“How can I prevent hair loss?” It’s a question we hear frequently from people preparing for bariatric surgery. Hair shedding is an unpleasant side effect that affects some people more than others after surgery. There are some things you can do to manage it but it’s not completely preventable for everyone.

Telogen Effluvium  (Stress-related Hair Shedding)

Most people who experience hair shedding will notice it in the first 3 to 6 months after surgery. It’s called telogen effluvium. It’s a form of temporary hair shedding that happens after stress or traumatic events. In this case, the stress is rapid weight loss.

The hair growth cycle has three phases:

  • Anagen (growing; lasts 3 to 5 years)
  • Catagen (transition; lasts 10 days)
  • Telogen (shedding; hair follicle is inactive for 3 months after hair sheds)

Normally, only 5 to 10% of your hair is in the telogen phase at any given time. However, in a state of stress, about 30% of your hair moves into the telogen phase so you will notice more shedding than normal. You might notice this when washing or brushing your hair or when you see hair in the drain or on your pillow.

The hair shedding you experience in the first 3 to 6 months after surgery will start resolving when your body feels less stressed by the weight loss. Your hair will get back into its normal cycle. You can prevent further damage to your hair by avoiding chemical or heat treatments during this time.

Nutrition-related Hair Shedding

Nutrition is also important for hair growth. We suspect that a nutrition deficiency is causing your hair shedding if it:

  • gets worse when you are more than 6 months out from surgery.
  • starts when you are more than 6 months out from surgery and isn’t connected to other major stressors in your life.
  • continues past 1 year after surgery.

Protein, zinc, iron, and biotin are the most important nutrients for hair growth. If you are taking a complete bariatric multivitamin, it will already contain the zinc, iron, and biotin in the recommended amounts:

  • Zinc 20 to 25 mg
  • Iron 18 to 45 mg (depends on type of surgery, menstruation status, history of anemia)
  • Biotin 300 to 600 mcg

Taking megadoses of biotin beyond your bariatric multivitamin will not prevent hair shedding. It can actually alter your thyroid lab values so we don’t recommend going overboard on biotin.

For protein, we recommend 60 to 75 grams protein daily for women and 75 to 90 grams daily for men after surgery. This comes from your food and beverage choices, including protein shakes. Using a food tracking app can help you determine whether you are meeting your protein needs consistently.

Other Causes of Hair Shedding and Loss

For most people who have hair shedding after bariatric surgery, it will be related to weight loss or nutrition. There are other causes of hair shedding, such as hormone changes related to pregnancy or menopause and other types of stress, such as divorce or unemployment.

Hair loss is different from hair shedding. With hair loss, the hair doesn’t grow back. Hair loss can be caused by genetic factors, medications, immune system overreaction, and harsh hair treatments. If you think you are having hair loss, you should talk with your doctor.

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