View Full Version : What to expect – shedding and growth

11-13-2015, 07:31 AM
Post op shedding

One of the most misunderstood aspects of hair transplantation is the shedding of the new hair. Many patients either aren’t told, or they become temporarily deaf at that point, that the majority of the newly transplanted hairs will fall out, in a process known as anagen effluvium, within the first three to eight weeks. Often, this happens in a wave at about week three to four.
This is perfectly normal and to be expected for 90% of the new grafts. They return from about three to six months post-op. Initially, they emerge as finer hairs, and gain length and diameter as their growth continues. By the end of the first year, the ‘new’ hairs should be as robust as the other, ‘native’ terminal hairs. They will also gain length at the same rate as non-transplanted hairs, which is roughly one half inch per month.

Sometimes during this first month, you may notice small hairs being shed along with their bulbs. They may even come out along with the small scabs within the first week or two. All this is normal; the part of the follicle which germinates new hair is still inside at the base of the follicle. Unless there is bleeding at a graft site, you haven’t lost the graft. Occasionally there is some textural change in the transplanted hair. It may become curlier than it was, or even somewhat wiry. This change in texture is temporary, and resolves itself with the normal growth cycles of the hair often in twelve to eighteen months.

Seasonal shedding

Seasonal shedding also becomes more significant when you’ve had a hair transplant. It is something that you need to be well aware of so that when it’s your time and it occurs, you do not panic and start organising your next HT in a desperate attempt to regain your lack of ‘density’.

Shedding unfortunately is part and parcel of the HT process. Seasonal shedding happens to us all. I personally experienced a shed recently which left my hair looking very thin and even though I knew it was only a shed it still made me anxious and very self conscious – it does every time. BUT I know through experience it is the periodic ‘shedding process’ and that given time it will slowly but surely come back in. Yes a waiting game ...yet again! (See ‘Patience!’ topic and videos I've made!)

When it does occur just ride it out and try your very best not scrutinise it by watching it, applying products, washing it, conditioning it, washing it again ;-) Also when you shed and then it returns...remember for the next time in order to limit the anxiety levels associated with it. You need to be aware that HT 's, when they shed, do expose the fact that they perform the ‘art of illusion’. Transplanted hair is not dense, like a ‘normal’ head of hair - but can give the illusion of density with skilled placement performed appropriately with accurate direction and correct use of your hair characteristics. HT's appear thicker than they actually are – until a dreaded shed.

When you shed say 25%, if not more, in a ‘shed cycle’ it makes the HT area appear thin in comparison to pre shed. This is when the panic and anxiety sets in. I have experienced many sheds and it still unnerves me most times. Best advice I can give is be patient (again) and it will all come back in over time - often three to four months. Consider taking MSM, if you are not already, just to help things along. Help the overall health of your hair with relevant hair vitamins (see spexhair.com products section for a reliable source).

DO NOT start applying Minoxodil or Nizoral shampoo (if you are not a regular applier) to boost growth. Big NO NO!! It may only shed more. The best thing you can do is focus on something else to take your mind off it; it will come back in much quicker if you do.

Post op growth

You will scrutinise your results constantly, inspecting it every chance you get and feel that you will always want more hair. Even at months five to seven patients are planning their second session, but my advice is WAIT and allow for the first session to reach its maximum potential at around twelve to eighteen months.

It doesn't matter how many times I say it to people, or write it, they still feel that their growth has stopped at month four, five, six, then come month ten, eleven, twelve, they say ‘wow you were right... I did get more’.

Growth doesn't stop - it can take up to 18 months to reach the max potential from your HT so why guys are convinced after five months their growth has stopped is just beyond me. If you have received your HT from one of the reputable clinics around today then your growth will continue along with a great deal of maturing.

You the HT recipient will not see the growth just occur; it takes months for the realisation to kick in. It is important to take pictures at monthly intervals to clearly see the progression. I’m going to reiterate this: 8 -18 months is an important time frame when the growth becomes more noticeable. You will not get the full result from your HT until at least twelve to eighteen months!

I think everyone needs to be made aware that even after a whole year there is still a great deal more in store, i.e. thickening and maturing and further development in general. It’s important that you realise that HT's are a commitment long term and you will always want to refine your hair and wish it were thicker/fuller/denser - this is the nature of hair.


11-13-2015, 11:10 AM
Hi Spex
When attending a HT consultation how should a doctor check for Donor Density?

11-14-2015, 11:54 AM
Do the transplanted hairs that don't shed grow immediately after? I shed a ton of transplanted hairs already but there are still a lot and many of them seem to be getting longer. Im not sure if those are native hairs or not. I'd love to retain enough to use concealers and go out in public

11-18-2015, 03:01 AM

Paget - The donor might well inspect your donor region with his naked eye and look through the entire region by combing through or might look a little closer with magnification to see the extent of miniaturisation.

Brock - HT might well not shed after the HT. It might simply stay there and rest or in rare cases grow straight away !


11-18-2015, 08:01 PM
When you're going through seasonal shedding and lost a lot of native hair, when should those hair grow back?

My transplanted hair at 11 months seem to be 90% but it's the thinned out native hair I'm concerned about. Could the native hair also take 12-18 months to restore its pre-op density?

11-19-2015, 02:57 AM
Hi Asain guy,

Seasonal shed can be brutal - Try not panic. Get yourself on MSM and Biotin and ride it out - Generally it will take 3-4 months to cycle.

A topic i wrote previously : Seasonal Shedding (https://www.baldtruthtalk.com/threads/1028-Seasonal-Shedding-of-Hair-transplants?highlight=seasonal+shedding)


12-12-2015, 03:30 PM
By seasonal sheds do you mean once a year the areas that were transplanted at the same time shed together? Even several years after the transplant?

12-31-2015, 10:02 AM
That seasonal shedding information was beyond useful. I think I'm going through one of those at the moment and it is quite unnerving. Thanks for the help. :)

I am a patient advocate for Dr. Parsa Mohebi in Los Angeles, CA. My opinions/comments are my own and do not necessarily reflect the opinions of Dr. Mohebi and his staff.

12-31-2015, 01:28 PM
Hey Spex this is great advice for new HT patients, seeing your new HT hairs falling out around you can cause panic, I even think 18 months and even 24 months should be given before scrutinizing a HT and deciding how successful HT has been.

01-01-2016, 12:52 AM
Thank you Spex for posting this. I'm one week out past the 5 month mark of 1431 FUE grafts. I'm guilty of the the aforementioned: washing, applying product, conditioning, washing again... in the hopes that perhaps (illogically) if I this enough everything will come back. I feel like applying Regenepure DR was the catalyst for my shed. I'm apply minoxidil every other day to every 3 days (Unfortunately it affects my asthma) but never really had tremendous success with it even prior to the transplant. Difficult to track progress of native hair now but on finasteride as well.