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

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 B(12), 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.