Have I got shock loss?

Question

I had a hair transplant nearly 5 weeks ago and most of my existing hair is growing back except the front, have I got shock loss? I wasn't that thin at the front before hand, I've been on propecia for 2.5 months as it was meant to prevent shock loss?

Anil R. Shah, MD · Answer

Shock Loss may occur after hair transplant surgery. 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

If you are having increased hair loss after a hair transplant surgery it may be shock hair loss.  If you are concerned, follow up with your doctor.

Tim Neavin, MD · Answer

It is possible you are experiencing shock loss.  The good news is that it should grow back.  Be patient and be sure to follow up with your doctor.

Parsa Mohebi, MD, FISHRS · Answer

Shock loss is something that can happen after hair transplant.   Taking Finasteride starting from the time of your surgery to at least 6 months after surgery is known to help with shock loss.  Those shock loss hair may or may not grow back.  However, if the hairs you lost were hairs that were genetically programmed to fall out, those hairs may not return.  If you are concerned you need to discuss its possibility with your surgeon.

Kyle S. Choe, MD, FACS · Answer

It is very possible you are having a shock loss from your recent procedure. In most cases, hair will grow back to normal. Taking propecia is not a guarantee for preventing shock loss.

William Rassman, MD (retired) · Answer

Propecia (finasteride) is the best preventive treatment for shock loss that I know. It does not work 100% of the time.

Jonathan Ballon, MD (in memoriam) · Answer

From what you describe, it certainly sounds as if you are experiencing some shock loss. Taking Propecia/finasteride is no guarantee that shock loss can be prevented, especially after having taken it for only 2 1/2 months. But try to be patient--most of what you have lost will grow back starting in another 2-3 months; however, if the hair you've lost was genetically programmed to fall out anyway in the near future, it probably will not regrow. If you were my patient, I would advise you to use minoxidil and or a laser device in addition to the Propecia/finasteride, at least for the next few months. Bottom line: you'll need to give it at least 9-10 months to get an idea as to whether or not the transplanted hair + the regrowth of any shock loss will provide satisfactory density, or whether a 2nd procedure may be necessary to do that.

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