Shock Loss

Shock loss is the shedding of hair after a transplant, affecting both the transplanted hairs and sometimes the native hair around them. It happens at around three to six weeks.

Where you'll meet it

Around week three to six after surgery, when most of what was planted falls out. Clinics use the term loosely. Strictly, some surgeons reserve "shock loss" for native hair shed around the grafts and call the loss of transplanted hairs simply "shedding", but in conversation both are called shock loss and the practical meaning is the same: hair comes out, follicles stay.

Why do transplanted hairs fall out?

Because moving a follicle is a trauma, and a traumatised follicle drops into a resting phase. The hair shaft it was carrying falls out; the follicle itself stays anchored in the skin and starts a new hair on its own timetable, generally from around month three. So the hair you see on the pillow or in the shower is not the graft. The graft is still in your head.

Not every transplanted hair sheds, and some people keep a fair share of them through the whole process. Either way is normal and neither predicts the final result.

What happens to the native hair?

Existing hair around the grafts can also shed, because the surgery disturbs the scalp around it: incisions, swelling and local anaesthetic all play a part. In most people this hair comes back over the following few months. Fine, miniaturising hair is the most vulnerable, and in someone whose loss was already active and untreated, some of it does not return, because it was close to the end anyway.

That is one more argument for being established on medication before surgery rather than starting afterwards. Some surgeons also suggest minoxidil around the operation to reduce native shedding; whether and when to use it is a question for your own surgeon, since many pause it for a short period either side.

Shock loss can occasionally happen in the donor area too, as a patch of thinning between extraction sites. It usually recovers in the same way.

How long does it last?

The shed itself typically runs for a few weeks. The low point, when the area looks barest, is usually around months two to three. New growth starts from about month three, fine and wispy at first, and the result is not judgeable until nine to twelve months, or longer for the crown and for body hair.

How do you get through it?

For a few weeks around month two the area can look thinner than it did before surgery. Knowing it is coming really does help. Monthly photographs in the same light are the most useful thing you can do, because growth on this timescale is invisible in a mirror and obvious in a sequence.

When to worry: if there is no sign of new growth by around month five or six, or if the shed comes with pain, spreading redness or pus, contact the clinic rather than waiting. After a transplant goes through the first year month by month.

← Back to the Glossary