated with a 26 percent increase.
There are a couple of ways that loneliness can potentially hurt our health. For one, friends and loved ones can influence us to take better care of ourselves — “having someone who encourages you to get to bed,” or eat fruits and vegetables, or quit smoking, is good for our health, Holt-Lunstad said.
But many studies actually control for lifestyle factors like smoking and diet, and still find that loneliness and isolation have a negative effect. One reason, some researchers believe, is that “our brains have adapted to expect proximity to others, and particularly trusted others,” Holt-Lunstad said. When they aren’t around, the brain signals other parts of the body to go into a heightened state of alert. That can lead to changes in heart rate and blood pressure that could increase our risk of cardiovascular disease. But it could also lead to systemic inflammation in the body, which in turn has been linked to a host of mental and physical problems, Holt-Lunstad said, from Alzheimer’s disease to, troublingly, increased susceptibility to viruses.
These impacts are especially concerning because some early research has found high rates of loneliness and isolation during the pandemic. In an August survey, for example, two-thirds of adults reported social isolation, and more than 7 in 10 said the pandemic had made it harder to connect with friends.
Luckily, there are ways to reduce isolation, even during a time of social distancing. In a study this summer sponsored by the neighborhood-focused social network Nextdoor, Holt-Lunstad and her colleagues found that performing small acts of kindness for neighbors, such as bringing them groceries or checking in on them over the phone, was associated with a significant drop in loneliness — 1 in 10 participants felt lonely at the beginning of the study, while just 1 in 20 felt the same at the end.
But it can’t all be on individuals to fix their isolation during this very lonely time. Instead, Holt-Lunstad has advocated for policymakers to pay more attention to people’s social needs throughout the pandemic and recovery, including increased funding to help students and older people, who may be especially vulnerable to loneliness right now. And while funding for anything remains a fraught subject in Congress, Holt-Lunstad writes at Health Affairs that decisions “should be based on scientific evidence of benefits and drawbacks to our well-being, not solely on economic costs and convenience.”
Some of the smaller effects of pandemic living may dissipate naturally when this time in our lives is over. When it comes to issues like irregular periods, for example, the biggest takeaway is “don’t panic,” Minkin says. “We will get back to normal.”
But for other, larger problems, like isolation and its serious effects on the body, the pandemic could be a wake-up call. “My hope is now that we have all experienced, in some degree or another, this feeling of isolation and loneliness, that there may be greater awareness and less stigma,” Holt-Lunstad said.