Hair Loss After Surgery – What to Look for?
Whether you’re heading into surgery or recovering from it, the last thing you should be worrying about is your hair falling out.
It seems hard to fathom. After everything you’ve been through, can surgery cause hair loss too?
As a general condition, hair loss is common. It’s usually caused by genetics and ageing but surgery can trigger it too.
It may be the anaesthesia or medication that leads to hair loss. Or rapid weight loss or nutritional deficiencies (from bariatric surgery, for example). Or it could be the result of having your head in one spot for hours on end (such as with head or neck surgery).
Whatever causes it, there’s a silver lining to hair loss after surgery.
It rarely leads to permanent balding.
In fact, most of the time the problem is temporary and will resolve on its own after a few months. If it doesn’t, high-quality treatments are available.
In this post, we’ll take a look at the causes and treatments of hair loss after surgery, including how hair loss medication can work to speed up recovery.
What Does Hair Loss After Surgery Look Like?
Hair loss after surgery isn’t the same as, say, hereditary hair loss. It has distinct symptoms that will let you know it’s not just related to age or genetics.
Post-surgery hair loss typically presents as general hair thinning across the scalp, rather than big bald patches.
Some people notice a progressive, diffuse thinning 1-4 weeks after surgery. Others experience more severe hair shedding, particularly around the crown, about 3 months after surgery.
In most cases, your hair loss may continue for 3-6 months but it usually returns to normal after that.
If your hair remains thin after about 9 months and shows no signs of improving, it may have turned into chronic telogen effluvium (see below) or androgenetic alopecia.
What Causes Hair Loss After Surgery?
Your hair works in a cycle of growth, resting, shedding, and regrowth. Most of your hair is in the hair growth phase, which usually lasts years.
At some point, the follicles that produce hair enter a resting phase and the hair stops growing. New hair grows underneath the old and eventually pushes the old hair out. We all shed 50-150 strands of hair every day in this way.
That’s if nothing disrupts the cycle.
But certain triggers can send your hair prematurely into the resting and shedding phase or prolong those phases.
Surgery may be one such trigger. Let’s look at some factors behind surgery that can cause hair loss.
Many doctors and patients connect post-operative hair loss to anaesthesia — particularly when it comes to longer surgeries.
But here’s how doctors think it might work:
Hair follicles contain some of the fastest but most sensitive cells in the body.
When anaesthesia relaxes your body, the cell division in your follicles slows down. The slower division might disrupt your hair growth cycle.
Such disruption might push follicles into a resting phase prematurely or change the way your hair grows. But the changes would be temporary and your hair growth cycle should return to normal in time.
It’s a valid theory. But it hasn’t been proven.
The best proof we have that anaesthesia may cause post-surgery hair loss is a 2012 study, which found that a specific type of anaesthesia (hypotensive anaesthesia), usually used in jaw realignment surgeries, may increase the risks of hair loss.
Anaesthesia is just one possible cause of surgery-related hair loss. But there are many other medications that may contribute to changes in your hair as you recover.
Hundreds of medications can affect hair growth, particularly if you’re allergic to them. Some of those medications are a necessary part of surgery or recovery.
These are just some of the post-surgical medications that may cause hair loss:
- ACE inhibitors
- Certain antibiotics
- Anticoagulants (blood thinners like warfarin)
- Certain antidepressants
- Anti-seizure medications
- Anti-thyroid medications
- Cholesterol-reducing drugs
- Oral contraceptive pills
Fortunately, your hair growth should return to normal once you’re off the medication but you can always talk with your doctor if you’re concerned about the possible hair loss risks.
Anxiety or Stress
There’s no doubt that surgery can be stressful. But the physical toll surgery can have on your body may produce an unexpected side effect — telogen effluvium.
Telogen effluvium is a type of hair loss triggered by extreme stress and is the most common reason behind hair loss after surgery.
Your body responds to stress by diverting nutrients from hair follicles to vital organs. Cortisol production also increases.
As a result, the hair follicles weaken and may stop producing new hair altogether.
Telogen effluvium becomes noticeable about 2-3 months after the stressful event has occurred — in this case, after a major surgery, childbirth, chronic illness, or severe infection.
It’s uncommon to see large bald spots with telogen effluvium — more likely it will appear as diffuse thinning across the scalp. It tends to last about 3 months before your hair cycle returns to normal and you start to see your hair regrow.
Hair growth isn’t your body’s main priority post-op. Instead, your body diverts nutrients away from your hair follicles to where it’s needed most to promote healing. This lack of nutrients might disrupt the hair growth cycle.
It’s also possible that your iron or ferritin levels became depleted from blood loss during surgery. If you don’t increase these levels post-op, the deficiency could make your hair more brittle or wispy. Or it could increase hair shedding (particularly around the temples).
A 2021 literature review also linked hair loss after bariatric surgery to lower levels of serum zinc, ferritin, and folic acid.
Thankfully it can be easy to correct nutritional deficiencies with supplements — but it’s important to confirm the deficiency through a blood test first.
Positional or Pressure Alopecia
Although rare, some patients may develop a particular type of hair loss when their head is kept in the same position for hours on end.
This type of hair loss (called positional or pressure alopecia) happens when the head has restricted movement. This creates prolonged pressure over one part of the scalp and limits the blood supply to the hair follicles there.
It typically only occurs in operations lasting more than 6 hours where the head remains in one position throughout the surgery.
Rapid Weight Loss (Caused by Bariatric Surgery)
As many as 57% of patients can experience hair loss after a weight loss surgery like bariatric surgery. Younger women are particularly affected.
The rapid weight loss puts stress on the body, which cuts the hair growth phase short, leading to greater shedding about 3 months after surgery.
It usually follows the same pattern as other types of hair loss after surgery: diffuse thinning across the scalp, occurring about 3 months after surgery and resolving on its own within a year.
Preventing Hair Loss after Surgery
Raise Hair Loss Concerns Before Surgery
While it’s tricky to prevent post-operative hair loss, you can discuss your concerns with your doctor before the surgery.
If you’re expected to have a long operation, you can discuss your concerns about positional alopecia with the medical team.
Your doctor may also be able to assess your risk factors for hair loss and create an action plan to minimise the fallout (no pun intended!).
Address Any Nutritional Deficiencies
There’s some evidence that micronutrients may play a role in hair loss, though there’s currently no clear link between nutritional deficiencies and surgery-related hair loss.
Even so, making sure you eat a balanced diet high in nutrients may help support hair follicles.
Protein and iron are known to promote healthy hair growth. There’s also some evidence to suggest these nutrients may have a role in improving hair growth:
- Antioxidants, including vitamins A, C, and E
- B vitamins
- Vitamin D
If you think you may have a nutrient deficiency, it’s best to consult your doctor and take a blood test before changing your diet or taking vitamin or hair growth supplements.
Hair Loss Treatments after Surgery
The best treatment for hair loss after surgery is patience. In most cases, your hair will start to regrow and return to pre-surgery thickness within six to nine months.
In rare instances, post-surgery hair loss can turn into chronic alopecia. But there’s still good news: there are still ways to reverse it.
Let’s take a look at some of the steps you can take.
Evidence suggests vitamin D and iron supplements may help improve the symptoms of telogen effluvium. It’s important to make sure you’re getting enough vitamin C if you have an iron deficiency.
Zinc, riboflavin, folic acid, vitamin E, biotin, and B12 supplements have also been recommended but there isn’t enough data to suggest they work.
Too much vitamin A (and possibly selenium) may lead to hair loss so these supplements are best avoided.
The most popular topical treatment doctors prescribe for hair loss is minoxidil, which may help stimulate hair follicles to start regrowing. This is usually a short-term treatment option applied to your scalp once or twice daily.
Another popular at-home treatment is hair thickening shampoo, though these treatments aren’t likely to be the miracle cure you were looking for.
Most hair-thickening shampoos only treat the scalp, without addressing the underlying cause of your hair loss.
That said, shampoos and hair tonics fortified with vitamins and zinc hold promise for improving telogen effluvium. Shampoos that contain salicylic acid, hydrocortisone 1%, or ketoconazole 1% may also be worth trying.
Just make sure you don’t overuse your shampoo and conditioner. You risk clogging your pores, which can lead to inflammation.
Cosmetic Hair Loss Procedures
Hair loss procedures are available in Australia that may help stimulate hair regrowth, although they have varying costs and effectiveness:
- Microneedling, which stimulates hair follicles with fine needles
- Laser therapy
- Platelet Rich Therapy (PRP), whereupon a doctor injects your own platelets into the scalp
- Corticosteroid injections
Hair Loss Medication
Hair loss medications like The Hairy Pill® are rigorously tested, refined, and the underlying technology has been clinically proven.
The Hairy Pill® provides access to an Australian hair regrowth treatment that contains active ingredients that stop hair loss in its tracks and stimulate regrowth.
Along with active ingredients, it contains a personalised mix of vitamins, essential elements, and amino acids to supercharge your recovery.
Talk to a Hair Loss Doctor Today with The Hairy Pill
Hair loss after surgery can feel discouraging but it’s important to remember that it’s almost always temporary.
The Hairy Pill® may help speed up recovery and restore your hair to its natural thickness faster. All it takes is 5 minutes to fill out our online form. Get started now.