If I Have Shock Loss After a Hair Transplant, How Long Until Hair Grows Back?

If I Have Shock Loss After a Hair Transplant, How Long Until Hair Grows Back?

Q: I had an FUE hair transplant three weeks ago and some of my existing non-transplanted hair has fallen out. I was a Norwood 3V, but now I look more like a 4 or 5 without the hair that used to help cover up my thinning area. Am I destined to look balder for the next few months? When can I expect to look like before? — T.M., New Haven, CT

A: You are describing shedding that is pretty typical following a hair transplant. The hair which is shed generally grows back together with the transplanted hair beginning at about three months. You should expect hair that is shaved for the FUE procedure to grow back right away at the normal rate of 1/2mm per day.

The shedding (also called shock hair loss) doesn’t mean permanent damage to the hair follicles. What it refers to is a physiological, or normal, response to trauma to the scalp which is caused by the hair restoration procedure. In general, only miniaturized hair (the hair that is affected by androgens and that has begun to decrease in diameter) is shed after a transplant. This hair would be lost in the near term anyway. Existing healthy hair is unlikely to shed, but if it were to shed, you could expect it to grow back as the transplanted hair grows in.

Posted by Robert M. Bernstein M.D.

Does Minoxidil Improve Graft Survival After a Hair Transplant?

Q: Does minoxidil play any role in the survival of the grafts after a Neograft/FUE procedure? — J.W., Philadelphia, PA

A: When a doctor performs a hair transplant, the hair should be taken from the permanent zone so, by definition, that hair is not affected by medication (i.e. does not need to be maintained by either minoxidil or finasteride). If the doctors using Neograft are suggesting that minoxidil increases survival, then they are probably harvesting hair outside the permanent zone. To clarify, I use the ARTAS robotic system for our FUE procedures, not Neograft, as the former is a far more accurate device for harvesting.

Posted by Robert M. Bernstein M.D.

If There is Some Bleeding at the Graft Site, Will it Affect Growth?

Q: I am currently 8 days post op. I started to massage my hair in the shower to get rid of the scabs. When I was done I looked in the mirror and saw two of my transplanted hairs were slightly bleeding but still intact. What does that mean? Did I lose the grafts? — B.G., Stamford, C.T.

A: If they bleed, but were not dislodged (i.e. did not come out), they should grow fine. Just be gentle for the next week. Generally, when follicular unit transplantation is performed with tiny sites (19-21 gauge needles) the grafts are permanent at 10 days. Since I did not perform your procedure and am not familiar with the technique your doctor actually used, I would give it the extra few days.

Read more about how to care for your scalp after a hair transplant

Posted by Robert M. Bernstein M.D.

Can Pulling Out Transplanted Hair Effect Growth After Hair Transplant?

Q: At about six days post op, I started to notice hairs on the tips of my fingers as I rubbed off my scabs. Additionally, if I tugged on the hairs lightly, they would immediately come out without any resistance. I did notice the small bulb at the end of the hair. My question is: is it not recommended to remove these hairs that have separated from the follicle? Should I just allow them to fall out on their own, or does it matter at all? Can pulling hairs out at 10 days post op effect growth differently than individuals who allow the hairs to fall out naturally? — T.T., Boston, M.A.

A: At 10 days it should usually not make a difference, but I would still just let the hair fall out naturally when you shampoo. If there are any crusts (scabs) on the hair they are cosmetically bothersome, they can be gently scrubbed off in the shower at 10 days when very tiny recipient sites are used and you should wait slightly longer if larger sites were used. Since I don’t know the technique or site size used in your procedure, I would wait a full two weeks to be certain the grafts are permanent.

Posted by Robert M. Bernstein M.D.

What Causes Poor Hair Transplant Growth?

Q: Do you ever see poor growth from a hair transplant? What causes this to happen? — R.L., Edison, NJ

A: The situations where I have encountered poor growth are:

1) When hair is transplanted to areas of skin that has been thickened due to the prior placement of larger grafts or plugs (this is called “hyperfibrotic thickening”). Removal of the larger grafts can somewhat ameliorate this problem.

2) When hair is transplanted into a thickened scar.

3) When a hair transplant is performed into an area of severe chronic sun damage. In this case, a very modest number of grafts should be used in the first session and if these grow well, additional grafts can be added in a subsequent session.

Read answers on the topic of Growth After Hair Transplant

Posted by Robert M. Bernstein M.D.