Repost from a long time ago
One of the most common questions people ask about weight loss surgery is whether or not they will lose their hair. The answer is difficult to provide because, as usual, it depends upon many factors including genetics and gender. I’ve paid close attention to my own hair following my various surgeries as well as responses from others after their surgeries and here’s the best response I can give, along with some recommendations.
First and foremost, yes, you can expect to lose some hair after your surgery. “Some” is the operative word here. Will you go bald? Have bald patches? Most likely not. I don’t recall seeing anybody ever report going from Lady Godiva to Telly Sevalas after WLS.
Here’s my experience: Prior to WLS, my hair was fine but I had a lot of volume. It was wavy bordering on curly and I kept the length somewhere around my shoulders. A couple of months after my WLS, I noticed the handfuls of hair to be heavier than what I considered to be normal. This continued for a few months. When it tapered off, I found that the hair that grew in was darker than my natural auburn and there was far less volume as well as curl. I did not use any sort of special products. I’ve always gone to higher end salons for my cuts because I’ve learned the hard way what happens when you do not go to someone who knows what they are doing with difficult hair like mine. I had it cut shorter (not short) and kept it in layers to try to retain the curl. The handfuls of hair that came out lessened dramatically.
After my breast reduction, I went through a very similar cycle a couple of months later. Again, I did not use anything special. Again, especially in the shower, I was getting large handfuls of hair. Once again, the regrowth was not nearly as full and the curl was lessened dramatically.
About a month prior to my tummy tuck, on the recommendations of the salon in New York that did my hair for Maury as well as my own stylist, I doubled up on vitamin B Complex supplements and began using Nioxin products. A couple of months later, I had far less hair loss than I had after the first two surgeries. I continued to use Nioxin and taking the extra B for several months and found that in addition to the lessened hair loss, the regrowth was stronger. However, while the volume returned, the color and texture remained the new kind. I also noticed fair more grey coming in.
This year, I was plagued by a variety of problems one right after another, beginning in February. An early onset miscarriage (no comments please, this revelation is for informational purposes only) jump started a massive depletion of iron and I was diagnosed as iron deficiency anemia. I was put on liquid iron which I took for a few weeks but the side effects were causing far too much pain for me to handle. A few weeks later, I had my thighplasty while my iron levels were still very low. Due to the anemia, however, I’d already stepped all of my other supplements but was still suffering from the problems that anemia can cause, one of them being hair loss.
In an attempt to speed up the recovery from my surgery, I doubled, almost tripled, my protein intake. The result of this, as I’ve written, was a short bout with kidney failure. However, one thing all of that protein appears to have helped was the hair loss trauma. I’d forgotten to start back on Nioxin but noticed that I did not have the same level of hair loss that I’d gone through in my prior surgeries. Then again, I was also wearing my hair shorter and in a sleeker style, giving up on my curls for the time being. This was on the suggestion of my stylist who said that by deliberately shearing down the volume and wearing it sleeker, I was giving my hair the ability to grow in with less trauma. Since I was still anemic, it made sense and seems to have worked.
Then of course was that emergency surgery not long ago. Not nearly as serious but of course yet another body trauma. According the the calendar, I should be pulling out handfuls of hair by now due to the surgeries. I’m not. I’ve also begun growing my hair out longer, keeping it cut and maintained (well, trying) in longer layers. However, the curl seems to be coming back. The color seems to be returning with more depth of red as well.
So, based upon my own experiences, I can surmise that there are some things that will lessen your hair loss following surgery. Two things, to be exact: Extra vitamin B complex and Nioxin. It’s not going to keep hair from falling out completely and I will explain why. But it does seem to help with the amount of hair you lose as well as stimulate your scalp for better and stronger regrowth. While I didn’t deliberately increase my vitamin intake this last time around, I was already overloading supplements due to the anemia and immediately after my thighplasty, I was protein overloading. Now my fault there was that while I had increased my protein intake, I didn’t increase my fluids which is what led to the kidney failure due to dehydration.
How are these all related? Your hair has three stages of growth, catagen, telogen, and anagen.
Catagen phase is a (club) transitional/death stage and 3% of all hairs are in this phase at any time. This phase lasts for about 2-3 weeks.
Telogen is the resting phase and accounts for 10-15% of all hairs. This phase lasts for about 100 days for hairs on the scalp (3 months). If you were to pull a Telogen hair out at the root, you would discover a hair and dry white bulb. At any given time, about 10% of your hair is in the Telogen phase.
Anagen is the active (growth) phase of the hair. The cells in the root of the hair are dividing rapidly. A new hair is formed and pushes the club (Catagen) hair up the follicle and eventually out. During this phase the hair grows about 1 cm every 28 days. At any given time, about 90% of your hair is in the Anagen phase. The longer your hair is in the Anagen stage, the longer your hair grows. If you have discovered that when trying to grow your hair longer but it always seems to “stop” at a certain length, you’ve found the life cycle of your Anagen stage. This is basically your biology and cannot be changed, not really.
Major shocks to the body (surgery of any type, delivery of a baby, rapid weight loss, emotional upset) can cause those perfectly happy, growing anagen hairs to switch prematurely into a telogen cycle. There isn’t a thing you can do once it gets to this stage, not more protein, vitamins, special shampoo, etc. Those hairs that have gotten “confused” and have gone into the telogen phase are destined to come out.
The reason that we see the hair start to fall out at the three month mark is because that’s the length of the average telogen phase. When these hairs come out, you can see the aforementioned bulb. If there is no bulb, that means the hair was in Anagen when it came off. In other words, it broke off inside the follicle, which is more damaging. This is frequently called Telogen Effluvium.
Periods of growth (anagen) between two and eight years are followed by a brief period, two to four weeks, in which the follicle is almost totally degraded (catagen). The resting phase (telogen) then begins and lasts two to four months. Shedding of the hair occurs only after the next growth cycle (anagen) begins and a new hair shaft begins to emerge.
OK, so there’s the biology behind it. There are a billion other factors that contribute to the quality and quantity of your hair. One thing I think is noteworthy that I discovered while researching this post is that your level of testosterone also impacts your hair. The more testosterone you have, the “stronger” your hair is likely to be. What does that mean? Well, it at least in part explains why men seem to have less hair loss than women (in addition to usually having shorter hair to begin with). But here’s another connection, my own hypothesis but certainly applicable to me:
Many MO and SMO women have PCOS and/or Type 2 diabetes, whether it’s diagnosed or not. One of the indicators of PCOS as well as Type 2 (in women) is an overproduction of testosterone. Have you ever noticed that so many MO and SMO women have full, thick, and gorgeous heads of hair? Well, the Duodenal Switch is known to “cure” Type 2 diabetes and while PCOS can never technically be “cured”, the issues associated with it such as testosterone levels, are usually dropped down to the normal & acceptable range. So it makes sense that as your rapid weight loss continues especially in those first few months, you’re going through dramatic hormonal changes which also effects your hair. Now, the reduced testosterone is a permanent thing and is probably the reason so many experience changes in color, texture, etc.
In short summation: You’re going to lose some hair after surgery. It happens to just about everyone and there isn’t much you can do. However, you can lessen some of the effects and many are not expensive. There are proactive and reactive steps you can take. This is from a variety of sources:
- Be nice to the hair you have. This means don’t use elastic ties to pull it back tightly or use tight rollers. Don’t brush your hair when it’s wet. You’re pulling out hairs by doing these things, weakening the follicles and shafts.
- Avoid chemical hair trauma. A month before and for a few months after, avoid harsh chemicals. The very worst thing you can do to your hair in this time frame is to get a permanent. Between the chemicals and the rollers, you’re begging for trouble. Don’t bleach it. If you need color, go for natural pigments without ammonia or peroxide. If you need a lift, speak to your stylist about a gloss sealant which will plump up your follicles, give it sheen, and protect it.
- Keep your hair maintained with regular cuts. This will lessen the amount of hair that comes out in your hands and brushes. Think of it like lawn maintenance. When you regularly mow your lawn, you’re removing the dead grass and scrub so that new grass can grow. Same goes for the grass on your melon. You’re not helping anything by letting it grow wild at this point. If you’re losing volume, consider a new style and go for layers, either long or short. This is where paying the extra money for a good stylist goes a long way. When you go to an established stylist, they have the training and experience in dealing with this sort of thing. In short, you get what you pay for. Hold nothing back from your stylist either - let him or her know that you’ve had surgery, what your nutrition is like, if you have vitamin deficiencies, and listen to recommendations. You don’t have to buzz cut your head but going shorter now will bring it back to life. Also, the longer your hair is, the more weight is on your follicles and tends to pull them out easier.
- Consider using a product like Nioxin. Nioxin is not a regrowth chemical. In fact, it’s almost completely natural. It won’t make your hair grow. What it does is clarify your scalp and feed it nutrients to stimulate healthier hair.
- Before considering something like Rogaine, talk to your doctor or stylist. Unless you’re getting bald patches, the chemicals in something like this could make the situation worse.
- Increase your Vitamin B Complex before and after your surgery. B is what gives you strong hair and nails. You’re not going to overdose on it unless of course you literally overdose.
- Make sure you’re getting enough protein.
You can expect the shedding phase to peak at three to four months post op and return to normal, or your “new normal” at around six months.
Here is more information on Nioxin. Personally, I’m a believer.
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