Why do people with hair loss undergo hair transplants? For one overwhelmingly critical reason: improvement of appearance. Why is improvement of appearance so important? Reasons are many, and may include any or all of:
- Having a better self-image and feeling better about oneself
- Appearing as youthful and energetic as one feels
- Enhancing appearance for personal and business relationships
Hair transplant may for some persons be part of a global program of personal improvement, including weight loss and physical conditioning. When this is the case, nutrition will almost certainly have an important role in any self-improvement program. And the manner in which nutrition is included in the program may have some potential for causing loss of newly transplanted hair.
A program of well-balanced dietary intake can help to weight loss and physical conditioning, especially when exercise is a part of the program. Well-balanced dietary intake meets the body’s needs for fuel (calories), and for vitamins, minerals, essential fatty acids and proteins to carry out biochemical functions, maintain the immune system to fight off infections and bolster tissue growth and repair. Every cell in the body needs these nutrients, including the cells in hair follicles that produce hair and cycle hair through its anagen-telogen-catagen phases.
A diet that is seriously lacking in essential nutrients, or has insufficient essential nutrients over a long timeframe, can cause malfunction in cells, including the cells in hair follicles. When hair follicle cells malfunction there is potential for (1) interruption of normal hair cycling, (2) inability of follicles to create new hair, and (3) temporary or permanent hair loss. Extreme diets that lack essential nutrients, or in which essential nutrients are below Recommended Dietary Allowance (RDA) levels (see U.S. Department of Agriculture Food and Nutrition Information Center for more information) can lead to nutrient deficiency.
The hair-loss condition most commonly caused by nutrient deficiency is telogen effluvium, an abnormality of hair cycling. The hair cycle is changed so that hair which would normally be in anagen (growth) phase is moved into telogen (resting) phase. The hair is then shed abnormally early. In addition to nutrient deficiency, other causes of telogen effluvium include hormone imbalance such as hypothyroidism, serious physical illness, physical and emotional stress and side effects of over-the-counter and prescribed drugs. Telogen effluvium may cause some postoperative loss of transplanted hair due to the effect of “surgical shock” on transplanted hair follicles. The effects of “surgical shock” can be reduced when the hair transplantation patient eats a balanced diet and stays well hydrated by drinking sufficient liquids in the immediate pre- and post-operative periods.
A similar cause of hair loss called anagen effluvium is due to toxic side effects of drugs, or to severe protein deficiency in the diet. In anagen effluvium, it is hair in anagen (growth) phase that is lost. The hair becomes brittle and easily plucked, often breaking off at scalp level. Anagen effluvium due to severe protein deficiency is uncommon in adults unless protein is extremely deficient in the diet.
The hair loss of telogen effluvium and anagen effluvium is usually temporary if the cause of the condition is removed (e.g., a drug) or halted (e.g., a nutrient deficient diet). Several months may be required for hair growth and hair cycling to return to normal. Failure to remove the cause of the condition can result in chronic and permanent hair loss.
Nutrient Deficient Diets Contributing to Hair Loss
Weight loss is typically a prime goal when a person is working towards improve physical appearance. A person may be determined to achieve a target weight, but is not sure how to reach the goal. What is a safe and effective weight-loss diet?
Tailoring of a diet to achieve a reasonable weight-loss goal must include appropriate levels of essential nutrients. Certain nutrient deficiencies are known to be specifically associated with hair loss:
- Iron deficiency is a cause of iron-deficiency anemia, and anemia is a known cause of hair loss. Iron deficiency anemia is a complex condition in which inadequate iron intake can be a sole or contributing cause. Fad diets and crash diets that are iron deficient will eventually result in low iron stores in the body and cause chronic anemia. Diseases that interfere with iron absorption or conditions that cause inappropriate blood loss can also be involved in iron deficiency anemia. Iron deficiency is diagnosed by laboratory tests. Treatment should be appropriate to the cause, and should be carried out under medical supervision. Iron deficiency due to inadequate iron in the diet may be treated by iron supplementation and by diet modification.
- Zinc deficiency is known to be associated with hair loss. A very low-calorie diet with little or no red meat protein can contribute to zinc deficiency. A low-calorie vegetarian diet can contribute to zinc deficiency because zinc is absorbed less readily from plant sources of zinc than from animal sources. Zinc deficiency can be difficult to diagnose; its symptoms are often non-specific, resembling those of many other conditions. Zinc deficiency should not be assumed; it must be diagnosed by laboratory tests. Zinc supplementation should be undertaken only under medical supervision; zinc overdose is associated with a number of adverse physical effects.
- Biotin deficiency is associated with hair loss as well as some skin disorders. Biotin is one of the B vitamins that have a broad range of functions in the body. Because biotin is found in many foods, biotin deficiency is likely to be caused by a very low-calorie diet that reduces the intake of many nutrients below recommended level.
- Protein deficiency is an outcome of inadequate protein in the diet over a period of time. Vegetarian diets avoid protein deficiency by including a variety of plant protein sources—beans, legumes and nuts. Extreme vegetarian diets and extreme low-calorie diets may provide inadequate protein intake.
A person who intends to pursue a weight-loss regimen before or after hair transplantation should discuss the intention with the physician hair restoration specialist. Diets that could cause or contribute to hair loss should be avoided or appropriately modified. Commercial weight-loss products promising quick weight loss and miraculous results are likely to be less effective over time than a normal diet modified to reduce calories while retaining a balanced intake of essential nutrients.