Anesthesia and Hair Growth Patterns

[seamonkey]

Yeah, I already know what y'all's reactions will probably be....but on the off chance somebody has heard this before.....

So, I'm at the barber today getting a cut, and the guy 2 chairs over is talking to his barber. Something about a recent surgery, blah blah blah, i'm not really listening.

And then I hear his barber, a late 40s-ish woman ask : "so has your hair been growing differently since being put to sleep? I find that for most people, after anesthesia, their hair grows in a different pattern for a while. It can take up to a year to go back to the way it was before."

Whuuuuhh?

On my way out I asked her where she got this from and she said it had happened to many of her clients and that she'd heard stories about it from other barbers as well.

I believe this to be most likely a BS old-wives' tale kind of myth, passed from barber to barber in an amusing sort of way. Cannot possibly imagine a mechanism for this to occur. Still, fairly amusing

Has anyone out there ever heard of this before?

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[Gimlet]

Yeah, I already know what y'all's reactions will probably be....but on the off chance somebody has heard this before.....

So, I'm at the barber today getting a cut, and the guy 2 chairs over is talking to his barber. Something about a recent surgery, blah blah blah, i'm not really listening.

And then I hear his barber, a late 40s-ish woman ask : "so has your hair been growing differently since being put to sleep? I find that for most people, after anesthesia, their hair grows in a different pattern for a while. It can take up to a year to go back to the way it was before."

Whuuuuhh?

On my way out I asked her where she got this from and she said it had happened to many of her clients and that she'd heard stories about it from other barbers as well.

I believe this to be most likely a BS old-wives' tale kind of myth, passed from barber to barber in an amusing sort of way. Cannot possibly imagine a mechanism for this to occur. Still, fairly amusing

Has anyone out there ever heard of this before?

Never heard about it, but if it will cause some hair to grow in the ever-enlarging bare spot on the top of my head, sign me up!

 

[lfesiam]

Never heard about it, but if it will cause some hair to grow in the ever-enlarging bare spot on the top of my head, sign me up!

I SMELL A STUDY!!! yes! that'll be one cool project!

 

[guitarguy09]

haha... well, never heard that one before. I'm trying to determine what the physiology of that would be (especially with the effects lasting a year). I've got nothin'...

Hmm, maybe it can delay the inevitable frontal baldness that is coming my way...

 

[jetproppilot]

I've heard several times in my years of practice from patients who said they noticed some hair loss after surgery.

At first I didnt believe it but maybe theres something to it.

 

[seamonkey]

sweet....it looks like I already have an ASA poster lined up before my CA-1 year....now if I can get a phrenologist on-board too, the possibilities are limitless!

 

[Planktonmd]

I have heard the story of hair loss after surgery many times from patients (maybe 10 times over a period of 10 years) and all these patients were convinced that the cause was general anesthesia.
Could it be the inflammatory syndrome triggered by surgery?
Is it a direct toxic effect on hair follicles?
Or, is it an urban legend that keeps circulating?

 

[proman]

We have had several patients develop alopecia post op. I think it's from pressure on the scalp leading to ischemia from lying on one position without moving for too long. I rotate the head every so often during long cases. One patient was in steep head down for a robotic RRP. Those cases get the jelly rings instead of the plastic ones.

 

[deleted162650]

While we're talkin about hair, I've heard that the disposable scrub caps have a coating of fire-******ant that has been linked to premature hair-loss. Anyone know if there's any truth to that or if it's total BS?

 

[Planktonmd]

While we're talkin about hair, I've heard that the disposable scrub caps have a coating of fire-******ant that has been linked to premature hair-loss. Anyone know if there's any truth to that or if it's total BS?

I think it's BS!
I am 42 Y/O, I have been wearing these caps everyday for more than 10 years and I still have a full head of hair!

 

[nutmegs]

We had a recent presentation on this topic. There is most definitely a pressure alopecia phenomenon (pressure alopecia, postoperative alopecia areata). It's associated (not exclusively) with gyn, breast, and cardiac surgery and thought to be related to hair follicle ischemia, although there is a high prevelance of psychiatric comorbidity... interesting and not explained. They get pain and tenderness after surgery, then crusty scalp, then the hair falls out and at least 60% of the time grows back in within about 6 months- but not always. What I found especially interesting was a case report of hair loss in the exact distrubution of where the damn jelly donut was- I always felt safe with that thing. The one and only thing that they reported a lower rate of it with was purposefully moving the head every half hour or so. Who knew?

 

[dfk]

on a related note, we take care of a recurrent inpatient for I&D type stuff. it most always is GA since the OR table can barely hold 'em. we had an M&M about this guy potentially developing some kind of tachyphylaxis from repeated GAs. he stated he had awareness after the "last" surgery, and both the CRNA and attending concurred that the pt did indeed say and experience this. fwiw, the guy was at 1 MAC agent. have you guys heard of/experienced a tachyphylaxis-type effect occurring from prolonged/repeated GAs?

 

[Planktonmd]

on a related note, we take care of a recurrent inpatient for I&D type stuff. it most always is GA since the OR table can barely hold 'em. we had an M&M about this guy potentially developing some kind of tachyphylaxis from repeated GAs. he stated he had awareness after the "last" surgery, and both the CRNA and attending concurred that the pt did indeed say and experience this. fwiw, the guy was at 1 MAC agent. have you guys heard of/experienced a tachyphylaxis-type effect occurring from prolonged/repeated GAs?

And how is that related to hair loss caused by GA??

 

[Bertelman]

While we're talkin about hair, I've heard that the disposable scrub caps have a coating of fire-******ant that has been linked to premature hair-loss. Anyone know if there's any truth to that or if it's total BS?

Why would they be coated with fire ******ant? If my head is ever close enough to a flame, the whole bitch is blowin up, and no amount of fire ******ant will slow it down.

 

[Masseter Spasm]

There are conditions in which hair loss can follow stress. Hair follicles are so rapidly growing that they are susceptible to "stress" like episodes such as a surgical procedure. (Disruption of nutrients or something required for sustained growth.) I have had a few patients describe this phenomenon. I tell them that it is not just anesthesia but the whole "stress"-related experience of a surgical procedure. This has been documented even in cases where pressure allopecia was unlikely. I have seen this phenomenon called telogen effluvium or allopecia effluvium.

 

[G0S2]

My father, an anesthesiologist, had surgery under GA a few months back and has noticed that he lost some hair on his arms and legs.

 

[bellatrix]

Telogen effluvium. Physiologic stress leads to hair follicles shifting from growth phase (anagen) to rest phase (telogen). Shedding begins when new anagen hairs begin growing and push the telogen hairs out -- usually a few weeks to months after the stressful event.

 

[d3d3!!]

I'm not a doctor but a patient. I've had 3 very minor procedures wherein the drug propofol was used to "twilight" me briefly. One of these procedures for instance was a routine colonoscopy. Each time, and it is very apparent (to the point that even my roommate comments on noticing a lot hair all over the place, which I of course clean up) I have experienced fairly severe and worrisome hair shedding within 2 weeks of the procedure. (Each time, after 2 weeks.) I find it daily all over the bathroom floor, and the hair clips I use routinely start to slide out more easily. As each procedure took 1.5 hours or less, I don't feel the shedding could be related to any extended pressure on my head. Also, a colonoscopy for instance is not a big "stress" event for the body (no polyps were removed--it was just a scope). As such from personal experience--I have no proof--I feel there is almost definitely a connection of some sort between hair shed and propofol, and possibly other drugs used for surgery. Never have I shed so much due to any other life factors, including stress, the seasons, diet, sleep, etc. Also, before I had been administered this drug I had never heard of hair loss related to surgery, so I was not anticipating any such thing. I started researching it only after I became alarmed after my last (third) "twilight" and it seems many people report hair loss after GA and major surgery, but for me just "twilight" propofol has been enough to produce this side-effect. Though I have experienced no other problems at all with this drug, I hope to not require it again--or maybe there is a good alternative I can ask for in the future. Just my personal experience, for what it's worth. I do not think that patients that mention this problem are imagining things (we are all aware that people shed plenty of hair daily), but rather that there has not been sufficient research, since it is not an important side-effect. My instinct is that possibly such drugs have a temporary effect on the hormones...but I of course have no way of knowing.

 

[deleted59964]

I'm not a doctor but a patient. I've had 3 very minor procedures wherein the drug propofol was used to "twilight" me briefly. One of these procedures for instance was a routine colonoscopy. Each time, and it is very apparent (to the point that even my roommate comments on noticing a lot hair all over the place, which I of course clean up) I have experienced fairly severe and worrisome hair shedding within 2 weeks of the procedure. (Each time, after 2 weeks.) I find it daily all over the bathroom floor, and the hair clips I use routinely start to slide out more easily. As each procedure took 1.5 hours or less, I don't feel the shedding could be related to any extended pressure on my head. Also, a colonoscopy for instance is not a big "stress" event for the body (no polyps were removed--it was just a scope). As such from personal experience--I have no proof--I feel there is almost definitely a connection of some sort between hair shed and propofol, and possibly other drugs used for surgery. Never have I shed so much due to any other life factors, including stress, the seasons, diet, sleep, etc. Also, before I had been administered this drug I had never heard of hair loss related to surgery, so I was not anticipating any such thing. I started researching it only after I became alarmed after my last (third) "twilight" and it seems many people report hair loss after GA and major surgery, but for me just "twilight" propofol has been enough to produce this side-effect. Though I have experienced no other problems at all with this drug, I hope to not require it again--or maybe there is a good alternative I can ask for in the future. Just my personal experience, for what it's worth. I do not think that patients that mention this problem are imagining things (we are all aware that people shed plenty of hair daily), but rather that there has not been sufficient research, since it is not an important side-effect. My instinct is that possibly such drugs have a temporary effect on the hormones...but I of course have no way of knowing.

ask for 'neurolept' with droperidol next time

 

[sigrhoillusion]

I dunno... when I was a resident during grand rounds, if I sat towards the back of the auditorium ad looked down, it seemed like a lot of the anesthesiologists were going bald. More so than the general population...

 

[Mad Jack]

I'm not a doctor but a patient. I've had 3 very minor procedures wherein the drug propofol was used to "twilight" me briefly. One of these procedures for instance was a routine colonoscopy. Each time, and it is very apparent (to the point that even my roommate comments on noticing a lot hair all over the place, which I of course clean up) I have experienced fairly severe and worrisome hair shedding within 2 weeks of the procedure. (Each time, after 2 weeks.) I find it daily all over the bathroom floor, and the hair clips I use routinely start to slide out more easily. As each procedure took 1.5 hours or less, I don't feel the shedding could be related to any extended pressure on my head. Also, a colonoscopy for instance is not a big "stress" event for the body (no polyps were removed--it was just a scope). As such from personal experience--I have no proof--I feel there is almost definitely a connection of some sort between hair shed and propofol, and possibly other drugs used for surgery. Never have I shed so much due to any other life factors, including stress, the seasons, diet, sleep, etc. Also, before I had been administered this drug I had never heard of hair loss related to surgery, so I was not anticipating any such thing. I started researching it only after I became alarmed after my last (third) "twilight" and it seems many people report hair loss after GA and major surgery, but for me just "twilight" propofol has been enough to produce this side-effect. Though I have experienced no other problems at all with this drug, I hope to not require it again--or maybe there is a good alternative I can ask for in the future. Just my personal experience, for what it's worth. I do not think that patients that mention this problem are imagining things (we are all aware that people shed plenty of hair daily), but rather that there has not been sufficient research, since it is not an important side-effect. My instinct is that possibly such drugs have a temporary effect on the hormones...but I of course have no way of knowing.

Correlation=/=causation

It is likely that people requiring surgery are either older or in poor health, both of which predispose toward hair loss. Particularly in the case of poor health, your body prioritizes vital organs over your peripheral tissues, which can cause noticeable and well recognized effects on your nails. Extrapolating from the fact that we know major health hits affect nail plate growth, it only makes sense that such events would also affect hair growth. It is probably more the surgery, illness, age, general health status, or procedure, not the anesthesia itself that is causing any hair growth disruption.

 

[d3d3!!]

ask for 'neurolept' with droperidol next time

Thanks--I will do that if I ever need another "twilight" but hopefully I won't anyway! I wonder if it would reduce the likelihood of another major hair shedding event if I requested those drugs instead..? Hopefully.

 

[d3d3!!]

Correlation=/=causation

It is likely that people requiring surgery are either older or in poor health, both of which predispose toward hair loss. Particularly in the case of poor health, your body prioritizes vital organs over your peripheral tissues, which can cause noticeable and well recognized effects on your nails. Extrapolating from the fact that we know major health hits affect nail plate growth, it only makes sense that such events would also affect hair growth. It is probably more the surgery, illness, age, general health status, or procedure, not the anesthesia itself that is causing any hair growth disruption.

Yes, I agree that is generally true. However, I'm relatively young (40's) and very active/fit/healthy with a good diet. I get yearly physicals/bloodwork which always comes back normal including hormones, and I rarely get sick. I don't have any diseases/disorders and I don't normally shed a lot. The 3 procedures I had twilight sedation for were all non-illness related (one was just a colonoscopy--normal results). I have read online a lot of opinions that anesthesia itself can't cause hair loss, just shock from surgery can, but I never have seen an explanation for why that is true. Maybe there's been a study that proves anesthesia (specifically propofol) never causes hair loss even in the absence of surgery--I don't know. But, hair loss doesn't seem like such an unusual side effect for any strong drug, really. I think that for me personally, all other things considered (my procedures were short and minor, and one was not even a surgery) it did cause or contribute to hair shedding. Next time I'll try asking for the drugs recommended upthread, though I hope to not need any more procedures of course. I don't think it's a big deal, but I think maybe patients could be forewarned about it so they aren't alarmed by the ensuing hairballs which are honestly rather demoralizing.

 

[deleted59964]

I SMELL A STUDY!!! yes! that'll be one cool project!

No need, I do a regular neurosurgery list, I run Tiva with propofol - my patients uniformly have hair loss.
Q.E.D.

 

[Pooh & Annie]

Never heard or seen this, and too many confounders to put a lot into the anecdotal stuff. I'm not completely discounting it, but I definitely don't buy it for now.

 

[jwk]

Don't you know by now that EVERYTHING is ANESTHESIA'S FAULT!

Donald Trump's election - anesthesia's fault.
Bridge collapse on I-85 in downtown Atlanta - anesthesia's fault.
Surgeon biopsies pulmonary artery during mediastinoscopy (actually seen this twice) - anesthesia's fault.
Even the heartbreak of psoriasis is anesthesia's fault (although as a product of the Emory system, I can tell you lidocaine cures it and just about anything else that ails you)

 

[DrZzZz]

No need, I do a regular neurosurgery list, I run Tiva with propofol - my patients uniformly have hair loss.
Q.E.D.

I am dying right now. One of the better responses I've ever read on here.

 

[leaverus]

most of you guys are talking about hair loss after anesthesia, but seamonkey's original post says barber was talking about hair growing "in a different pattern" not even sure what the means - the part is on the right instead of the left??