Edmond Griffin, MD

What you are experiencing is not uncommon, and may even be only temporary. At any given time, from 6% to 8% of the hair follicles on the scalp are naturally in the telogen or “resting” phase, which usually lasts for about 100 days. Various factors, like accidents, illnesses, and significant hormonal shifts, can disrupt this cycle, forcing a disproportionate amount of follicles into the telogen phase at once. When this occurs, the effects are not necessarily noticeable right away, and patients may not experience widespread shedding until up to three months after the initial disruption. Once the underlying problem has been dealt with the hair follicles will usually resume their natural growth cycle, so hair that is lost as a result of telogen effluvium will most likely regrow by itself over the course of the next year.

This assumes, of course, that the underlying medical issues have been addressed. Platelet rich plasma works primarily by accelerating the transition of the hair follicle from the dormant telogen state back to the actively growing anagen state, so if your hormone levels have stabilized PRP therapy may definitely help. However, if you are still having thyroid problems, any change resulting from PRP will be minimal. I would recommend that you make sure your hormone levels have stabilized and wait to see whether your hair begins to regrow by itself. Telogen effluvium does not result in permanent damage to the hair follicles, so PRP will still be a viable option at that point.

Although it is very rare for complications to occur when your hair transplant surgery is performed by an experienced, board-certified dermatologist, it is important to note that every patient is different so a comprehensive, in-person consultation will be necessary in order to determine how many grafts you may need and what your specific health considerations may be. During that consultation, there are basically four extremely important questions that you should ask:

Are You Board Certified?  Although any licensed physician can attempt to perform hair transplantation surgery, only a doctor have with certification in an appropriate specialty, like dermatology or plastic surgery, will have the years of additional experience and training that you want.  Because dermatology specializes in the hair, skin, and nails, it is particularly applicable.

Do You Have Hospital Privileges?  Making sure that your doctor has surgical privileges at accredited, state-licensed, or Medicare-certified surgical facilities ensures that they can properly address any problems or emergencies that may arise.  Hospitals will only grant privileges to surgeons with a well-established track record.

Can I See Examples of Your Work?  The best surgeons will be more than happy to supply you with before and after hair transplant pictures and testimonials that will give you an excellent indication of the kind of results that you can expect. An extensive “portfolio” will show you that a doctor has experience with the procedure and can give you a better idea of what you should expect.

Who Will Be Performing the Surgery?  Some doctors may find it faster or more convenient to rely on technicians working under their supervision to complete part or all of a surgical hair transplantation procedure.  No technology can substitute for surgical skill, and only a highly experienced surgeon can place and angle each graft so that it blends seamlessly with the existing hair, providing natural-looking hair restoration results.

One of the most difficult challenges of transplant surgery is to avoid damaging the follicles, particularly when using the follicular unit extraction (FUE) technique. Because it is impossible to see the orientation of the individual follicles underneath the skin during FUE harvesting, each cut must be made blindly, and so even the most proficient and experienced surgeon may damage some of the follicles during the procedure. Additionally, after the cut has been made, tension must be applied to remove the follicles from the scalp, placing additional stress on the grafts and potentially causing further injury. This means that after harvesting there are often several follicles that are not suitable for transplantation, and so these must be discarded.


It may also be the case that, during implantation, your surgeon decided not to overcrowd the transplant area, since trying to force too many grafts into a small area can compromise blood flow to the scalp and place the health of every follicle in jeopardy. Still, assuming that all of the follicles that were implanted thrive in their new location and start to produce new hair, 3,800 out of 4,000 grafts would be a 95% survival rate. Although we routinely achieve higher survival rates by using the follicular unit grafting (or strip) technique, that percentage is actually very good for an FUE procedure and not a reason to be concerned.

Every individual case is different, and without a closer examination it is difficult to determine whether any damage might have been done. However, I do not think that you have anything to be concerned about. Most people don’t realize that even clear glass will naturally block most ultraviolet wavelengths, and glass that has been specially treated to block ultraviolet light (like the UV protective windows you mention) will block virtually all of them. The visible and infrared light that is able to pass through a window has virtually no chance of damaging your grafts. In fact, certain wavelengths of focused, red-spectrum (low frequency) light have even been shown to increase the energy production around the hair follicles and wake the cells from dormancy into an active growth phase. I often prescribe red light laser therapy to patients who have recently undergone hair transplant surgery to help maintain the hair on the head, prevent further thinning, and stimulate regrowth.

Although it is impossible to make a definitive diagnosis without examining your scalp personally and going over your medical history in greater detail, it sounds as though you may be experiencing shock loss, a relatively common complication that may arise from hair transplantation surgery. Follicular unit grafts that are packed too densely into a small area can potentially overtax the existing blood supply, impairing the growth of the hair follicles that are already in that location. Certain patients may even experience shock loss regardless of the amount of care taken during the procedure, but in such cases the effects are usually only temporary.

In our practice, we have found that non-surgical hair restoration treatments like platelet rich plasma and red light therapy can help improve circulation to the follicles and so can help to alleviate some forms of shock loss. However, it is also important to remember that most forms of hair loss are progressive, so it is not at all unusual for hair follicles that were healthy and vital at the time of the surgery to eventually start to show signs of deterioration. That is why we always recommend that our patients carefully adhere to a post-surgical hair maintenance plan that minimizes future hair loss.