Months 1-2 after a hair transplant are the shedding phase. Nearly all transplanted hair shafts fall out during this period, leaving the treated area looking similar to or thinner than before surgery. This is a normal part of the transplant cycle and does not mean grafts have failed.
What Happens During the Shedding Phase
The shedding process follows a predictable biological sequence:
Week 1: Transplanted hairs are still in place. The scalp shows redness, tiny scabs around each graft, and mild swelling. The transplanted area may temporarily look denser than expected because the transplanted hair shafts are still attached.
Weeks 2-3: Scabs begin to fall off, often taking the transplanted hair shafts with them. This is shock loss beginning. The hair shaft detaches from the follicle, but the follicle root and dermal papilla remain alive beneath the skin surface.
Weeks 3-6: Peak shedding period. Between 50-70% of patients experience noticeable hair loss from the transplanted zone. Some patients lose nearly all visible transplanted hairs. Others retain some hairs that skip the shedding phase entirely.
Weeks 6-8: Shedding is complete. The transplanted zone may look nearly the same as before surgery. The follicles are alive but dormant beneath the surface, preparing to enter a new growth cycle.
Does Graft Count Affect Shedding?
The number of grafts transplanted does not change the shedding rate, but it changes how noticeable shedding appears:
| Graft Count | Shedding at Weeks 2-6 | Visual Impact |
|---|---|---|
| 800-1,500 | Same rate (most hairs shed) | Less noticeable since fewer hairs were added |
| 1,500-2,500 | Same rate | Moderate visual change as transplanted hairs fall |
| 2,500-4,000 | Same rate | More noticeable since larger area affected |
| 4,000-6,000+ | Same rate | Most dramatic visual change, can cause significant anxiety |
Patients with higher graft counts often experience more anxiety during shedding because the visual change is more dramatic. A patient who had 5,000 grafts placed may notice substantial shedding across a large area, while a patient with 1,000 grafts sees a smaller difference.
Why Shedding Happens
Transplanted follicles undergo a process called catagen induction after being relocated. When a follicle is extracted from the donor area and placed in a recipient site, it experiences:
- Severed blood supply: The follicle loses its original blood vessels during extraction
- Temporary nutrient deprivation: Until new blood vessels form (angiogenesis), the follicle operates on stored energy
- Growth cycle reset: The trauma signals the follicle to shed its current hair shaft and enter telogen (rest phase)
- New cycle initiation: After 2-4 months of rest, the follicle re-enters anagen (growth) and produces a new hair
This process is similar to how healthy hair naturally cycles through growth, rest, and shedding phases. The transplant simply forces all grafts into the shedding phase simultaneously.
Protecting Grafts During Months 1-2
While shedding is unavoidable, protecting the grafts during this fragile period supports maximum survival:
Days 1-10: No touching, rubbing, or scratching the transplanted area. Sleep on your back with head elevated. Grafts are not fully anchored and can be dislodged.
Days 10-14: Gentle washing with prescribed shampoo. Let water run over the grafts without direct pressure. Pat dry with a soft cloth.
Weeks 2-4: Resume gentle washing. Avoid hats that press tightly against grafts. No swimming, saunas, or intense exercise that causes heavy sweating.
Weeks 4-8: Most restrictions lift. The grafts are securely anchored. Resume normal activities including exercise and hat-wearing.
What Not to Do During Shedding
Common mistakes that can harm graft survival during months 1-2:
- Picking at scabs: Let scabs fall off naturally. Pulling them can extract the graft with the scab
- Using Rogaine/minoxidil too early: Wait until your surgeon clears you (usually week 2-4) before applying topical treatments
- Panicking and stopping medications: If prescribed finasteride, continue taking it. Stopping during shedding does not affect transplanted grafts but may cause additional native hair loss
- Obsessive mirror checking: Daily inspection during shedding causes unnecessary stress. Photos once per week are sufficient
When Shedding Is Abnormal
While shedding of transplanted hairs is normal, certain signs warrant contacting your surgeon:
- Severe pain, increasing redness, or warmth at the graft sites after week 2 (possible infection)
- Pus or unusual discharge from multiple graft sites
- Significant shedding of native (non-transplanted) hairs in areas far from the treated zone
- Fever above 38.5C (101.3F) in the first two weeks
These symptoms are uncommon but require prompt medical evaluation.
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Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Individual results vary based on patient health, surgeon skill, and adherence to post-operative protocols. Consult a board-certified hair restoration surgeon for personalized guidance.