Bariatric surgery has many benefits for improved health concerns. It can reshape one’s overall body from the inside out. From reducing or eliminating the use of medications to joint relief to reversing obesity-related diagnosis and conditions. Amongst all of the benefits that come along with bariatric surgery, there can be minor side effects from the surgery itself.
“Approximately 57.0% of patients experience hair loss after metabolic and bariatric surgery. [mfn]https://www.sochob.cl/web1/wp-content/uploads/2021/03/Hair-Loss-After-Metabolic-and-Bariatric-Surgery-a-Systematic-Review-and-Meta-analysis.pdf[/mfn]”
One minor side effect of bariatric surgery is temporary hair shedding. Typically this causes pause for potential patients, aesthetics or not, no one wants to go through the loss of hair, even if it is temporary. Hair can be important for self image and confidence. Furthermore, hair shedding or hair loss can cause distress psychologically, leaving patients feeling defeated.
The Hair Growth Cycle
The hair growth cycle has a three-stage cycle. Anagen is the growth phase which can be influenced by age, genetics, hormones and metabolic factors. Between 80-90% of hair will be in anagen at any given time.
At the end of the anagen phase hair enters a transition period called catagen. This phase contains cutting off the nutrient supply to the root. This is the shortest phase lasting 1-2 weeks and only 1% of the hairs are in this phase at any time.
Telegen, is the last of the phases known as the resting phase.The hair is inactive for 1-4 months until the anagen begins again. When the new hair growth begins it causes the hair to detach.
Most healthy human scalps have 100,000 hairs, and remain in the scalp for 1-6 years. Typically 100 of these hairs will shed daily. When normal shedding occurs continuous hair growth replaces what is lost.
Temporary hair shedding can affect all persons regardless of sex, age, ethnicity, and health. It can be a mild case to a severe case, everyone may have a different experience with it, or perhaps not at all.
Hair loss is different from temporary hair shedding. Meaning hair won’t be lost forever, it can and will grow back. The difference between hair shedding and hair loss is that hair shedding happens naturally to everyone and will grow back vs., hair loss can be due to a diagnosis or age-related and is typically lost for good.
Telogen effluvium is a condition in which more hairs than normal will enter in the telogen phase simultaneously. This results in overall hair thinning and shedding. It can be caused by a number of factors; mental or emotional stress, surgery, childbirth, rapid weight loss, medication use, hormonal changes, chronic illness, hypothyroidism and malnutrition.
The use of anaesthesia is also associated with telogen effluvium. It sends anagen hair follicles into premature telogen by blocking the rapid cell division required to sustain hair growth. Telogen can last for several months, and there is usually a delay between the trigger event and onset of hair shedding.
Why Hair Shedding?
Temporary hair thinning and shedding can be a side effect of weight loss surgery. It is a very common and normal reality of bariatric surgery.
Usually occurring at 3 months to 6 months post-op, and can last for up to 6-12 months post surgery. Contributing to hair shedding can be a calorie reduction. This directly correlates to the lack of macronutrients and deficiencies in vitamins and minerals patients may endure. Furthermore, surgery may cause stress and hormonal changes as well. Due to these factors, all patients have higher chances of shedding hair, especially in the rapid weight loss phases.
Once nutrition and weight stabilize, the body repairs itself. Therefore hair regrowth begins.
Can Hair Shedding Be Prevented?
Hair shedding can not be totally prevented, although there are steps that patients can take in order to reduce the severity of temporary hair shedding.
Hair shedding is caused by:
- Rapid Weight Loss
- Lack of Protein
- Lack of Vitamins/Minerals
To prevent hair shedding you should consume ample amount of protein and take vitamins/minerals[mfn]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096273/#!po=19.2308[/mfn].
Protein is comprised of amino acids; building blocks to form proteins. In order to benefit from essential amino acids; they must be consumed through food sources. A diet lacking in protein can negatively affect hair growth, leading to telogen effluvium. Hairs itself can also become reduced in elasticity, strength and volume.
If you are concerned about hair loss, try adding additional vitamins and minerals daily; like the ones listed below. Minerals like iron, zinc, biotin, and magnesium can affect hair. The multivitamin recommended for all patients post surgery should contain all minerals listed below, along with 100%of all B vitamins. Despite popular belief adding Biotin and Zinc can help the hair strengthen and thicken, although it cannot prevent hair shedding.
- Zinc is involved in multiple processes related to the hair cycle; cell division, protein synthesis and helps regulate the transition from telogen to anagen.
- Biotin, also known as vitamin B7, provides healthy support in skin, hair and nail growth.
- Iron deficiency can be related to low keratin production and has been linked to telogen effluvium.
Vitamins B6, B7, B12, Folic acid, and Protein are essential for hair health.
- Pyridoxine B6 sources; fish, beef, starchy vegetables like potatoes; non citrus fruits and spinach.
- Biotin B7 sources; eggs, fish, meats, seeds and nuts.
- Cobalamin B12 sources; lean meats like poultry and fish, eggs, and dairy products. (Greek yogurt or swiss cheese.)
- Folic Acid B9 sources ; dark leafy green vegetables, citrus fruits, nuts, seeds, peas, seafood, eggs, poultry and dairy products.
- Protein can be found in lean meats, eggs, tofu, beans, and plant-based options like nuts, nut butters, seeds, spinach, broccoli, asparagus, brussel sprouts, blackberries, nectarines, and bananas.
For future patients or those thinking about having bariatric surgery, do not let a temporary side effect fog your judgment when deciding to choose bariatric surgery as a viable, practical and sensible solution to health concerns and weight loss.
Temporary hair shedding can be a short lived reality and part of the bariatric process.
Bariatric surgery can offer many potential patients a number of favorable and valuable health benefits that far exceed temporary hair shedding. Remember to thoroughly follow post-op directions from your bariatric surgeon to ensure the minimum hair loss possible.