The shedding phase during months 1 and 2 after a hair transplant is the most psychologically difficult part of the recovery timeline. Transplanted hairs fall out, your scalp may look thinner than before surgery, and there is nothing to do except wait. This is completely normal and does not mean your transplant has failed.
This article is for informational purposes only and does not constitute medical advice. Consult a qualified hair loss specialist before making any treatment decisions.
What Happens During Months 1 to 2
After a hair transplant (FUE or FUT, both with 7 to 14 day initial recovery), the transplanted follicles go through a predictable sequence:
Week 1 to 2: Scabs form around each graft site. Redness and mild swelling are present. The transplanted hairs are still in place.
Week 2 to 4: Shock loss begins. Transplanted hairs start falling out as the follicles enter the telogen (resting) phase. This is not graft rejection. The follicle remains anchored in the scalp while the hair shaft is shed.
Week 4 to 8: Shock loss peaks and begins tapering off. By the end of month 2, most transplanted hairs have shed. The transplant zone may look bare or nearly the same as before surgery.
Why Shock Loss Happens
When a follicular unit is extracted from the donor area and placed into a recipient site, it experiences two types of trauma: physical disruption to the follicle structure and temporary loss of blood supply. The follicle's response is to stop growing hair and enter a resting phase while it re-establishes vascular connections in its new location.
This resting phase (telogen) is a survival mechanism. The follicle diverts its energy from hair production to healing and revascularization. The old hair shaft, no longer receiving nutrients, falls out. Once the follicle has rebuilt its blood supply and recovered, it re-enters the growth phase (anagen) and produces a new hair. This process takes approximately 3 to 4 months from the date of surgery.
What Is Normal During This Phase
| Symptom | Normal? | When to Worry |
|---|---|---|
| Transplanted hairs falling out | Yes, expected | Only if entire grafts (follicle and all) are dislodged in week 1 |
| Redness at graft sites | Yes, for 4 to 8 weeks | If accompanied by pus, fever, or increasing pain |
| Native hair shedding near transplant zone | Yes, temporary | If shedding spreads far beyond the surgical area |
| Itching at graft sites | Yes, sign of healing | If severe enough to cause scratching damage |
| Mild numbness in donor/recipient areas | Yes, temporary | If numbness worsens or persists past 6 months |
| Transplant zone looks thinner than before | Yes, expected | Not a concern at this stage |
Recipient Zone Shedding vs Native Hair Shedding
Two distinct types of shedding can occur simultaneously:
Recipient zone shedding (shock loss): The transplanted hairs fall out. This affects 50 to 100% of grafts and is unavoidable. Graft survival remains at 90 to 95% despite the hair shafts being lost.
Native hair shedding: Existing native hairs near the transplant zone may also temporarily shed due to the surgical trauma to surrounding tissue. This type of shedding is less common but more alarming because it makes the area look even thinner. These native hairs regrow within 3 to 6 months in the vast majority of cases.
How to Care for Your Scalp During Months 1 to 2
Follow your surgeon's post-operative instructions precisely. General guidelines include:
- Gentle washing: Start gentle shampoo per your surgeon's instructions, typically 48 to 72 hours post-op
- No scratching or picking: Scabs must fall off naturally, not be removed manually
- Sleep with head raised: Keep your head propped up for the first week to reduce swelling
- Avoid sun exposure: Protect the scalp from direct sunlight for at least 4 weeks
- No strenuous exercise: Avoid heavy physical activity for 2 to 4 weeks to prevent increased blood pressure to the scalp
- No swimming: Avoid pools, hot tubs, and ocean water for at least 4 weeks
Medications During the Shedding Phase
If you are taking finasteride (80 to 90% halt further loss) or minoxidil (40 to 60% regrowth), your surgeon will advise on timing. Most surgeons recommend:
- Finasteride: Continue throughout recovery without interruption
- Minoxidil: Typically paused for 1 to 2 weeks post-surgery to avoid irritation, then resumed
PRP therapy ($500 to $2,000 per session) is sometimes administered at the time of surgery or within the first month to support graft survival and reduce the shedding phase duration. Evidence for this benefit is promising but still being studied.
What Comes After the Shedding Phase
After months 1 to 2, your scalp enters a quiet period during month 2 to 3 where very little is happening visually. The follicles are alive and rebuilding beneath the surface, but no new hair is visible. The first signs of new growth typically appear between months 3 and 4 as tiny bumps or fine stubble.
For a look at the next milestone, see what to expect at month 6 and our guide on managing expectations during recovery.
Frequently Asked Questions
When will I see results after hair transplant?
Months 1 and 2 are the shedding phase, and your transplant zone will look thinner than before surgery. First new growth appears between months 3 and 4. Visible improvement begins around month 5 to 6, with full results at month 12 to 18.
Is shock loss after hair transplant normal?
Shock loss is completely normal and expected. It affects 50 to 100% of transplanted hairs between weeks 2 and 6. The follicles are alive beneath the skin and simply entering a resting phase. Native hairs near the transplant zone may also temporarily shed but will regrow.
How do I know if my hair transplant is working?
During months 1 and 2, you cannot assess whether your transplant is working based on appearance. Shedding is the normal process. The first positive sign comes at month 3 to 4 when you see small bumps or fine stubble emerging from the transplant zone.
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