Hair Transplant | Recent Hair Transplant - Losing A Lot of Hair | Shock Loss

Recent Hair Transplant - Losing A Lot of Hair | Shock Loss

I recently had a hair transplant, about 5 months ago and I think I’ve lost a lot of hair. Is it possible for a hair transplant to make your hair worse?

“Shock Loss” after hair transplantation is a well known phenomenon and occurs with loss of existing hair in the recipient site. Generally shock loss is temporary and reversible. Whether it is reversible depends on thecause or causes. There are a number of possible causes of shock loss.

1. Existing hair is cut above the surface during making of incisions. This is like a hair cut and 100% reversible.

2. If a lot of hair is present prior to the transplant (existing hair) and care and time is not taken to preserve existing follicles during the making of incisions, these follicles can be damaged with the instrument that thephysician uses to make the recipient sites. This loss of the follicles can be permanent due to direct trauma.

3. Hair follicles normally cycle into the telogen (resting) phase. From 50-100 hairs are normally shed each day. By spraying and wiping during the surgery to see the spaces between hairs to avoid damaging the hairs,paradoxically, hairs which would normally shed in the future are essentially pulled out on the day of surgery. This cause of shock loss is completely reversible.
4. Injection of anesthetic with vasoconstrictor may increase the amount of shock loss especially due to the vasoconstrictor and especially its action on hairs which are miniaturized and would be lost in the future. This potential cause of shock loss is more theoretical and it’s impossible to say if it’s permanent or temporary.

Application on minoxidil prior to and after hair transplantation can decrease the incidence of shock loss. Even at five months post op use of minoxidil could help although shock loss should be complete after a fewmonths. At five months post op, the transplanted hair and shocked hair are just beginning to re-grow so one would have to wait a full year to see the final result of any hair transplant. When full and appropriate care is taken during the making of recipient sites there should be little to no shock loss experienced by the patient.

So it is possible to have a net loss of hair after a transplant if care isn’t taken to avoid direct trauma to existing hair during the making of incisions and if there are a lot of miniaturized hairs just “hanging on”.Again, I would recommend the use of minoxidil to induce growth of existing and transplanted hair and finasteride to retain existing hair. Good luck and remember you must wait for a year to evaluate the full effect of your transplant.

Bradley R. Wolf, MD
Medical Advisor, IAHRS