Alopecia and zinc deficiency in postbariatric surgery patients

Background: Bariatric surgeries form an integral part of morbid obesity management. In addition, alopecia is steadily being reported as a postoperative event. Alopecia is related to the nutritional deficiency occurring due to bariatric surgery, postoperative rapid weight loss, and major surgery-related stress. This review aims to evaluate rates of zinc deficiency as a postoperative complication of bariatric surgery and its association with alopecia. Methodology: A PubMed literature search conducted between February 6, 2020 and April 3, 2020, from which 32 studies were identified that reported zinc status and hair loss following bariatric surgery. Results: Most of the articles, 14 (48.28%) articles, 7 (24.14%) articles, reported prospective cohort and retrospective cohort studies, respectively. Moreover, 16 (55.17%) publications were about Roux-en-Y gastric bypass (RYGB) surgery, while sleeve gastrectomy was conducted in 9 (31.03%) studies. Rates of zinc deficiency were reported in 93.10% of the studies. Five studies (17.24%) included the rates of alopecia and most of them revealed female predominance. Decreased food intake was considered as a common cause of zinc deficiency after gastrectomy; on the other hand, decreased zinc absorption was a factor in RYGB patients. Conclusion: Bariatric surgery is an effective measure in managing morbid obesity and its complications. However, it could be associated by zinc deficiency and consequent alopecia, particularly in females. A meta-analysis is needed to assess this correlation more thoroughly and to determine the potential value of regularly giving micronutrient supplements to prevent such a complication.