HAIR LOSS AFTER BARIATRIC SURGERY
Bariatric surgeries are performed on individuals suffering from severe obesity to induce long lasting weight loss. These are life saving surgeries with several health benefits. Benefits of surgeries significantly outweigh the risks.
Hair loss (Alopecia) is one of the common problems noticed during weight loss period after bariatric surgeries in more than 1/3 of the individuals. It is generally a temporary problem noticed in the first one year after surgery.
Any type of weight loss can lead to temporary hair loss during weight loss period. Since weight loss is significant after bariatric surgeries, hair loss is more prominent. However hair loss stops once weight is stabilised.
Hair is one of the skin appendages. It grows out of the hair follicle (hair bulb) located in the dermis. Hair is mainly made up of keratin, an insoluble fibrous protein, rich in disulfide bonds.
Growth cycle of hair follicles has 3 phases –
1. Anagen phase – Active hair growth phase (~ 5 years on scalp).
2. Catagen phase – Conversion from active growth to resting phase (~ 2 weeks on scalp).
3. Telogen phase – Resting phase at the end of which the club hair is shed off (~ 3 months on scalp).
On an average ~ 100 hairs may shed from the scalp on a daily basis in healthy individuals.
Hair loss varies from person to person. People having preexisting hair loss tendency will notice more hair loss.
Protein deficiency leads to hair loss.
Since keratin is a protein rich in disulfide bonds, deficiency of sulfur-containing amino acids such as cysteine and methionine leads to the formation of brittle and fragile hairs and subsequent shedding.
Nutritional deficiencies (Vitamins such as Biotin and minerals such as Zinc, Iron) shorten the anagen phase leading to a large number of hairs entering telogen phase simultaneously. This leads to thinning of the hairs and subsequent shedding.
Water soluble B complex vitamins (Including Biotin – Known as vitamin H or vitamin B7) act as co-enzymes in many metabolic reactions and help in maintenance of healthy hair and skin.
Zinc has a role in protein and nucleic acid synthesis in hair follicles and other body cells. Low ferritin (Iron reserves in the body) is also associated with significant hair loss.
Stress, poor intake also influence hair loss. Hair loss is more after operations where part of the intestine is bypassed (such as gastric bypass, sleeve + bypass combination surgeries).
PREVENTION OF HAIR LOSS –
1. Take adequate protein.
2. Take bariatric vitamin and mineral supplements to prevent deficiencies.
3. Hydrate yourself well.
4. Reduce stress – Prepare mentally for temporary hair loss. Lack of preparation increases stress which in turn aggravates hair loss.
If you notice hair loss even after weight is stabilised, then you need to consult a dermatologist to rule out unrelated conditions and for further treatment.
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Dr. AMAR VENNAPUSA
Chief Consultant Bariatric & Metabolic Surgeon
Dr. Amar Bariatric & Metabolic Center,