Recovering calmly: what helps the body and the hair

After an illness, a hospital stay or surgery, a strange phase arrives: the person already feels better, has gone back to their routine, and it is precisely at this point that hair starts to fall out in larger amounts. It is natural to feel frustrated and want to "do something", to buy supplements, change shampoo, try everything.

The good news is that, in the great majority of cases, this hair loss (a telogen effluvium) is temporary and the hair recovers on its own. The less good news is that hair has its own calendar, slower than the rest of the body, and no product can shorten it significantly. What the evidence shows is that it is worth ensuring the conditions for the body to recover well: eating enough, sleeping, getting moving again, correcting real deficiencies and not adding further harsh treatment to the hair.

In this article we bring together what really helps, what is not worth the money and the signs that justify an assessment.

Why hair takes longer than the body

Hair grows on average about 1 centimetre a month. Each follicle goes through a growth phase (anagen, which lasts years), a short transition phase and a resting phase (telogen, about three months), at the end of which the hair falls out and a new one begins to grow.

In an illness or operation, the body conserves resources and many follicles enter the resting phase at the same time. Three months later, they fall out. By the time hair loss is noticed, new hair is already growing underneath, but it is short and takes time to give volume. That is why hair recovery always lags behind that of the body.

The realistic timeline

In most people, hair loss slows in less than six months. When it continues beyond that, it is called chronic telogen effluvium, or another condition may be involved (such as an androgenetic alopecia that the illness made more visible), and an assessment is worthwhile.

A sign of good prognosis: the hairs that fall out have a small white bulb at the root (the telogen bulb). This means the follicle has finished a cycle, not that it has died.

Eating to recover

The hair follicle is one of the fastest-dividing tissues in the body, but it is not a priority for the body. When energy or protein is lacking, resources go first to healing, the immune system and muscles. That is why diet in the recovery phase is the first "treatment" for hair.

Enough energy

After an illness, it is common to have little appetite, and many people take the opportunity to "lose a few kilos". Adding a restrictive diet to a telogen effluvium is asking for more hair loss. At this stage, the aim is to return to your usual weight and eat regularly. If your appetite is low, smaller, more frequent meals help.

Protein at every meal

For a healthy adult, the European reference (EFSA) is about 0.83 g of protein per kilo of body weight per day. In recovery from illness or surgery, needs rise, and clinical nutrition guidelines (ESPEN) often speak of 1.2 to 1.5 g/kg, adjusted by the doctor, especially if there has been muscle loss. In practice, this means including a source of protein at every meal: eggs, fish, meat, dairy, pulses, tofu. Those with kidney disease should follow their doctor's advice.

Micronutrients: correct what is missing, do not stockpile

• Iron: blood loss, hospital stays and some illnesses leave ferritin low. Low iron is associated with hair loss, and correcting it makes sense when it is confirmed.
• Vitamin D: low levels are common, especially after weeks at home; it is corrected on the basis of blood tests.
• Vitamin B12 and folate: important in people on vegetarian diets, with bariatric surgery or taking certain medicines (such as metformin).
• Zinc: deficiency causes hair loss, but in excess it interferes with copper.

If in doubt, the way forward is a varied diet and, if hair loss is heavy, targeted tests. See Protein, iron and zinc: what your hair needs and Blood tests for hair loss: what to ask for.

A typical recovery plate

Half vegetables and fruit, a quarter protein (fish, eggs, meat, pulses) and a quarter cereals or potato, with a drizzle of olive oil. Simple and enough for most people.

Sleep, movement and a gradual return

Sleep

Sleep is when the body does much of its tissue repair and regulates hormones such as cortisol. There are no studies showing that sleeping more makes hair grow faster, but prolonged sleep deprivation is associated with poorer general recovery and more stress, which in turn can keep hair loss going. After a hospital stay, the sleep rhythm is often disrupted: fixed bedtimes and wake-up times, natural light in the morning and fewer screens at night help to reset the clock. More details in Sleeping well and hair: what rest changes.

Moving, little by little

Days or weeks in bed cause rapid loss of muscle mass, especially in older people. Getting moving early, within what the doctor permits, is one of the measures with the best evidence in recovery after illness and surgery. Short, frequent walks, gradually increasing, are a good starting point. Light strength exercises, when allowed, help to rebuild muscle and use dietary protein better.

Do not go back to 100% on the first day

A common mistake is to go back to work and social life at full speed as soon as the symptoms disappear. Fatigue after an illness, especially after infections such as COVID-19 or after major surgery, can last for weeks. Planning a gradual return, with breaks, protects the body and reduces the stress load that can prolong hair loss.

Anxiety about hair loss

Watching your hair fall out in handfuls is frightening. Many people start counting hairs, avoiding washing their hair, spending hours comparing photographs or searching the internet for answers. The concern is understandable, but it can turn into a cycle: more anxiety, worse sleep, more stress.

Some ideas that help:

• Knowing what to expect. Understanding that hair loss is the end of a cycle, and not the permanent loss of follicles, relieves many people.
• Track it sensibly, not every day. A photograph of the parting, in the same light, once a month, shows progress better than counting hairs in the plughole.
• Choose a practical cut, if your hair is long: a slightly shorter or layered cut disguises the loss of volume and puts less weight on the hair each time.
• Talk about it. With someone close or with a professional.

If the worry becomes hard to control, or if there is persistent sadness, lack of motivation or anxiety that interferes with daily life, talk to your GP. After serious illness or a stay in intensive care, symptoms of anxiety and depression are common and treatable. In a crisis, call SNS 24 (808 24 24 24) or, in an emergency, 112. For simple strategies, see How to lower stress without effort.

Looking after your hair during recovery

The new hair and what remains are, at this stage, more vulnerable to breakage. The care is simple:

What to do

• Wash as often as usual, with a gentle shampoo. Washing does not make hair fall out that was not going to fall.
• Use conditioner on the ends to reduce friction when combing.
• Comb with a wide-toothed comb, starting from the ends.
• Dry with a towel by pressing, without rubbing, and use the hairdryer at a medium temperature.
• Protect the scalp from the sun, especially if the parting is more visible.

What to avoid for a few months

• Tight hairstyles, high ponytails, braids and extensions, which add traction.
• Bleaching, straightening and perms.
• Iron and straighteners at high temperatures, every day.
• Constantly changing products in search of a "miracle".

Colouring your hair, carefully and without bleaching, is not forbidden, but it would be better to wait for the peak shedding phase to pass.

Supplements and treatments: what the evidence says

"Hair" supplements

The systematic review by Almohanna and colleagues (Almohanna et al., 2019) concluded that vitamin and mineral supplementation only shows a clear benefit when there is a deficiency. In people without a deficiency, there is no evidence that they speed up recovery. A few precautions:

• Biotin: deficiency is rare. At high doses, it can distort important tests, such as thyroid tests and cardiac troponin, a warning issued by the FDA. If you take it, say so before having blood tests.
• Vitamin A and selenium: in excess, they cause hair loss.
• Iron: without a confirmed deficiency, it does not help and may do harm.

If hair loss is heavy or prolonged, it is more useful to have targeted tests than to pile on supplements.

Minoxidil

In acute telogen effluvium, which recovers on its own, minoxidil is not usually needed. In chronic telogen effluvium, or when the condition has unmasked androgenetic alopecia, it can be discussed at a consultation. In a retrospective study of 36 women with chronic effluvium, low-dose oral minoxidil reduced the shedding score from 5.64 to 3.9 at six months and 3.05 at twelve months, with increased facial hair in about a third of patients as the most common adverse effect (Perera and Sinclair, 2017). This was a study without a control group, and oral minoxidil is used outside its approved indications (off-label) in this situation: it should only be taken with a prescription and under medical supervision.

Other treatments

In-clinic treatments, such as hair mesotherapy or platelet-rich plasma, have been studied mainly in androgenetic alopecia. In telogen effluvium, the evidence is limited. The decision to use them should follow a medical assessment that confirms the diagnosis.

Warning signs and when to seek advice

At Luxmed, the Hair Medicine consultation begins with a clinical history (with the timeline of the illness or surgery), followed by examination of the scalp and trichoscopy. When indicated, we request blood tests and agree a follow-up plan, with follow-up photographs to measure progress.

This article is for information purposes and does not replace a medical consultation. The results of any treatment vary from person to person.

Frequently asked questions