On average, humans shed 50 to 100 hairs every day. However, after bariatric surgery, it’s very common for patients to experience significant hair loss. This hair thinning eventually goes back to normal, but it’s important to know the reasons why that happened and what we can do about it.
Why we lose hair after weight loss surgery
Hair loss is a common side effect of bariatric surgery, and there are several reasons why this happens. In a way, it’s the body’s response to the rapid weight loss, lack of nutrients and general stress of the procedure. Luckily, this type of hair loss usually resolves within 6 months.
Although rapid hair loss is common across all types of bariatric surgeries, the likelihood of it depends on how much the surgery alters the stomach or intestines, as it often involves significant changes to the digestive system.
Next, we’ll look at some of the most common reasons why weight loss surgery causes hair loss.
Telogen Effluvium
Human hair follicles have two different states: They all start in the anagen phase (growth) and, eventually, they transition to the telogen phase (dormant), which lasts 100–120 days, after which the hair falls out. Under normal circumstances, 90% of our hair is in the anagen phase and 10% in the telogen phase.
However, when we struggle with telogen effluvium, a common type of hair loss, our hair follicles get triggered to enter their dormant phase prematurely. Those triggers can be undergoing surgery, physical trauma, exposure to certain toxins, pregnancy, etc. Once the hair enters the dormant phase, it takes from 3 to 4 months to fall out.
Luckily, you won’t become bald because of this, you’ll just experience more hair shedding, but this is just temporary. The hair follicles themselves are not damaged, so the hair should regrow after about six months.
Stress
Bariatric surgery can cause both physical and mental stress.
Physical stress on the body redirects nutrients towards vital organs like the heart and brain and away from cosmetic and less critical functions like hair growth.
When we talk about mental stress, we might refer to the lifestyle changes that come from the surgery. Adjusting to a new diet, managing weight loss or coping with body image changes can elevate cortisol levels, a hormone that has been linked to hair thinning and shedding.
Nutrient deficiencies
Once bariatric surgery is performed and the stomach or intestine’s size has been reduced, the patient might experience malabsorption. The procedure alters the digestive system, and it makes it harder for our body to digest nutrients. Not being able to digest or absorb nutrients leads to not meeting our nutrient requirements.
The nutrients that are commonly affected are the following:
- Protein: Keratin, the protein that makes up our hair, provides strength and structure. Without it, hair can become weak, and more prone to shedding. In a normal situation, with a good level of protein intake, our hair follicles are nourished during our hair growth phase, but if there’s a protein deficiency, the follicles can shift to the resting phase prematurely. Even with enough protein intake post surgery, the body might still have difficulty absorbing it effectively, which can contribute to hair loss.
- Iron: Iron plays a crucial role in carrying oxygen towards hair follicles. Without oxygen, hair follicles become weak, leading to hair shedding. In the same way that the digestive system has a harder time digesting protein post operation, iron’s absorption becomes more difficult too.
- Zinc: Zinc is essential for cell division and plays a role in keratin formation. That means that during the hair growth phase, zinc helps divide and generate new cells to build hair. Having a zinc deficiency is common after duodenal switch, gastric bypass, or adjustable gastric band.
Hormonal changes
Both bariatric surgery and stress itself can lead to hormonal shifts, which exacerbates hair thinning. These hormone shifts can disrupt the normal hair growth cycle, causing hair follicles to shift into the shedding phase. Some of the most common hormones that can shift after bariatric surgery are the following:
- Hormones related to hunger, such as ghrelin and leptin
- Hormones related to stress, like cortisol
- Hormones related to metabolism, like testosterone and estrogen
Similarly, patients with polycystic ovary syndrome could also struggle with hair loss. PCOS is an imbalance in sex hormones, and while for some women bariatric surgery can reduce its symptoms, some others still struggle with hormonal imbalances, and therefore experience hair thinning.
How to prevent hair loss after weight loss surgery
Because every case is different, it’s important to follow the nutritional plan provided by your doctor, as they will make sure that any nutrition deficiency is covered. It’s also important to be patient, hair loss after bariatric surgery is temporary, so your hair will go back to what it was in less than a year.
Nutrient-rich diet
A well-balanced bariatric diet full of nutrients, vitamins and minerals will help not only your hair growth, but your overall health. Aim for 60 to 80 grams of protein each day by including a protein in each meal and snack. Try to incorporate foods like seeds and nuts, fish, eggs, spinach, chicken and red meat into your diet.
Food supplements
Even if you have a well-balanced diet, your body post surgery might not let you eat as much as you would need. That is why doctors often suggest their patients to take food supplements.
Protein supplements or powders will help you reach your protein daily intake, while zinc and iron supplements along with vitamin C can make it easier for your body to absorb nutrients and prevent hair thinning.
Just remember, it’s essential that you consult your healthcare provider about nutritional supplements. You’ll need a thorough revision and some blood tests to know what nutrients you’re missing.
Manage stress
Experiencing stress after going through surgery and seeing your body change is normal. However, there are some techniques and habits that can alleviate the anxiety.
Start practicing relaxation techniques such as meditation and breathing exercises. Similarly, incorporating light physical activity in your daily routine will help you release endorphins, which are natural mood enhancers.
Another essential habit is to prioritize sleep. Aiming for 7 to 9 hours each night reduces stress and ensures that your body is well rested.
If needed, seek emotional support. Talk with a therapist, your loved ones, or join a bariatric surgery support group to find people who will understand the experience and challenges that you’re going through.
Hair Care
Due to the fragile state of your hair after surgery, it’s crucial to use gentle hair products and tools and avoid excessive brushing or tight hairstyles.
Using shampoos for hair loss with ingredients like biotin, coffee extract or peppermint oil as well as minoxidil (an FDA-approved product that stimulates hair follicles to enter their growth phase) are often recommended. However, these products usually take up to a year to show results, and since this type of hair loss is temporary, it may not be effective in the short term.
Still, you can talk with your hairdresser which products and haircuts will help you keep your hair strong or appear to have more volume.
Although hair loss caused by weight loss surgery is typically temporary, it’s important to pay attention to your nutritional needs and overall health during your recovery. If you’re looking for less aggressive bariatric methods, the Spatz3 gastric balloon is a non-surgical solution with higher success rates. By not altering your organs, you’ll be less likely to experience hair loss and other side effects that come with other, more invasive bariatric surgeries. Regardless of the method, hair loss post bariatric surgery will eventually recover with the right care and patience.
