Understanding Hair Shedding After a Hair Transplant
Hair shedding is a natural occurrence, dictated largely by our hair’s life cycle. Every day, our hair follicles progress through growth, transition, and resting phases—resulting in the regular loss of 50 to 100 hairs. This inherent cycle ensures that older hairs are naturally replaced by new growth. Moreover, when a hair transplant is performed, the trauma from the procedure can trigger a temporary increase in shedding, known as “shock loss” or effluvium, where both the transplanted and existing hairs shed to pave the way for healthier regrowth.
Hair shedding is a natural process—most people lose between 50 and 100 hairs a day. However, it’s important to distinguish between normal hair shedding and the post-operative shedding of transplanted hair grafts.
Normal Hair Shedding
The Hair Growth Cycle
Hair naturally cycles through three phases:
- Anagen (Growth Phase): otherwise known as the active phase of hair, and lasts for about 2-6 years. During this phase, hair grows about 1cm every 28 days.
- Catagen (Transitional Phase): The catagen phase is referred to as the “transitional phase”, and lasts for 2-3 weeks. At any given time, about 3% of all hairs are in this phase.
- Telogen (Resting Phase): The telogen phase, otherwise known as the “resting” phase, is where most shedding occurs. About 6-8% of all hairs can be in the telogen phase, and can last for about 100 days. During this time, as much as 50-100 hairs are shed.
The hair growth cycle in humans is random, meaning that at any point, different hairs may be at different stages of the cycle.
Why Hair Shedding After Hair Transplant Happens?
After a hair transplant, patients often observe continued hair shedding. This shedding is a normal response to the trauma caused by the transplant procedure.
This temporary shedding, known as effluvium or shock loss, usually occurs 1–5 weeks after the procedure. Keep in mind that “shock loss” is a normal part of the hair restoration process and is not indicative of any permanent damage on the hair – though it is unavoidable, it is also temporary. New hairs will take time to mature and will grow at different rates.
Interestingly, the more severe one’s hair loss and hair miniaturization is, the more likely that person will experience increased hair shedding after a hair transplant.
Shock loss caused by trauma of a hair transplant, causing native hairs to temporarily shed. While the hair is shed due to trauma, the dermal papilla remains so hair does grow back.
Hair Transplant Procedure Overview
A hair transplant procedure is the movement and individual placement of genetically resistant hairs from the donor area (located at the back of the head) to the areas where the scalp is losing hair. Tiny openings are created—otherwise referred to as “stab incisions”—wherein the individual grafts are placed. Regardless of whether FUT or FUE is performed, the procedure can be quite traumatic on the scalp and the surrounding hairs, and as a result, the hair grafts and the existing hairs can temporarily shed.
How to Reduce Hair Shedding after a Hair Transplant
Though hair shedding or shock loss is unavoidable, there are a few things you can consider to minimize hair shedding.
1. Medication
- Minoxidil (sold under the brand names Rogaine® and Regaine®) increases hair growth and darkens fine hairs—yielding results within about 4-6 months. Rogaine, in particular, has been known to be more effective on people younger than 30 years old and who have only been experiencing hair loss for less than 5 years. While the body normally tolerates Rogaine well, side effects have been reported and may include eye irritation, itching, redness and/or irritation of the area, and unwanted hair growth in other parts of the body.
- Finasteride (sold under the brand name Propecia®) works by binding to the enzyme 5-Alpha Reductase responsible for helping produce DHT in the body. It does not completely stop DHT production, but rather, suppresses it well enough to interrupt the development of male pattern hair loss and hair miniaturization in men. When used regularly, results may be seen in as early as 3 months. Some men may experience decreased libido when taking the drug. Some men may also experience erectile dysfunction and a decrease in the amount of semen released during sex. Finasteride does not work on all men, and hair thinning and hair loss are not based on DHT alone as they can continue when on the medication.
- Dr. Amiya Prasad’s Hair Regeneration Treatment is also an effective way to minimize postoperative shedding. The Hair Regeneration Treatment is made up of an extracellular matrix designed for wound healing and platelet-rich plasma, which is taken from the patient’s own blood. The mixture is then injected into areas of the scalp where hair loss is evident. There is a 99% treatment success rate in cases of male pattern and female pattern hair loss. The wound healing properties of the Hair Regeneration Treatment also improves the survival rate of hair grafts.
2. Timing and Size of Hair Transplant
Many patients choose to have a hair transplant at the onset of hair loss or when they have significant miniaturization. When patients take this kind of approach, their hair often ends up looking thinner than it did before the procedure was performed because the progression of the hair shedding was not taken into account.
Another approach would be to wait until a later date after the hair loss has been stabilized with a procedure like Hair Regeneration. It is also essential for the surgeon to carefully determine a suitable number of grafts required for the desired area of coverage and the estimated number of hair grafts available in the donor area.
3. Camouflaging Products
Patients may opt for cosmetic camouflaging products which can disguise the physical evidence of hair shedding and hair thinning. These products cover up balding areas by:
- adding volume and lift to the base of the hair shafts
- incorporating hair building fibers for fuller coverage and thickness
- using topical shading to disguise bare spots on the scalp.