Guest blog by Lillian Craggs-Dino, DHA, RDN, LDN, FASMBS-IH If you have been shedding more hair than usual after metabolic and bariatric surgery, you are not alone, and it’s not permanent. This is called telogen effluvium, a temporary pause in the hair growth cycle triggered by surgery, rapid weight loss, and a limited diet.1 Your skin and nails can be affected, too. The good news: The right nutrients, at the right doses, can help your body recover. Why Hair, Skin, and Nails Take a Hit After Surgery Hair, skin, and nails (your integumentary system) are especially sensitive to nutrient shortfalls. After bariatric surgery, deficiencies are common for two main reasons:2 Food intake is limited because of the surgery’s restrictions The surgery itself may reduce how well your body absorbs nutrients Together, these make it harder to get and keep enough vitamins and minerals, even when you are eating well. How Dietitians Catch a Deficiency Early Registered dietitians perform a full nutrition assessment after surgery, including a nutrition-focused physical examination, and researchers have recently developed a version of this exam tailored specifically to bariatric patients.3 This exam looks for physical signs in your skin, hair, and nails that can point to a specific deficiency. For example: Nails that turn concave or spoon shaped can signal an iron deficiency Dry, scaly skin or dull hair can point to low iron, zinc, vitamin A, vitamin D, vitamin E, or essential fatty acids4 Building a Diet and Supplement Plan That Support Recovery As you progress your diet, aim for a variety of nutrient-dense foods. But diet alone is usually not enough after bariatric surgery. Vitamin and mineral supplements are typically needed long-term to make up for what your body is not getting or absorbing from food. If a deficiency has already developed, your care team may recommend a higher repletion dose to correct it before scaling back to a maintenance level. Protein remains the top priority macronutrient after bariatric surgery. Getting enough high-quality protein every day gives your body the building blocks it needs to support and regrow healthy hair, skin, and nail tissue. Daily Nutrient Targets for Healthy Hair, Skin, and Nails The targets below reflect general recommendations to support hair, skin, and nail health while you adjust to your new diet and supplement routine:5,6 Nutrient Suggested Daily Amount Protein Women: average 80g/day | Men: average 100g/day Zinc 15mg/day Copper 1–2mg/day Elemental iron 45mg/day Vitamin C 500mg/day Biotin 3,000–5,000mcg Flaxseed oil 15ml/day B complex 75–100mg/day Vitamin B12 500mcg Adult multivitamin One that contains 100% of the daily value for vitamin A and vitamin E Always check with your doctor or dietitian before starting any new supplement. These are general targets, and your personal needs may be different based on your labs, your surgery type, and your health history. Food Sources to Help You Meet These Targets Supplements fill the gaps, but food still matters. Here are everyday sources for each key nutrient:7 Nutrient Food Sources Vitamin A Fish, cheese, sweet potato, brightly colored fruits and vegetables (beta-carotene) Vitamin D Salmon, eggs, cheese, shitake mushrooms Vitamin E Wheat germ, oils, olives, almonds Vitamin C Kiwi, potatoes, citrus fruits, green peppers Folate Spinach, asparagus, back-eyed peas Biotin Almonds, banana, eggs, tomato, yogurt Niacin Peanuts, chicken, mushrooms, broccoli Iron (heme) Red meat, poultry, seafood Copper Oysters, lobster, crab, cashews Zinc Pumpkin seeds, wheat germ, garbanzo, garlic Selenium Brazil nuts, tuna, oysters, chicken The Bottom Line Hair-shedding, dry skin, and brittle nails after bariatric surgery are usually temporary and tied to nutrient shortfalls A dietitian can spot early warning signs during a physical exam, often before labs confirm a deficiency Consistent protein intake, a nutrient-rich diet, and daily supplementation together give your hair, skin, and nails what they need to recover Talk to your care team before adding or adjusting any supplement References Cohen-Kurzrock RA et al. Cureus. 2021;13(4):e14617. Gasmi A et al. Eur J Nutr. 2022;61(1):55–67. Sylvestre J et al. Dietetics. 2026;5(2):27. Silva ACF et al. Sao Paulo Med J. 2022;140(5):723–733. Mechanick JI et al. Surg Obes Relat Dis. 2020;16(2):175–247. National Institutes of Health, Office of Dietary Supplements (dietary-supplements.info.nih.gov) Whitney E et al. Understanding Nutrition (17th ed.). 2025. Boston: Cengage.