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Hair Loss After  Bariatric Surgery

I had a Sleeve and now I’m losing handfuls of hair!! What to do? First of all, a couple of points of reassurance.  Number one, temporary hair loss after bariatric surgery is a really common issue that affects about 40% of bariatric patients in our practice.  It usually begins at 3-4 months after bariatric surgery in San Antonio, then tapers off at 6-8 months out.  Second, the hair essentially always grows back to its normal thickness and texture.

Vitamins and Nutrition

In a moment we’ll talk about why the hair loss happens and how it grows back to normal, but it’s a good idea to start by checking that you’re taking the right vitamins and that you’re getting good nutrition to provide resources for hair growth.  For the vitamins, your bariatric team has given you handouts or an App, or you can check in with a phone call to confirm you’re on the right track.  In addition to the essential bariatric supplements (Multivitamins, Calcium) most programs recommend biotin to be taken daily and some programs have special amino acid formulations that may be useful.

In terms of basic nutrition, if you’re comfortably eating solid foods like seafood and chicken, and if you are keeping your food plan focused on protein, then you’re almost certainly getting enough nutrition for healthy hair re-growth.  If there is any remaining concern about nutrition status, your team can check blood work to be sure.

Why It Happens

Current medical understanding is that the hair loss comes from your body’s response to the stress of the surgery, followed by the recovery process.  In normal circumstances each hair follicle has natural cycles of growth phase alternating with rest phase, in growth phase about 90% of the time and rest phase about 10%.  The hair follicles are not normally synchronized, so that only a random 10% of follicles are in rest phase at one time.  The stress of the surgery seems to put most hair follicles into a prolonged all at the same time, and for many follicles the growth pause is long enough for the hair to become “disconnected.”  Then, when the body begins to recover and resume normal hair growth about 3 months after sleeve gastrectomy, all the resting follicles “wake up” and return to growth phase in synch all across the scalp.

The new hair growth pushes out the many disconnected hairs all at almost the same time.  This can result in really impressive and even scary hair loss; patients find their hair brush is full, hair is all over the shower, and hair covers their clothes.  The shedding process usually lasts for a few months, then it is basically always followed by new little hair ‘sprouts’ at the scalp level that are the beginning of a new healthy head of hair.

Can I Prevent It?

There are several steps you can take to help minimize hair loss after weight loss surgery.

  1. Adequate protein intake: Make sure you are eating around 60 grams of protein daily.  Examples include lean meat, dairy, eggs, seafood, beans and soy.  After surgery, you won’t be able to eat as much as before, so make sure that what you are eating is high in protein.
  2. Multivitamins: Your absorption of vitamins and minerals will be altered by weight loss surgery.  Bariatric multivitamins are essential after weight loss surgery because they are modified to be absorbed by weight loss surgery patients.  Starting them beforehand is a good way to make sure your body has all the vitamins and minerals it needs to best handle the stress of your upcoming procedure.
  3. Address Iron Deficiency: If you have a history of iron deficiency, make sure to eat foods high in iron, and take any prescribed iron recommended by your doctor.  If you aren’t sure, have your blood levels checked before surgery. Having normal iron levels can help minimize hair loss.
  4. Biotin: Although the research is limited, many patients find that taking biotin helps with hair loss after bariatric surgery.  Taking some beforehand may assist in preventing hair loss.

As far as we can tell, hair stimulants such as tonics or minoxidil don’t make much difference in how much hair a person sheds or in how quickly they recover.  On the other hand, they don’t seem to be harmful so if a product from your hairdresser gives you the feeling of taking some positive action then we will not object.

The good news is that the hair essentially always returns to normal, the bad news is that it needs to grow back from the very root so it can take a while.


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