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Hair Loss experiences?

Started by lizzy25, Sep 25, 2009 5:06 AM
24 replies to this topic
24 replies to this topic



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Posted September 25, 2009 - 5:06 AM

Hey guys!

I'm considering the VSG, and I'm very concerned about hair loss. I have very thin hair already, and if it gets any thinner I will need a wig. I've seen that many people report hair loss as a side-effect of VSG, but I'm wondering what your experiences are with it? How much hair did you lose? When did you start losing hair? Was the hair loss long-lasting, or has the hair grown back?

Thanks for your time!!


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Posted September 25, 2009 - 5:14 PM

Hair loss is a side-effect of all WLS, not just VSG.

Mine started very early, probably due to hormones, and then around 7-8 months out, it slowed way down and now, at 12 months out, it's a trickle and some days I don't lose any in the shower.

I have very thin hair and no one but me noticed my hair loss. Well, my hair dresser finally noticed at my last haircut, but no one else. Thank goodness!


    Believes in the Sleeve

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Posted September 25, 2009 - 7:23 PM

Hairloss can and does happen with all of the surgeries not just VSG. I just recently noticed that I ma losing more hair than I normally do. I'm almost months post op, and it's coming out pretty severely, but it'll grow back.


    Aspiring Evangelist

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Posted September 25, 2009 - 7:49 PM

I am 5 weeks out and have lost some hair. I actually lost more hair before surgery due to stressing myself out about surgery! Seriously.

At least for me right now you can't tell. Only I know because I can see a little more in the brush and in the shower drain.

Not to discount your fear......hair loss was/is the least of my worries. I so wanted to be healthy and skinny I could have gone bald for awhile and it would have been fine. I have seen very few posts on boards about severe hair loss.


    Senior Member

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Posted September 27, 2009 - 1:26 AM

I agree with Tiffy - hair loss is a side effect of all surgeries, generally it is a side effect of the anesthesia and I believe it can last up to 8 months post surgery. I don't think it is so severe that others notice it (other than our hair dressers).


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Posted September 27, 2009 - 4:06 AM

With band surgery, mine started out at 4 months and didn't quit until I was 1 yr. post op. I am hoping this time it will stop before that. Mine is coming out quite badly right now.


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Posted September 28, 2009 - 9:18 AM

I'd rather lose hair than no weight. I am 5 months out, a few weeks ago my hair started to thin, and it has stopped now. Its not even noticable.


    Senior Member

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Posted September 28, 2009 - 11:54 AM

Hair loss is from the anesthesia. It generally starts at around 3-4 months out, and starts growing back around 8 months out if you're getting the proper nutrition your body requires. It's a temporary problem.


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Posted March 28, 2010 - 2:00 AM

From the anesthesia? Then why doesn't every single person who has surgery have hair loss. I think it's more related to the body producing ketones. But hey I don't really know...but it's just hard for me to believe the anesthesia thing....anyone else know?? :sleep0:


    Believes in the Sleeve

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Posted March 28, 2010 - 3:16 AM


From the anesthesia? Then why doesn't every single person who has surgery have hair loss. I think it's more related to the body producing ketones. But hey I don't really know...but it's just hard for me to believe the anesthesia thing....anyone else know?? :sleep0:

Here's a great article that explains hair loss with any surgery is possible. It may not be as bad with other surgeries, but it is a possibility.

Telogen Effluvium: eMedicine Dermatology

Major surgery is cited as one of the main causes for hair loss to occur post-op.

Telogen effluvium is a form of nonscarring alopecia characterized by diffuse hair shedding, often with an acute onset. A chronic form with a more insidious onset and a longer duration also exists.1,2 Telogen effluvium is a reactive process caused by a metabolic or hormonal stress or by medications. Generally, recovery is spontaneous and occurs within 6 months.

Telogen effluvium can affect hair on all parts of the body, but, generally, only loss of scalp hair is symptomatic.
Understanding the pathophysiology of telogen effluvium requires knowledge of the hair growth cycle. All hair has a growth phase, termed anagen, and a resting phase, telogen. On the scalp, anagen lasts approximately 3 years, while telogen lasts roughly 3 months, although there can be wide variation in these times between individuals. During telogen, the resting hair remains in the follicle until it is pushed out by growth of a new anagen hair.
In most people, 5-15% of the hair on the scalp is in telogen at any given time. Telogen effluvium is triggered when a physiologic stress or hormonal change causes a large number of hairs to enter telogen at one time. Shedding does not occur until the new anagen hairs begin to grow. The emerging hairs help to force the resting hairs out of the follicle. Evidence suggests that the mechanism of shedding of a telogen hair is an active process that may occur independent of the emerging anagen hair. The interval between the inciting event in telogen effluvium and the onset of shedding corresponds to the length of the telogen phase, between 1 and 6 months (average 3 mo).
Headington has described 5 functional subtypes of telogen effluvium, based on which portion of the hair cycle is abnormally shortened or lengthened.3 These subtypes represent variations on the principles discussed above. It is rarely possible to distinguish these subtypes clinically.


This condition is quite common, but exact prevalence is not recorded. A large percentage of adults have experienced an episode of telogen effluvium at some point in their lives.

Mortality has not been reported. Morbidity is limited to mild cosmetic changes.

No racial predilection is recognized.

Acute telogen effluvium can occur in either sex if the proper inciting conditions occur. Because hormonal changes in the postpartum period are a common cause of telogen effluvium, women may have a greater tendency to experience this condition. In addition, women tend to find the hair shedding more troublesome than men do; thus, more women seek medical attention for the condition. Chronic telogen effluvium has been reported mainly in women.

Telogen effluvium can occur at any age. It is not uncommon for infants in the first months of life to experience an episode of telogen effluvium.


The symptom of both acute and chronic telogen effluvium is increased hair shedding. Patients usually only complain that their hair is falling out at an increased rate. Occasionally, they note that the remaining hair feels less dense. In both forms of telogen effluvium, hair is lost diffusely from the entire scalp. Complete alopecia is not seen.

  • Acute telogen effluvium is defined as hair shedding lasting less than 6 months. Patients with acute telogen effluvium usually complain of relatively sudden onset of hair loss. Careful questioning usually reveals a metabolic or physiologic stress 1-6 months before the start of the hair shedding. Physiologic stresses that can induce telogen effluvium include febrile illness, major injury, change in diet, pregnancy and delivery, and starting a new medication. Immunizations also have been reported to cause acute hair shedding. Papulosquamous diseases of the scalp, such as psoriasis and seborrheic dermatitis, can produce telogen effluvium.
  • Chronic telogen effluvium is hair shedding lasting longer than 6 months. The onset is often insidious, and it can be difficult to identify an inciting event. Because of the duration of the hair shedding, patients are more likely to complain of decreased scalp hair density, or they may note that their hair appears thin and lifeless.

  • The physical examination is the same in both acute and chronic telogen effluvium. Physical findings are sparse. Usually, the physician does not appreciate a decrease in hair density. However, if the patient's hair has been falling out for several months, the hair may appear thin when compared with old photographs.
  • Depending on the duration of hair loss, close examination of the scalp may reveal a higher than expected number of short new hairs growing. Because hair grows at a nearly constant rate of approximately 1 cm per month, the duration of the hair shedding can be estimated by measuring the length of the short hairs.
  • In active telogen effluvium, the gentle hair pull test will yield at least 4 hairs with each pull. If the patient's active shedding has ceased, the hair pull will be normal. Forced extraction of 10-20 hairs will yield a large percentage of telogen hairs. If greater than 25% of extracted hairs are in telogen, the diagnosis of telogen effluvium is confirmed.
  • There is one caveat to reliance on strict physical findings or numerical criteria in the diagnosis of telogen effluvium. Each patient's scalp hair has an individual characteristic growth cycle. There are patients who have a very long anagen phase and a small proportion of hair in telogen at any given time. These patients may experience an episode of telogen effluvium but have completely normal physical findings. History alone must guide the physician to the correct diagnosis in these cases.
  • There should be no areas of total alopecia in a patient with telogen effluvium. Scarring is not present. There also should be no sign of an inflammatory scalp dermatitis. Usually, there are no complaints of body hair loss.

Physiologic stress is the cause of telogen effluvium. These inciting factors can be organized into several categories, noted below. Evidence from mouse studies indicates that psychological stress can induce catagen, mainly by effects on neurotransmitters and hormones.4 In humans, however, the role these effects play in hair loss has not yet been determined. While substance P has been extensively studies in human hair follicles in vitro, in vivo studies have not been performed.5 In HIV disease, apoptosis may be related to HIV-1 viral Protein R.6

  • Acute illness such as febrile illness, severe infection, major surgery and severe trauma
  • Chronic illness such as malignancy, particularly lymphoproliferative malignancy; and any chronic debilitating illness, such as systemic lupus erythematosus, end-stage renal disease, or liver disease
  • Hormonal changes such as pregnancy and delivery (can affect both mother and child), hypothyroidism, and discontinuation of estrogen-containing medications7

Posted ImageTelogen effluvium secondary to hypothyroidism.


Posted Image

Telogen effluvium secondary to hypothyroidism.

  • Changes in diet like crash dieting, anorexia, low protein intake, and chronic Iron deficiency8,9,10
  • Heavy metals such as selenium, arsenic, and thallium
  • Medications, of which the most frequency cited are beta-blockers, anticoagulants, retinoids (including excess Vitamin A), propylthiouracil (induces hypothyroidism), carbamazepine, and immunizations11,12,13
  • Allergic contact dermatitis of the scalp14

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