Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2021 Jun;31(6):2649-2659.
doi: 10.1007/s11695-021-05311-2. Epub 2021 Mar 5.

Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis

Wen Zhang  1 , Meiling Fan  2 , Cunchuan Wang  3   4 , Kamal Mahawar  5 , Chetan Parmar  6   7 , Weiju Chen  8 , Wah Yang  9   10   11   12 ; Global Bariatric Research Collaborative
Affiliations
Meta-Analysis

Hair Loss After Metabolic and Bariatric Surgery: a Systematic Review and Meta-analysis

Wen Zhang et al. Obes Surg. 2021 Jun.

Abstract

Background: Hair loss is a common complication after metabolic and bariatric surgery (MBS). There is a lack of published systematic review in the scientific literature on this topic. The aim of this study was to perform a systematic review and meta-analysis on hair loss after MBS in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) guidelines.

Methods: PubMed, CINAHL, EMBASE, Web of Science, SCOPUS, and four Chinese databases were searched. Data were pooled using Review Manager 5.3 and Stata 12.0, and subgroups were performed if necessary and feasible.

Results: A total of 18 studies (n = 2538) were included. The pooled results showed that the incidence of hair loss after MBS was 57% (95% CI 42-71%). It decreased with longer follow-up times. Hair loss was significantly more common in younger (mean difference (MD), - 2.45; 95% CI, - 4.26 to - 0.64; p = 0.008) women (OR, 3.87; 95% CI, 0.59 to 17.59; p = 0.08). Serum zinc (standardized mean difference (SMD), - 1.13; 95% CI, - 2.27 to 0.01, p = 0.05), folic acid (SMD = - 0.88, 95% CI - 1.29 to - 0.46, p < 0.0001), and ferritin levels (SMD, - 0.22; 95% CI, - 0.38 to - 0.05; p = 0.01), but not serum iron and vitamin B12, were associated with hair loss following MBS.

Conclusions: Hair loss is common after MBS especially in younger women, and those with low serum levels of zinc, folic acid, and ferritin. Prospective studies on larger cohorts are needed.

Keywords: Bariatric surgery; Hair loss; Meta-analysis; Metabolic surgery; Nutrition.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of study selection
Fig. 2
Fig. 2
Forest plots of overall incidence
Fig. 3
Fig. 3
a Forest plots of follow-up duration. b Forest plots of procedures
Fig. 4
Fig. 4
Forest plots of studies in serum zinc
Fig. 5
Fig. 5
a Forest plots of studies in serum iron. b Forest plots of studies in serum ferritin
Fig. 6
Fig. 6
a Forest plots of studies in folic acid. b Forest plots of studies in vitamin B12
Fig. 7
Fig. 7
a Forest plots of studies in gender. b Forest plots of studies in age
See this image and copyright information in PMC

Comment in

References

    1. Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism. 2019;92:6–10. doi: 10.1016/j.metabol.2018.09.005. - DOI - PubMed
    1. National Clinical Guideline C. National Institute for Health and Clinical Excellence: Guidance. Obesity: identification, assessment and management of overweight and obesity in children, young people and adults: partial update of CG43. London: National Institute for Health and Care Excellence (UK) 2014. - PubMed
    1. Singhal R, Tahrani AA, Ludwig C, Mahawar K. Global 30-day outcomes after bariatric surgery during the COVID-19 pandemic (GENEVA): an international cohort study. Lancet Diabetes Endocrinol. 2021;9:7–9. doi: 10.1016/S2213-8587(20)30375-2. - DOI - PMC - PubMed
    1. Ledoux S, Flamant M, Calabrese D, Bogard C, Sami O, Coupaye M. What are the micronutrient deficiencies responsible for the most common nutritional symptoms after bariatric surgery? Obes Surg. 2020;30:1891–1897. doi: 10.1007/s11695-020-04412-8. - DOI - PubMed
    1. Ruiz-Tovar J, Oller I, Llavero C, Zubiaga L, Diez MA, Arroyo A, Calero A, Calpena R. Hair loss in females after sleeve gastrectomy: predictive value of serum zinc and iron levels. Am Surg. 2014;80:466–471. doi: 10.1177/000313481408000517. - DOI - PubMed

LinkOut - more resources