Hair Loss After Weight Loss Surgery

Hair loss is one of the most common side effects patients experience after bariatric surgery and is usually experienced between 3-6 months following surgery. One study that looked at post-laparoscopic sleeve gastrectomy patients found that 56% of patients experienced hair loss, 46% female and 10% male.¹ There are two stages of hair loss after surgery; one is fairly common, while the other may require assessment for nutritional deficiencies.

Hair Shedding

This most commonly happens in the early post-operative stage. You may notice hair shedding more when you brush your hair, when you shower, or even when simply running your fingers through your hair. This is normal and is caused by telogen effluvium, a disruption in the normal hair cycle triggered by stress and hormone changes your body experiences from rapid weight loss.² Hair shedding is less commonly associated with protein malnutrition or vitamin/mineral deficiencies, although one study found that patients with higher zinc and iron intake experienced lower hair loss at 6 months post-surgery. ³ 

Alopecia

If hair loss continues more than 1 year after bariatric surgery or starts more than 6 months after surgery, it is more likely to be associated with nutrition deficiencies. Common nutritional deficiencies linked to hair loss include zinc, iron, selenium, biotin, essential fatty acids, and protein.⁴ If you are a patient experiencing this, it’s recommended to consult with your bariatric team to establish a plan to correct any deficiencies you may have. 

What can you do?

The good news is that hair loss is normal, common, and usually resolves on its own in the early post-operative stages. As your body changes and adjusts to the weight loss, hair loss will stop and hair will regrow (as long as there are no nutrient deficiencies). If this is an area of concern for you, here are a few tips to help stay on track:

• Make sure you’re getting adequate protein.
• Stay consistent with your vitamin and mineral supplementation.
• Have your nutrition-related laboratory values checked as prescribed by your bariatric team.
• Regularly consult with your bariatric team. They will help determine your individual protein and vitamin/mineral supplementation goals.
• Consult with your primary care doctor to assess for any underlying diseases that might trigger hair loss, such as liver disease or hypothyroidism. 

References:

1. Katsogridaki, Georgia, et al. “Hair Loss After Laparoscopic Sleeve Gastrectomy.” Obesity Surgery, vol. 28, no. 12, 2018, pp. 3929–3934., doi:10.1007/s11695-018-3433-3.
2. Halawi, Ali, et al. “Bariatric Surgery and Its Effects on the Skin and Skin Diseases.” Obesity Surgery, vol. 23, no. 3, 2013, pp. 408–413., doi:10.1007/s11695-012-0859-x.
3. Rojas P, Gosch M, Basfi-fer K, et al. “Alopecia in women with severe and morbid obesity who undergo bariatric surgery.” Nutr Hosp. 2011;26:856. DOI: 10.1590/S0212-16112011000400028
4. Cummings, Sue, and Kellene A. Isom. Academy of Nutrition and Dietetics Pocket Guide to Bariatric Surgery. Academy of Nutrition and Dietetics, 2015.

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