Hair loss and weight loss surgery
18 / 09 / 13
Bariatric Surgery
Temporary hair loss and thinning is common after many weight-loss surgery procedures. Often this is mild but sometimes it can be more severe. The medical name for this kind of hair thinning is telogen effluvium and it can occur after any major stressful event such as childbirth, a crash diet or major surgery. With a combo of surgery and rapid weight loss, patients who’ve undergone WLS are obviously at particular risk of this problem.
There are several reasons why people lose hair after surgery. Early hair loss (in the first 3 months after surgery) is attributed to the stress of the operation interrupting the normal growth of scalp hair. It works is like this:
At any given time about 90% of your hair is in a ‘growing phase’ and the remaining 10% is in a ‘resting (telogen) phase’. After the hair rests for 2-3 months, it falls out. After a short break, a new hair grows to replace it. This whole cycle takes about 3 years for each hair. Telogen effluvium tends to affect the older hairs that are brought to the end of their life prematurely, which is thought to explain why patients who’ve undergone major surgery start to ‘moult’ a few months later. A normal pattern and thickness of scalp hair usually returns within a few months once the new hairs re-grow and become established.
However, excess hair shedding lasting maybe 9 -12 months can be an issue for WLS patients who’ve undergone operations such as gastric bypass or duodenal switch (DS). It’s important not to forget that any kind of rapid weight-loss will produce hair loss (it doesn’t only happen with surgery) and likewise lack of nutrients (particularly iron and zinc) can compound the effect too. Your doctor can do a blood test to check for these and prescribe supplements. Your bariatric team may also recommend a daily dose of calcium citrate, an additional B vitamin complex tablet or maybe kelp (which is rich in iodine) … follow their guidelines to the letter.
So it goes without saying that the best way to minimise hair loss is to maximise nutrition, particularly your protein intake because after all that’s what your hair (and nails) are made of!
WLS patients after surgery need to aim for about 70g protein a day for good nutrition and to supplement their diet with a daily multi-vitamin. This is essential for all patients but especially important for DS patients whose ‘re-plumbing’ means their body cannot absorb all the nutrients it takes in as food. They need to be aiming for about 120g of protein a day to compensate for this and require a much more complex multivitamin regime under specialist supervision.
It’s not easy and can be tricky to get the high level of protein in your diet in the early days after WLS when appetite is low and toleration levels of food are small. Some people, who constantly underscore in achieving the recommended levels, opt to take a protein drink supplement. There are many available in a multitude of flavours, but if you’re considering one, then do check out its nutritional profile and choose one that is low in fat, sugar and calories. Don’t opt for the body-builder’s version!
Others boost their protein levels by adding dried skimmed milk or unflavoured protein powder to their food. Tasteless and virtually unnoticeable it can be stirred into soups, stews, smoothie-type drinks and most pureed foods for a welcome protein boost.
What is the best treatment for post-op hair thinning? To be honest, no treatment is available or required in most cases. Once the stressful event has passed, hair thickness will usually return to normal within a few months. If you are found to have zinc or iron deficiency, taking appropriate supplements speeds up resolution of the problem. Focusing on getting your nutrition right is the way forward to minimise hair loss and maximise hair regrowth after surgery. Gentle shampoos and some hair supplements may also help but there is no guaranteed over the counter solution.
The good news is that most hair thinning does grow back to normal after about 1 year, once the period of very rapid weight loss is over .