Weeks 2 to 4 after a hair transplant mark the transition from acute recovery to the healing phase, where scabs resolve, shock loss begins, and the scalp returns to its normal state. This period is often the most psychologically challenging because the transplanted area may look worse before it looks better, but every change during this window is a normal step toward your final density result.
This content is for informational purposes only and does not constitute medical advice. Always follow your surgeon's specific post-operative instructions.
Week-by-Week Healing Timeline
Week 2: Scab Resolution and Early Shedding
By week 2, the small scabs that formed around each graft site begin loosening and falling off naturally during gentle washing. This is an important milestone because it means the tiny wounds have closed and the grafts are secured.
What happens this week:
- Scabs loosen and begin detaching during washes
- Some transplanted hairs start to shed (the beginning of shock loss)
- Redness decreases noticeably compared to week 1
- Swelling has fully resolved for most patients
- The donor area continues healing (FUE dot scars fading, FUT incision maturing)
Scab removal by graft count:
| Graft Count | Scab Resolution Timeline | Notes |
|---|---|---|
| 800 to 1,500 | Most scabs gone by day 10-12 | Smaller area, faster resolution |
| 1,500 to 3,000 | Most scabs gone by day 12-14 | May have stubborn scabs in thicker areas |
| 3,000 to 5,000 | Scabs resolve by day 12-16 | Larger treatment zone takes slightly longer |
| 5,000+ | Full resolution by day 14-18 | Mega sessions may have extended scabbing |
Week 3: Shock Loss in Progress
Week 3 is typically when shock loss becomes most noticeable. Transplanted hairs that were visible during weeks 1 and 2 begin falling out. This can be alarming, but the follicle roots are securely anchored in the scalp and will regrow.
What happens this week:
- Noticeable shedding of transplanted hairs during washing and throughout the day
- The transplanted area begins looking thinner or similar to its pre-surgery appearance
- Native hairs near the transplant zone may also start shedding
- Scalp may feel itchy as deep healing continues
- Most patients can return to all normal social activities
Week 4: Transition to Dormancy
By the end of week 4, the acute healing phase is essentially complete. Most scabs are gone, redness has faded significantly, and the scalp looks relatively normal. Shock loss continues but is no longer accelerating.
What happens this week:
- Scalp appearance nearing pre-surgery normalcy
- Shock loss continues at a steady rate
- Donor area healing is well advanced
- No visible new growth yet (this is completely normal)
- Safe to resume most physical activities per your surgeon's guidance
The Healing Process by Graft Count
The number of grafts placed affects the scale of healing, though the biological process is the same.
Small Sessions: 800 to 1,500 Grafts
The healing footprint is limited. By week 3, the transplanted temples or hairline area is nearly indistinguishable from the surrounding skin. Shock loss is limited to a small zone, and the overall recovery feels minimal. Most patients resume normal activities by the end of week 2.
Medium Sessions: 1,500 to 3,000 Grafts
The frontal zone shows more visible healing during weeks 2 to 3. Pink skin where scabs have fallen off gradually normalizes. Shock loss is more visible because it affects a larger area. By week 4, the scalp color has evened out and the area looks clean.
Large Sessions: 3,000 to 5,000 Grafts
Larger sessions mean a wider zone of healing and more extensive shock loss. The transition from scabbed to healed to shedding is more visually dramatic. Some patients notice the contrast between the transplanted zone (which is shedding) and untreated areas. Patience is critical during this phase.
Mega Sessions: 5,000+ Grafts
With extensive coverage, the entire top of the scalp goes through the healing cycle. Scab resolution may take up to 18 days. Shock loss can be significant, with patients temporarily losing most visible evidence of the procedure. This is normal for mega sessions and resolves with regrowth starting at month 3.
Scalp Care During Weeks 2-4
Washing
By week 2, most surgeons allow more normal washing, though gentle technique remains important.
- Use the medicated shampoo prescribed by your surgeon
- Apply shampoo with fingertips using a gentle patting motion
- Allow lukewarm water to flow over the grafts (avoid direct shower pressure until week 3)
- By week 3 to 4, you can typically return to normal shower pressure per surgeon guidance
- Pat dry with a soft towel; do not rub
Scab Management
| Approach | Safe? | Details |
|---|---|---|
| Gentle soaking during washing | Yes | Helps scabs loosen naturally |
| Picking or scratching scabs | No | Can dislodge grafts and cause scarring |
| Using baby oil to soften scabs | Depends | Some surgeons recommend it; always ask first |
| Letting scabs fall off naturally | Yes | The safest approach |
Activity Resumption
| Activity | Week 2 | Week 3 | Week 4 |
|---|---|---|---|
| Desk work | Safe | Safe | Safe |
| Light walking | Safe | Safe | Safe |
| Moderate exercise | Not yet | Light cardio OK | Moderate intensity OK |
| Weight lifting | Not yet | Not yet | Light weights with surgeon approval |
| Swimming | Not yet | Not yet | Not yet (wait until week 6+) |
| Contact sports | Not yet | Not yet | Not yet (wait until week 8+) |
| Hat wearing | Loose, no pressure on grafts | Loose hat OK | Normal hat wearing OK |
Emotional Aspects of the Healing Phase
Weeks 2 to 4 are when many patients experience doubt about their decision. The transplanted area has lost its initial post-op fullness (due to shock loss), and the scalp may look no different from before surgery. This is sometimes called the "ugly duckling phase."
Managing Expectations
- Review your pre-surgery photos alongside current photos to remember where you started
- Refer to a complete hair transplant growth timeline to confirm your progress is on schedule
- Remember that growth does not begin until month 3; weeks 2 to 4 are purely about healing
- Consider joining a hair transplant community for support from others in the same phase
Medications and Supplements
| Treatment | Status During Weeks 2-4 |
|---|---|
| Finasteride (1mg daily) | Continue if prescribed; halts loss in 80-90% of users |
| Minoxidil | Resume per surgeon's timeline (often week 2 to 4) |
| Antibiotics | Typically completed by end of week 1 |
| Biotin supplement | Safe to continue; supports hair health |
| Multivitamin | Recommended for overall recovery support |
What Comes Next
After week 4, you enter the dormancy period (months 2 to 3) followed by early growth starting around month 3. Check density expectations by graft count for what to expect at each upcoming milestone.
Check Your Hair Loss Stage
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This article is for educational purposes only and does not replace professional medical advice. Consult a board-certified dermatologist or hair restoration surgeon for diagnosis and treatment recommendations.