Native hair loss after hair transplant with a white bulb at the end? shock loss?

Question

12 weeks ago I had a HT with FUT technique . From last 3-4 weeks I can see few of my native hairs (nearby by the transplanted area) are falling out with white bulb at the end . It seems to me those hairs are good hair & thick / z-black . Is that for shockloss ? I am not taking any medicine just using Biotin from last many years . Rogine does not work for me(I tried it for 2 years) & not using finasteride as i dont want to use it for long term . Does those hairs that i am loosing will come back ?

Donovan Rosas, MD · Answer

Shock loss is not an uncommon phenomenon which usually accompanies grafting in an area of persistent native hair growth. This is likely the result of an interruption of blood flow to hair in the resting phase (telogen). It  occurs in about 5% of cases (more common in women) and is usually temporary beginning 2-3 months post procedure and recovering after.As always, discuss your concerns with a board certified plastic surgeon (ABPS) with experience in hair restoration.

Anil R. Shah, MD · Answer

Shock loss is due to the loss of normal hair whether it is from donor site or recipient area.  It can occur with both FUE and strip procedures.  Usually if it occurs it will take place in the recipient area.  
Shock loss from hair transplant can occur due to the following:
Anesthesia-  excessively long procedures taking longer than 12 hours can induce shock loss more likely.  the repeated use of lidocaine, marcaine, and perhaps most importantly epinephrine can affect nourishment of the hairTraumatic harvest-  In strip surgery, traumatic harvest can induce shock loss.  Recipient area trauma- during the incision making process the hairs are either crushed or cut and damaged during the process. 
Ways to minimize shock loss are as follows:
Improve recipient bed and donor area environment.  Make your recipient environment improved by addition of growth factors and/or PRP to help reduce incidence of shock loss to native hairs.Use of Rogaine and Propecia- can help miniaturized hair become more stable and less likely to fall out during procedure9xRobotArtas-  The latest version of the robot can make recipient sites and can determine angle of existing hair and help ensure that the angle will not damage existing hair.  Especially helpful in patients where you are transplanting hair to create densityMinimize anesthesia time and procedure time- We limit number of grafts to a safe number per session.  Extended anesthesia periods and harvest times can cause patients to have a higher chance of shock loss.  The 9x Robot harvests between 1000-1500 grafts per hour making it superior to previous additions and traditional FUE approaches.Best, 
Anil Shah

Jae Pak, MD · Answer

It is normal to lose transplanted hairs weeks after surgery.  It may take 6 to 12 months to see new hairs grow out.

William Rassman, MD (retired) · Answer

Shock loss is the loss of native hair after a hair transplant. When it occurs it is difficult to treat other than the best prevention which is the drug finasteride.  See below

Native hair loss after hair transplant with a white bulb at the end? shock loss?

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