Video: What Is Shock Fall Out After Hair Transplant?
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April 30th, 2012

In this audio clip, Dr. Bernstein answers a frequently asked question about shock fall out after a hair transplant. Listen to the clip (2 minutes 34 seconds):

What Is Shock Fall Out After Hair Transplant?

Here is a transcript of the clip:
Hair is interesting in that it is constantly growing, shedding, and then starting a new cycle. There is a normal physiologic reaction of hair to grow -- we call that the anagen phase -- and then to go into the resting phase -- called telogen -- where then the hair is shed, and then new hairs grow again. Each hair is not growing and resting at the same time, because then all the hair would fall out and obviously you'd have this massive shedding. Animals do this, and it's called molting. But in humans each hair seems to be on its own cycle. However, when the hair is stressed, the body is stressed or the scalp is stressed, more hairs can be shunted into this resting phase, or shunted from the growing phase to the resting phase at the same time. Then, several months later when the resting phase is over, the hairs will simultaneously shed and that reaction is called telogen. So what happens in a hair transplant is that we're obviously shocking the scalp. We're poking little holes in it. We're giving anesthetic that has adrenaline in it, which causes blood vessels to constrict. So all these things that are going on in surgery cause the scalp to be shocked, essentially. In many cases there is some shedding a few months after the procedure. We refer to that as shock hair loss. Shock hair loss has doesn't imply damage to the hair follicles. What it implies is a physiological, a normal, response to this trauma to the scalp which is caused by the hair transplant. Hair that is healthy is going to come right back after some period of time. Hair that may be near the end of its lifespan may not come back. When we're doing a hair transplant we're obviously doing it for someone that has a substantial amount of hair loss already, so the upside of the transplant is going to be much greater than any hair that might be lost in the shock hair loss. The time that shock hair loss really can be a problem is when hair transplants are done too early. So the upside of the surgery is small and then the risk of shedding, since you have so much hair, is great. When a hair transplant is performed at the proper time on the proper candidate, shock hair loss really should just be an incidental problem. Patients often ask how much hair can be lost, and in general the patient may notice something, but it's usually not visible to other people, to the outside world.
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