Just as your scalp had healed after your surgical hair restoration, you may be disheartened to see your newly implanted hair falling out. This is commonly known as hair transplant shock loss and can represent a considerable source of stress and anxiety for patients during their hair transplant recovery[1][2].
However, while it may seem concerning, this temporary condition is nothing to worry about. Although your newly implanted hair fibres are falling out, their follicles are healthy and will start producing new hair within a few months.
This article will tell you everything you need to know about hair transplant shock loss. You will learn why this phenomenon happens, what it looks like, how common it is and its typical timeline from onset to recovery.
Moreover, we will show you how to tell normal hair shedding apart from hair transplant complications that require medical attention. Finally, we will present you with helpful tips and tricks to reduce the duration and intensity of your shock loss and prevent further, unnecessary hair thinning during this stage.
The insights and recommendations in this article are courtesy of Dr Peter Barron. Dr Barron specialises in FUE hair transplants and prides himself on his ultra-natural looking results.
Research suggests that shock loss usually occurs as a combination of two similar and temporary conditions that can cause diffuse hair shedding: telogen effluvium and anagen effluvium [1][2][3].
This temporary condition occurs when an excessive proportion of hair follicles go into the telogen (shedding) phase at the same time, causing diffuse hair thinning in the affected area [4]. It is commonly associated with stress and anxiety-induced hair loss. However, a physically demanding event, such as sudden weight loss, an illness or, in this case, a scalp surgery, can trigger it as well (find out more about hair loss after surgery). Our experienced surgeon, Dr Peter Barron, explains this phenomenon more clearly:
“Post-transplant shedding” is a recognised phenomenon that happens in almost every post-operative patient, anywhere from 2-4 weeks post-procedure, as the hair follicles enter their resting phase. About 10% of your scalp hair is resting at any one point; however, because follicles do this asynchronously, all over the scalp, we don’t notice it. The single physical stressor of moving transplanted hairs from the donor area to the recipient area, however, synchronises these follicles that have been moved, hence the hair shafts shed at a similar time.
This type of hair shedding is most often associated with medication-induced hair loss (e.g. chemotherapy hair loss). However, it can occur any time there is considerable disruption to the growth (anagen) phase of your hair follicles [5]. Temporary loss of access to resources your hair follicles need to keep producing healthy hair (e.g. being cut off from the blood supply during transplantation) can lead to this phenomenon [3]. Having a greater sensitivity to the local anaesthetic, which can constrict the small blood vessels in your scalp, can also play a role in this condition.
While anagen and telogen effluvium occur in follicles that are in different stages of the hair growth cycle, they both share the same major symptom: a substantial proportion of your hair temporarily falls out in the affected area.
The most visible, severe and often anxiety-inducing post-procedure hair shedding occurs in your transplant area. That is because it is the area most traumatised by surgery, but also the one you are most closely watching. Seeing your newly implanted hair fall out, often alongside some of your native hairs, can be concerning and difficult to ignore until regrowth finally starts, providing relief.
However, your donor area can sometimes also be affected by hair transplant shock loss. While this happens less frequently and is often less severe than in the transplant area, you may notice some native hair thinning around your graft harvesting sites. This is especially true if you had FUT surgery, which implies harvesting an entire strip of skin from the back of your head, cutting it up into grafts and suturing the wound [2]. The sizeable incision is a form of trauma to the scalp and may also sometimes sever small blood vessels which nourish the hair follicles in the area. So it is not uncommon to see some temporary hair thinning around the FUT scar or in the donor area in general. Fortunately, your shed hair will grow back in 3-4 months, just like it will in your transplant area.
Here is all you need to know about when you can expect your shock loss to start, how long it usually takes and when you can see your hair growing back:
As the name suggests, waking up one day to see your freshly transplanted hair falling out can be shocking, even if you are expecting this to happen. There is always one part of us that hopes we will be the exception and that we will be spared this extremely common side effect. Dr Barron captures the emotional charge experienced by patients at the onset of hair transplant shock loss:
Once they are comfortable, happy and getting used to seeing new hairs on their head (roughly three weeks post-op), it’s all going to be cruelly snatched away from them as the hairs shed and they begin to look similar to their pre-transplant appearance.
A good way to be prepared for this reality is to know when to expect it. Typically, you can expect to see the first signs of shock loss 2-3 weeks after your hair restoration surgery (although some may experience it as late as 4 weeks post-op) [2].
Fortunately, this post-surgical dormant stage of your hair follicles doesn’t last very long. After 3-4 short months after your hair transplant, you will be able to see the first signs of regrowth [2]. The new hairs will gradually break through the scalp, each at its own pace. They won’t be visible at first, although you’ll be able to feel them with your fingertips. While initially patchy, your transplanted hair will get denser over the next few months. It should grow as fast and steadily as your native hair. Dr Barron provides more insight into how patients experience this process:
Within the next three to four months, they’ll begin to doubt themselves as to whether the transplant has failed, until one day they’ll start to see small numbers of little hairs begin to wake up in a very patchy manner. At month five or six, there will be one week where the growth should take off, and they’re filled with excitement again as things start to take shape again. Almost every patient tells me how I was right with these predictions whenever they come to see me at follow-up.
Your transplanted hair will grow at different rates, slowly maturing for up to a year (or, in some patients, even eighteen months) before you see the final result of your hair restoration surgery.
Most qualified, experienced surgeons achieve a graft survival rate of at least 90% [6], so if your procedure was successful, you can expect almost all of your transplanted hair to grow back within the first year and a half post-op.
Once this process is complete, you will be able to enjoy your long-awaited results for the rest of your life, as well-maintained hair transplants last forever.
According to the experts, almost all hair transplant patients undergo this temporary shock loss period before being able to enjoy the results of their hair restoration surgery. This phenomenon is encountered in men as well as women and in patients of all ages and types of hair loss.
There are, of course, a lucky few whose hair follicles are extremely resilient and can withstand the stress of surgery without shedding. However, this is the exception rather than the rule. Researchers found that they make up less than 5% of all hair transplant patients [2]. So it’s best to be mentally prepared to experience some shock loss after your procedure.
The only visible symptom of shock loss is a rapid and pronounced hair shedding. Patients undergoing this phase of their hair transplant recovery should not experience any other scalp symptoms, such as inflammation, crusting, flaking, or a rash. On rare occasions, mild scalp burning (trichodynia) has also been reported. While some hair transplant redness may still persist, it is a different side effect of the procedure, unrelated to the shock loss.
In most cases, during this stage, you can expect your transplant area to look similar to the way it did pre-surgery. Moreover, some patients may experience even lower hair density than they had pre-surgery if some of their native hairs are also affected by shock loss.
When it comes to your grafts, it is common to shed the majority of the newly implanted hair in your transplant area. However, some of the native hair that was already there since the hair transplant may fall out as well, as a result of telogen effluvium. Dr Barron paints a clear picture of the most common scenario:
Expect almost 100% of the transplanted follicles to shed and potentially even some native hairs in the surrounding area.
Moreover, especially if you had FUT surgery, you may experience some visible shock loss in your donor area as well, especially around your scar.
While most patients experience shock loss after their hair restoration surgery, some patients are at a higher risk of developing more severe shedding than others. Here are some of the factors that can influence shock loss intensity and duration [2][7]:
While this procedure is generally safe and successful, hair transplants still carry some risks. A small number of patients encounter complications, some of which can cause hair loss. If they occur alongside shock loss (or around the time you are expecting its onset), they can be mistaken for normal post-surgical shedding. Here are a few complication signs which should never be ignored, or attributed to shock loss without discussing them with your surgeon [1] [2] [8]:
Shock loss is a normal part of recovery after hair restoration surgery, and it cannot be fully prevented. However, some things can help reduce the duration and, in some cases, the intensity of your hair shedding:
An inexperienced surgeon can do things that inadvertently make your hair transplant shock loss more severe, such as [2]:
However, experienced surgeons use a specific Shock Loss Prevention Protocol, meant to reduce the duration and severity of this phenomenon. This starts by performing a thorough dermoscopy of the recipient area and taking note of the properties of the native hair. Then, during surgery, being mindful of the following aspects:
As you can see, choosing an experienced surgeon to perform your procedure can have a considerable impact on your recovery process, as well as your results. If you want to be sure you are in the best possible hands, book a free hair transplant consultation with one of the world-class surgeons at the Wimpole Clinic. Their undeniable excellence is one of the main reasons we were voted Hair Transplant Clinic of the Year for 4 years running (2021-2024).
Science shows there are 3 main things you can do to help improve your shock loss and reduce its duration:
Aside from this, there are a few more things you can do to prevent further stress to your hair follicles, which may cause additional, unnecessary hair loss:
Normally, this common phenomenon requires no treatment, as it resolves over time without any kind of medical intervention. As stated above, hair growth medications and therapies can help shorten its duration, but your hair will still grow back within a few months even without using them.
No presently known treatment can make your shed hair grow back overnight or even sooner than at least 2 months post-transplant. Your hair follicles need to rest and recover after your surgery, and there is presently no known way to rush them right back into hair production.
While shock hair loss sounds dramatic, the hair shedding is almost always temporary. So, although it might cause you some anxiety initially, as long as you are following your post-surgery care advice, there is no need to worry, and the hair will grow back thick, full, and healthy.
If your hair does not grow back after shedding (or remains patchy even after a year or more), it is not because of the shock loss. It is a sign that your hair transplant has failed. That happens when a significant proportion of your implanted grafts have not survived. Unfortunately, this can only be fixed with a second hair transplant.
However, you can rest assured that this situation is extremely rare if you choose an experienced surgeon. We, at the Wimpole Clinic, are proud to report a 97-100% hair transplant success rate.
Normally, hair transplant shock loss should come and go on its own, with no need for medical intervention. However, be sure to let your surgeon know as soon as possible if you experience any of the following:
At the Wimpole Clinic in London, we have been performing expert hair restoration procedures for over 50 years. Our experienced consultation teams can take you through what to expect following the hair transplant procedure before you decide whether to opt for surgery. Book a free consultation to discuss any questions or concerns you have about the hair transplant process.
Couldn’t find the information you were looking for? Try reading the answers to these frequently asked questions:
No, the presence or absence of shock loss does not influence your hair transplant results in any way. So if you are among the lucky few who were spared this stage, feel free to relax and enjoy it – you are just as likely to achieve an excellent outcome as those who experienced hair shedding.
While some people experience Minoxidil hair shedding within 2 weeks of first starting this treatment, it is the same kind of temporary hair shedding you would be experiencing around this time anyway and lasts a similar period. In some situations, it may push a few more of your follicles into a dormant state than would normally enter it. However, research shows that using Minoxidil reduces the overall duration of shock loss.
Some patients experience an almost 100% shedding of their implanted hair during shock loss and they may even develop some shock loss on their donor area as well. However, you are unlikely to become fully bald. The shock loss is normally only that severe in your transplant area. In most cases, during this stage of recovery, your hair will look similar to its pre-surgery appearance.
The surgical method (FUT vs FUE) should not influence the shock loss in your transplant area, as both use the same implantation techniques. However, since the harvesting method is different, FUT may indeed carry a higher risk of donor area shedding than FUE, as the surgery is more invasive and has a longer recovery time.
Yes, since every person is unique, some patients can start experiencing shock loss a bit later than 3 weeks after their hair transplant. However, if more than 6 weeks have passed since your procedure and you are suddenly starting to experience new hair loss, it is best to let your surgeon know, as it may have a different cause.
Simply fill in your details and we’ll get in touch with you shortly.
Δ
Simply fill in your details in the form below and we'll get in touch with you shortly.
