Hair Loss After Surgery: Causes, Symptoms, and Management
Hair loss is a common condition many individuals face worldwide.
While it is commonly associated with aging, genetics, and certain medical conditions, hair loss can also occur after surgery.
This type of hair loss, known as postoperative hair loss, can be distressing for recovering individuals.
Postoperative or pressure Alopecia (PA) is a rare type of hair loss that can occur after certain surgeries or keeping the head in a fixed position for an extended period.
Hair loss becomes apparent within 3 to 28 days following the surgery, and hair regrows within 1 to 4 months.
It is characterized by scarring or non-scarring bald patches on the scalp.
This article explores the causes, symptoms, and management of hair loss after surgery.
Hair loss and surgeries
Hair loss after surgeries or postoperative hair loss has been observed in many surgeries, such as pediatric, cardiac, gynecological, abdominal, and facial surgeries.
Cardiac surgery
Postoperative or pressure Alopecia (PA) is commonly reported in cardiac surgery.
A study found that PA occurred in 14% of patients who got coronary artery bypass grafting.
The PA was higher in patients with longer surgery duration.
Permanent Alopecia was more likely in patients intubated for a more extended period.
The study also showed that regular head turning during and after surgery significantly reduced hair loss.
Other cases of Pressure Alopecia have occurred in patients of various ages undergoing cardiac surgery.
Extended periods of cardiopulmonary bypass increase the risk of permanent Alopecia.
Biopsies of affected scalp areas have shown symptoms such as fibrosis, inflammation, and absence of anagen hairs.
A separate study found that during coronary artery bypass grafting, the pressure on the back of the head (occiput) was too high, which could lead to pressure ulcers and hair loss.
To prevent these issues, it is advisable to change the position of the head during surgery regularly.
This helps avoid excessive pressure on the occiput and reduces the risk of developing sores and losing hair in that area.
Gynecological and breast surgery
A study observed eight patients who experienced hair loss on the top of their scalp within four weeks after gynecological surgery.
These patients had undergone surgery while positioned in a way that put downward pressure on their scalps for three hours or more.
Some patients had experienced scalp crusting and tenderness before the hair loss, while others only noticed the hair loss.
Biopsies of six patients’ scalps revealed a condition called vasculitis, which involved inflammation of blood vessels and atrophic hair follicles in the areas of hair loss.
This resulted in reversible hair loss in those areas.
The recommendation for preventing postoperative hair loss was to change the position of the head regularly during surgery.
Cases of postoperative hair loss have also been reported after breast surgery, which indicates the need for greater awareness of this condition among surgeons.
Abdominal surgery
Temporary hair loss occurred in individuals who underwent liver transplant surgery as donors and recipients.
The development of temporary hair loss in these cases and in patients who had cardiac surgery was hypothesized to be influenced by psychiatric conditions.
Another case involved a 21-year-old female with biliary surgery lasting over nineteen hours, resulting in temporary hair loss.
Biopsy results showed that all hair follicles were in a phase of hair growth cessation, with cell death caused by reduced oxygen supply due to pressure.
Orthodontic/Ophthalmological surgery
Orthognathic surgery, which involves procedures on the jaw and face, can increase the risk of postoperative hair loss.
It can happen due to the length of surgery, anesthesia, and forces applied to the head during bone adjustments.
Temporary hair loss has been reported in a 37-year-old woman who underwent a five-hour orthognathic surgery.
Similar cases have been observed after breast and ophthalmic surgeries, suggesting that even shorter procedures can lead to temporary hair loss.
In some cases, the shape and pressure from headrests or headbands used during surgery have been identified as the cause of temporary hair loss.
For example, headbands used for orthodontic treatment have been associated with temporary Alopecia.
Pediatric surgery
Hair loss after surgery or ICU stays can also affect children and neonates.
In children, hair loss was observed after chest wall and cardiac surgeries, where immobilization of the head during the procedure can lead to temporary Alopecia.
Some children may even experience permanent hair loss in the affected area.
Similar cases have been reported in teenagers undergoing breast surgery and 11-year-old children undergoing ophthalmological surgery.
In neonatal intensive care units (ICUs), cases of pressure ulcers and subsequent scarring alopecia have been observed in newborns.
Newborns with severe cardiac problems that required prolonged periods of head immobilization and had episodes of low oxygen levels had Pressure Alopecia.
These cases highlighted the importance of turning schedules to prevent pressure ulcers and hair loss.
Hair loss has also been observed in children sedated for extended periods in ICUs, potentially due to hypotension and poor nutrition.
Will the hair grow back after surgery, and what is the timeframe?
According to the study, pressure alopecia (PA) is generally reversible, and hair regrowth can occur within a few months after surgery or the inciting event.
The study found that hair regrowth in PA occurred between 1 and 4 months.
The exact time frame for hair regrowth can vary among individuals. It may depend on the duration and severity of pressure-induced ischemia.
In the study, PA was observed in six cases, and the patients experienced hair regrowth within the mentioned timeframe.
However, it’s essential to consider that individual cases may vary.
Additionally, the time frame for hair regrowth after surgery can also depend on factors such as the individual’s overall health, hair growth cycle, and any underlying conditions that may affect hair growth.
Suppose you have undergone surgery and are experiencing hair loss, especially in areas such as the top of the scalp (vertex) and the back of the head (occiput).
In that case, consult a dermatologist or healthcare professional specializing in hair disorders.
They can evaluate your case and provide more accurate information and guidance regarding the potential for hair regrowth and the expected time frame based on your circumstances.
Management and treatment of hair loss after surgery
The management and treatment options for pressure-induced Alopecia after surgery may include the following:
Prevention
The best approach is to prevent pressure-induced Alopecia by ensuring proper positioning and head support during surgery or prolonged immobilization.
This can be achieved using appropriate padding, cushions, or specialized devices to distribute pressure evenly and minimize the risk of blood flow restriction to the scalp.
Early detection
Promptly recognizing and diagnosing pressure-induced Alopecia is crucial for initiating appropriate management.
Dermatologists or healthcare providers with expertise in hair disorders can assess the condition and provide guidance.
Observation and reassurance
Hair regrowth is expected within a few months in mild cases of pressure-induced Alopecia, with no scarring or ulceration.
Patients should be reassured and advised to monitor their hair regrowth progress.
Topical treatments
In some cases, topical treatments may be recommended to promote hair regrowth.
Minoxidil, a medication commonly used for Androgenetic Alopecia, has been reported effective in some cases of pressure-induced Alopecia.
It can be applied to the affected areas of the scalp.
Supportive care
Patients with pressure-induced Alopecia can benefit from supportive measures to optimize hair regrowth.
This may include maintaining a healthy diet, managing stress levels, and avoiding practices that further damage the hair (e.g., excessive heat styling and harsh chemical treatments).
Dermatological interventions
Dermatological interventions may be considered in cases of scarring or persistent hair loss.
These may include corticosteroid injections into the affected areas, which can help reduce inflammation and promote hair regrowth.
However, such treatments’ effects on Pressure-induced Alopecia may vary, and individualized assessment is necessary.
Conclusion
In conclusion, hair loss after surgery, also known as postoperative hair loss or pressure alopecia, can be distressing for individuals recovering from various surgical procedures.
It can occur in cardiac, gynecological, abdominal, orthodontic, ophthalmological, and pediatric surgeries.
The exact causes of postoperative hair loss are not fully understood. However, factors such as prolonged pressure on the scalp, reduced blood flow, and inflammation can contribute to hair loss.
Fortunately, in most cases, postoperative hair loss is reversible, and hair regrowth can be expected within a few months after the surgery.
If hair loss is experienced after surgery, it is recommended to contact your dermatologist or healthcare professional specializing in hair disorders for accurate diagnosis and guidance.
Frequently Asked Questions
Why does hair loss occur after surgery?
Hair loss after surgery, known as postoperative hair loss or pressure Alopecia, can be caused by prolonged pressure on the scalp, reduced blood flow to the hair follicles, inflammation, and temporary disruption of the hair growth cycle. The exact mechanisms may vary depending on the type of surgery.
Is hair loss after surgery permanent?
In most cases, hair loss after surgery is temporary and reversible. Hair regrowth can be expected within a few months after the surgery. However, the timeframe for regrowth may vary among individuals, and some cases may require additional time for a full recovery.
Can all types of surgeries cause hair loss?
Hair loss after surgery can occur in various surgeries, including cardiac, gynecological, abdominal, orthodontic, ophthalmological, and pediatric surgeries. The risk and severity of hair loss may depend on the duration of surgery, head immobilization, and pressure on the scalp.
Does hair loss after surgery affect everyone?
Hair loss after surgery is not experienced by everyone who undergoes a surgical procedure. The occurrence and severity of postoperative hair loss can vary among individuals. Genetics, overall health, and individual susceptibility may contribute to the likelihood of experiencing hair loss after surgery.
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