Hair loss of transplanted hair after emotionally traumatic experience: Is it permanent?

I had a hair transplant 3 months ago , the density was good. However, yesterday I was involved in a motor vehicle accident and the next day I noticed a significant difference in the hair density of the transplanted area. Fact: "When the male body is stressed, it produces additional testosterone and adrenaline. Additional testosterone means more DHT which often leads to hair loss in men." My question: will the hair eventually grow back? (IMPORTANT : There was no physical injury in the accident)

Doctor Answers 4

Post-Traumatic Shedding

Intriguing question! While you are correct that stress does cause the body to produce additional adrenaline, it also increases the production of the hormone cortisol, which actually blocks the activity of testosterone, so it is unlikely that it will exacerbate the progression of genetic pattern hair loss, or androgenetic alopecia, directly. The hair loss that you are experiencing is far more likely to be the result of telogen effluvium, which most often occurs when the body’s natural hair growth cycle is disrupted by a significant change in the body’s chemistry.

Hair follicles on the scalp do not continuously produce hair.  Instead, they progress through a regular growth cycle consisting of three stages: anagen (growth phase), catagen (transition phase), and telogen (resting phase).  During the anagen phase, new hair is formed and gradually grows from the follicle. Eventually, the hair progresses into the telogen stage, when it loosens in the follicle and subsequently falls out.  Normally, only about 15% of the hair follicles are in the telogen stage at any given time, and so a healthy scalp sheds anywhere from 50 to 100 hairs each day, a negligible amount that is easily replaced by newly growing hair.

During extremely stressful situations, however, the body can trigger a disproportionately large number of hairs to move into the telogen phase all at once.  This means that the hair begins to shed in significantly larger amounts than usual, causing diffuse thinning over the entire scalp. Anything that can cause a shock to the body can potentially cause telogen effluvium, from physical trauma, such as being in a car crash or undergoing major surgery, to crash dieting that starves the body of necessary proteins.  Even significant emotional stress, like the death of a loved one or a divorce, can prompt changes in eating and sleep patterns that the body can interpret as dangerous stress, resulting in the same symptoms. 

Fortunately, the hair loss from telogen effluvium is usually temporary, especially if you suffered no physical damage from your accident.  Unlike the hair loss that occurs as a result of androgenetic alopecia, the hair follicles are not permanently or irreversibly damaged; there are simply more hair follicles in a resting state than there should normally be.  Once the external cause of the stress is over, the hair follicles should return to their growing state and start producing new hair fibers within six months.  However it is extremely important to remember that your underlying genetic pattern hair loss is a progressive condition and that that you must continue post-transplant maintenance treatments and/or medications in order to keep additional shedding from occurring.

Atlanta Dermatologic Surgeon
4.0 out of 5 stars 6 reviews

It would be very unlikely to lose significant hair a day after a car accident due to emotional stress or adrenaline.

It would be very unlikely to lose significant hair a day after a car accident due to emotional stress or adrenaline.

Jae Pak, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 90 reviews

Hair loss of TP after stressful event

November,You had good density 3 months after a hair transplant, that is one of the fastest hair transplant growth rates ever, as it typically takes between 4-8 months, sometimes longer to grow. But your hair loss 1 day after a stressful event, is surreal. Stress or an inciting event will take 3 months to trigger an effluvium, or hair shedding. I am unsure of what is occurring, would recommend a thorough evaluation with a good hair restoration physician.
Bernardino A. Arocha, MD

Bernardino Arocha, MD, FISHRS
Houston Hair Restoration Surgeon
5.0 out of 5 stars 10 reviews

Stress and hair loss

Yes, stress is a contributing factor in male genetic hair loss. Stress can accelerate the process. Drugs like finasteride, protect and may stop the progression of the hair loss

William Rassman, MD
Los Angeles Hair Restoration Surgeon
5.0 out of 5 stars 27 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.