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There is no research to show that joint replacement surgery and hair loss or thinning are directly linked. Hair loss can occur for many different reasons, some of which are associated with the trauma of surgery and the recovery process.

Do you think you’re experiencing hair loss after total hip replacement surgery (THR or THA)? Perhaps hair loss after a total knee replacement (TKR or TKA)? As you prepared for hip or knee replacement surgery and went through with the procedure, your head of hair was probably the last thing on your mind. Rightfully so—you had bigger fish to fry. However, now that you’re in your recovery you may have noticed something alarming: hair loss or hair thinning. Increased hair loss is probably not something that your care team mentioned but it is something patients commonly report.

Read on as we break down why hair loss after joint replacement surgery may be happening to you and what you can do about it.

Hair Loss Basics: What’s Going On?

First and foremost, it’s important to understand what normal hair loss looks like. Each day, the average person loses approximately 100 hairs. In a normal hair growth cycle, this number can increase. In the natural hair growth cycle, there two different phases called “anagen” and “telogen”. In the anagen phase hairs are actively growing (this is approximately 90% of the hairs on your head). During the telogen phase, hair is no longer growing but is “resting” and the hair follicles that have entered this phase are not growing hair. It’s during this phase (which lasts about 2-4 months) that these hairs will fall out.

When someone experiences above average shedding—in the excess of 200-300 hairs per day—this is can be due to “telogen effluvium” (TE). This is when greater than the standard 10-15% of head hairs enter the “telogen phase”. The result of fewer hair follicles actively growing hair and more follicles getting sleepy and letting go of their resting stands is thinning hair. During TE, up to 30% of your total hairs may enter the telogen phase, fast-tracking noticeable hair loss.

Telogen Effluvium is the most common type of hair loss linked to surgery.

Although seeing your precious hair falling out excessively can be extremely upsetting, with TE (the most likely type of hair loss you would experience after a replacement) it is completely reversible. In other words, hair loss that can be linked to a hip or knee replacement will correct itself. The timeline for the reversal is usually within 6 months.

Hair loss after joint replacement surgery: how long does it last? If your hair loss was in fact triggered by surgery or other factors associated with recovery, it will be temporary. You should see a full reversal once your growth cycle normalizes. This typically happens within 6 months.

Why Hair Loss After Joint Replacement Surgery?

Although there hasn’t been research directly linking hair loss to joint replacement surgery, there are some known causes for TE. Hair loss can be caused by shock, trauma to your body (like undergoing surgery or being in a car accident), poor nutrition, chronic stress, regularly taking medications like NSAIDS, other anti-inflammatories and some prescription medications for general health and depression. Any of these things ring a bell? In this sense, although hair loss cannot be directly isolated to one part of surgery, the entire episode can create a perfect storm for your luscious locks.

Body trauma + stress + NSAIDS + anti-inflammatories + some prescription meds = hair loss.

If you’re experiencing hair loss two or more months out from surgery, this is completely normal. As we mentioned, hair that enters the telogen phase can take 2-4 months to actually fall out.

For instance, if you had a TKR or THR in April, which inevitably caused your body trauma and could have triggered TE, your hair may not begin to fall out until June or July.

However, as quickly as your hair loss started, it will likely stop. Once you’ve adjusted mentally and emotionally and you’ve cut down on the meds that can increase hair loss, things on the top of your head should return to normal.

How Can I Treat My Sudden Hair Loss?

Incision Phases of Healing

When it comes to hair thinning or hair loss after a joint replacement, there is no silver bullet that will undo the damage that’s been done. However, in time, it is totally reversible. Here are some things you should do to promote hair regrowth and discourage shedding.

1. Relax. Less Stress = More Hair.

Like many diseases and conditions, stress is a huge contributing factor. It’s also directly linked to hair loss. Although you couldn’t control the stress and trauma caused by surgery, you can control your post-op anxiety, emotional stress and level of relaxation. It may be easier said than done, but there are tricks to cut stress—even when stresses are higher than normal as your work through the frustrations of recovery.

Here are some tips to control stress:

  • Follow PeerWell’s guided audio mindfulness exercises. These brief anti-anxiety lessons have been adopted by even the most reluctant joint replacement patients. Mindfulness teaches you to be present, accept what you cannot control, deal with pain, be more relaxed in stressful situations and so forth. Allan, who recently had a total knee replacement said, “The mindfulness exercises did help with the anxiety and taught me how to treat anxiety. I did find myself in hospital going through the mindfulness breathing exercises.”
  • Keep up with your daily ReHab exercises. Exercise is one of the body’s best remedies for reducing stress. Although you won’t be getting the mega endorphin release associated with intense cardio, working through a basic routine (even if it’s low impact) will let you mentally and physically relax.
  • Set the stage for better sleep. A common point of frustration after surgery is the inability to sleep. A lack of sleep can add to feelings of stress. Creating an atmosphere that will help you get to sleep is helpful. This means: a dark cool room, no technology (yes, this means no computers or phones), removing distractions like a noisy partner or pets, and taking out clutter from your sleep space.
  • Eat a healthier diet. We will get into specifics below but even just removing caffeine and alcohol can have a big impact on stress levels. If you’re newly into your recovery, you shouldn’t be consuming alcohol anyways. Eating balanced meals and eliminating mood-altering foods and drinks will go a long way.

2. Eat a Balanced Diet

A major part of a solid PreHab program that prepares you for joint replacement surgery and a ReHab program that guides you past the finish line of recovery is nutrition. What you eat matters a lot. It matters on any given day but this is especially true as your body heals from a traumatic event. There are superfood and nutrient combinations that decrease inflammation, boost your immune system, rebuild issue and bone, and more.

Here’s the high-level version of the foods you should be eating to make sure you are not nutritionally deficient:

  • Protein—Getting protein from a variety of sources, specifically non-meat products, like tofu or soya is part of a balanced diet. Too much red meat has been linked to hair loss.
  • Vitamin C and Iron—Vitamin C is a standalone antioxidant and helps the body absorb iron. Iron deficiency can cause and increase hair loss levels.
  • Vitamin D and Calcium—Vitamin D fortified milk, cheese or orange juice will hit two birds with one stone. This powerful duo repairs damaged tissue, offering the building blocks of healing.
  • Zinc—Zinc boosts your immune system, repairs damaged tissue and is great for hair growth. A zinc deficiency can lead to hair loss, so making sure you’re up on the zinc has a twofold purpose—heal your joint and your hair! Foods high in zinc: cooked oysters (highest of all), followed by beef, lamb, spinach, pumpkin seeds.
  • Take biotin—Biotin is an increasingly popular over-the-counter vitamin that is said to increase hair growth. It is the main ingredient in most “hair, skin and nails” vitamins. There are mixed reviews and little scientific proof of its effectiveness. Ask your doctor before taking biotin. If he or she signs-off, you can be the judge.

Read more about superfood and nutrition combos that help with joint replacement recovery here.

3. Be Patient

Okay, so this sounds like an annoying point to make but it’s true. Be patient. Have faith that this isolated period of hair loss will soon pass. If your hair loss is in fact due to the joint replacement surgery you’re recovering from, then you should see a full bounce-back. You can incorporate the special shampoos, pray to a higher god, and make up concoctions at home to dump onto your head, but in reality, only time will repair your hair. Keep your eye on the prize of a healthier tomorrow and your hair issue will correct itself as you heal.

4. Talk to Your Doctor

If you’re concerned about your hair loss, talk to your doctor. He or she may have some recommendations for you and will have greater knowledge of some of the side effects of surgery and the medication they’ve prescribed to you. Your care team is here to help so don’t be shy about bringing up any concerns—especially if you’re not seeing any improvements or your hair loss is adding stress to your recovery.

In pain? Preparing for surgery? PeerWell Health helps you fast forward to better with 1:1 doctor visits, physical therapy, and a custom at-home program for your condition. 

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