It’s unusual for transplanted hair grafts to fall out a year after a hair transplant, but it can happen. Hair shedding at this point is normally due to native hair loss or another type of alopecia, which can be triggered by many different factors. That’s why it’s important to seek a professional diagnosis if you’re concerned about your hair transplant falling out after 1 year.
Research shows that the majority of hair transplant patients are happy with their results 1 year after their hair transplant [1]. But a few people see continuing or new hair loss after their procedure. Here, we explore the reasons your hair transplant may be falling out after a year, and what you can do to tackle this.
Key takeaways
Some shedding after a hair transplant is very normal, but it tends to happen much earlier than a year after the procedure. Hair transplant shedding normally occurs around 2-4 weeks after surgery, and is linked to the hair growth cycle.
Post-hair transplant shedding — also known as shock hair loss or dread shed — happens because the freshly transplanted grafts move from the telogen phase to the exogen phase of the hair growth cycle.
When the hair graft is extracted, the follicle is detached from the blood supply, causing it to move into the shedding phase of the hair growth cycle. When the blood vessels reattach to the follicle in its new position and blood supply recovers, the follicle will start to produce new hair.
Because this happens for hundreds or even thousands of grafts at a similar time, it can cause alarm. But rest assured that this is a normal part of hair transplant recovery, and your new hair will start to grow very soon.
Wimpole Clinic patient advisor Adam Smith reveals more in this video:
After this initial period of shedding, most patients return to a regular cycle of growth, resting, and shedding. It’s not typical to see hair falling out en masse again. So if your hair is falling out a year after your hair transplant, it needs investigating.
It’s very uncommon for your transplanted hairs to fall out after a year. Most patients who have undergone a high-quality hair transplant operation see excellent results within 12 months of surgery. But while it’s not usual to see hair loss 1 year after a hair transplant, there are a few common explanations.
A hair transplant replaces your lost hair. However, it won’t prevent ongoing hair loss. For those with male pattern baldness or female pattern hair loss, a continuation of this is the most likely reason for hair loss a year after a hair transplant.
Supplementary medicines like finasteride and minoxidil are designed for this purpose. If you’re not using treatments to manage ongoing hair loss — or you’ve recently stopped taking them — it is possible for hairfall to continue despite your hair transplant.
In this case, the hair that falls out isn’t usually your transplanted hair grafts. Instead, the native hairs around your new grafts (which are vulnerable to dihydrotestosterone and other hormones that lead to pattern baldness) start falling out. This may look like your new hair is falling out due to decreased density in the transplanted areas.
While pattern baldness is the most common type of hair loss, affecting 80% of men and 50% of women by the age of 80, it’s possible to be affected by a different type of alopecia at the same time [2-3]. These can include:
All these types of alopecia are much less common than hereditary hair loss, and they have unique symptoms that trichologists can recognise. So it’s important to get a physical exam if you have unexplained hair loss a year after a transplant.
All hair is vulnerable to natural ageing processes, including transplanted hair [4]. Both men and women experience hair thinning as they get older, which can make your hair look and feel less dense. This may be disappointing if you’ve had a hair transplant to increase hair density.
If this is the reason for your hair transplant falling out after a year, it will happen very gradually. You shouldn’t see a large amount of hairfall at the 12-month mark, but you may start to see some initial shedding that develops over time.
A second hair transplant may help fill in the developing gaps in your hair. Alternatively, scalp micropigmentation is a minimally invasive procedure that can help create the illusion of density without undertaking a full hair transplant, though it’s only suitable for patients with dark hair.
Certain health conditions may impact the long-term success of your hair transplant. While these conditions don’t affect transplanted hair exclusively, they can affect grafted hair and cause unexpected shedding. For example:
These conditions can disrupt the hair growth cycle and limit blood flow to the scalp, causing your hair to shed [5]. Additionally, some medications have been linked with hair loss, including chemotherapy drugs, high blood pressure medication, statins, psychotropic agents, anti-convulsants, anticoagulants, and antiretrovirals [5].
It’s important to note that any hair loss caused by these health conditions and/or drugs isn’t directly linked with having had a hair transplant. These conditions and medications can cause hair loss anywhere on the scalp, including your transplanted grafts.
Hair breakage is easily mistaken for hair loss. Breakage happens when your hair shafts are brittle and break off easily, creating the appearance of thin, lacklustre hair.
Routine styling practices are responsible for much of the hair breakage we see, and it particularly affects women and people with Black or curly hair types [6-7]. That’s because women are more likely to use damaging styling practices repeatedly, and Black hair types are more vulnerable to traction alopecia.
Styling practices known to cause or contribute to hair damage include:
Look closely at the areas affected by hair loss. If it’s caused by breakage rather than true hair loss, you should see short, spiky hairs, rather than bald patches.
Struggling with hair breakage? Find safer ways to achieve your desired look in these articles related to common hair styling practices.
Some hair transplant patients are victims of poor donor site selection. This happens when your surgeon extracts grafts outside of the safe hair transplant donor area.
Grafts outside this area may be prone to shedding, which could lead to transplanted hair falling out a year or later after your procedure. Find out more about the safe donor area from Wimpole Clinic technician Evgeniya:
Poor donor site selection is very uncommon at good clinics with experienced surgeons. A good surgical team knows where to extract grafts for optimal hair transplant results, and if you have a depleted or unsuitable donor region, they won’t accept you as a candidate for surgery. So you’re more likely to be affected by this if your hair transplant took place at an unlicensed or black market clinic.
The human hair growth cycle is asynchronous, which means hair follicles across the scalp are in different phases of the growth cycle at any given time.
After a hair transplant, the transplanted grafts re-enter their native shedding cycles at different times after the initial shedding phase. This can lead to uneven hair growth and density in the early months post-transplant. This is known as graft desynchronisation, and it can last 12 months or more after your procedure.
However, graft desynchronisation is more likely to manifest as slow growth rather than hair loss after a hair transplant.
Losing hair a year or so after your hair transplant can bring on lots of different feelings, from disappointment to alarm to anxiety. You may be worried that the hair loss is permanent, or that you’ll need to pay for another hair transplant.
It’s not uncommon for people who feel their hair transplant has failed to have a lapse in confidence and self-esteem. But fortunately, if your hair is falling out a year after your hair transplant, the causes are often fixable, especially if your hair loss is diagnosed early.
It’s not very common to lose hair 12 months or more after a hair transplant. One study found that 94% of hair transplant patients with moderate to advanced balding were satisfied with their results at 12 months [1].
At 24 months, 9% had noticed a decrease in density in their transplanted areas. This may be due to the advanced nature of their hair loss, making a further increase more noticeable.
Determining if it’s transplanted or native hair falling out is important for finding the right treatment. Examine the hairs and use the table below to discover which type of hair you’re losing:
It can be very difficult to check for these symptoms yourself, so it’s best to get a professional hair loss assessment. The Wimpole Clinic is an award-winning hair transplant clinic, but we also offer comprehensive trichology services to diagnose and treat all kinds of hair loss.
Treating your hair loss early can significantly limit the amount of hair you lose, and even reduce feelings of unhappiness associated with hair loss [8]. So it’s really important to seek advice as soon as possible if you think your hair is falling out a year after your hair transplant.
Learn about your options for treating a hair transplant that’s falling out after a year, or other types of hair loss that may be affecting you several months after your FUE or FUT procedure.
The first stop should be at the hair transplant clinic that did your initial procedure (assuming this is possible for you). Your clinic will have all the details of your surgery, including any complicating factors that may compromise your results later down the line.
They can assess your current hairline and diagnose if you have hair loss or breakage, and whether it’s your grafted or native hair that’s affected. If there is an issue with your hair transplant, they may be able to help address this, whether it’s recommending medications to reduce ongoing hair loss or a top-up transplant to fill in any density gaps.
It’s a good idea to visit your GP for a general health checkup, as hair loss can be a symptom of other health conditions. Some of the most common health-related reasons for hair loss include:
Your GP is best placed to assess your medical history and establish if any health conditions are contributing to the late-onset loss of your transplanted hair. Based on your diagnosis, they can help you devise a treatment plan to stop hair loss and stimulate regrowth as quickly as possible.
If you’re in good general health but are still noticing hair loss, it’s best to get an assessment from a trichologist.
Some types of hair loss have unique symptoms that make them easy to identify, while others need more investigation. Special trichological tools and techniques can be used to assess your hair and scalp, such as:
Trichologists use these tools (along with their own expertise) to uncover any underlying types of alopecia that may be affecting your grafted hair. See our comprehensive list of types of alopecia for more information.
There’s no one-size-fits-all treatment plan for stopping hair loss. It all depends on what’s causing it, especially in an unusual case where your hair is falling out a year after a hair transplant.
Depending on your diagnosis, your doctor may recommend some of the following treatments:
With the exception of a hair transplant, all these treatments require long-term commitment. If you stop using them, or leave it too long between treatments, you could see your hair loss resume.
In most cases, you’ll need a combination of treatments to prevent even more hair loss down the road. It’s why a long-term hair loss management strategy is so important.
Sometimes, a second or even third hair transplant is a good option to increase hair density following further hair loss. But this isn’t always the case. If you don’t have enough grafts left in your donor area, or you have an underlying health condition, another hair transplant is unlikely to help.
This checklist can help you decide if you’re a good candidate for a top-up hair transplant:
The Wimpole Clinic is an award-winning hair loss clinic with 50 years’ experience of diagnosing and treating hair growth problems. With hair loss clinic locations around the UK, we can help with:
If you’re concerned about your hair transplant falling out after a year or more, book a consultation at your nearest clinic for a comprehensive assessment and treatment plan.
Find out more about late-onset hair shedding after a hair transplant in these frequently asked questions.
Quite unlikely. It’s unusual to see visible growth in the first 12 months after a hair transplant, followed by shedding at the 1-year mark. If a hair transplant has gone wrong or failed, this usually manifests as limited growth within the first 6-9 months.
Yes, if your current hair loss is due to ongoing pattern baldness or age-related shedding. But it also depends on whether you’re a good candidate for a second hair transplant, and how many grafts remain in your donor area after your first transplant.
Talk to one of our patient advisors to find out if a second hair transplant is a suitable way to tackle your current hair loss.
Alternatives to finasteride include minoxidil, PRP therapy, low level laser therapy, and natural DHT blockers like rosemary hair oil and saw palmetto for hair loss.
Alternatively, you could consider switching to topical finasteride. Topical finasteride works in a similar way to oral finasteride, but has a lower systemic impact, possibly reducing the likelihood and severity of side effects [9].
The best thing to do is seek advice from your hair transplant clinic as soon as you have concerns. They can assess your growth and either provide reassurance or recommend treatments to help stimulate hair growth. In some cases, they may offer you a top-up hair transplant to improve your results.
If you’re dissatisfied with their analysis or outcomes, seek advice elsewhere to see what options are available to you.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
Dr Harpreet Kalra is a hair transplant specialist and GP based in our Newcastle hair transplant clinic. Born in Scandinavia, Dr Kalra qualified as a doctor in Denmark in 2007, and was subsequently trained as a hair transplant surgeon by Dr Kapil Dua in 2012 (President of the International Society of Hair Restoration Surgery). He is registered with the General Medical Council (7126076).
Dr Kalra is an expert hair transplant surgeon with a comprehensive grasp of advanced hair restoration techniques, including FUE and FUT. With his profound commitment to patient welfare, medical innovation, and professional development, Dr Kalra has restored the confidence of hundreds of patients struggling with hair loss.
In addition to his role as a hair transplant consultant at the Wimpole Clinic, Dr Kalra is a member of the Royal College of General Practitioners (MRCGP) and a practising GP in the UK. Beyond clinical practice, he is an active participant in medical seminars, conferences and workshops, underscoring his dedication to advancing healthcare and improving patient outcomes across the UK.
