Can hair transplant fall out it if using finasteride for the 1st time?

Question

I was wondering about starting oral finasteride after my hair transplant as I’ve never taken it before. I have had two hair transplants. I want to know will starting oral finasteride after my surgery make my implants fall out as my surgery is next month in October. I currently take 5mg of minoxidil and topical dustasride.

Anna Chacon, MD, FAAD · Answer

Thank you for your thoughtful question.

Starting oral finasteride after a hair transplant will not cause your transplanted hairs to fall out. Transplanted hairs are typically taken from the permanent donor zone (usually the back or sides of the scalp), which are genetically resistant to DHT (the hormone implicated in male pattern hair loss). These transplanted hairs retain their DHT resistance even when moved to thinning areas.

What may happen, however, is shedding of native, non-transplanted hairs that are still susceptible to DHT. This is a phenomenon known as "shock loss" or initial shedding, and it can occur when starting finasteride or after hair transplant surgery itself. The shedding is usually temporary and is often followed by regrowth over time.

Since you’re already on topical dutasteride and minoxidil, you’ve been proactively managing DHT and stimulating hair growth. Adding oral finasteride can further enhance your results by preserving native hair and possibly improving density in the long term.

In summary:

Finasteride will not affect transplanted hairs negatively.

It may help protect and preserve surrounding native hairs.

Shedding of native hairs is possible but typically temporary.

Always consult your surgical team before making medication changes around the time of your procedure, but starting oral finasteride post-transplant is a widely accepted and supportive step in most hair restoration protocols.

Marco Barusco, MD · Answer

Hello,

Starting oral finasteride after your hair transplant will not cause your implants to fall out. Finasteride works to stabilize hair loss by reducing DHT, which can protect your existing hair and support the long-term success of your transplant. Adding it to your routine alongside minoxidil and topical dutasteride can be beneficial. Be sure to discuss timing and dosage with your doctor to ensure a smooth transition.

Best regards,
Dr. Marco Barusco

Ross Kopelman, DO · Answer

Starting oral finasteride after your hair transplant should not cause your transplanted hair to fall out. In fact, finasteride is often recommended post-transplant to help maintain the existing hair and prevent further hair loss. It's great that you're already on minoxidil and topical dutasteride, as these treatments support hair growth as well. However, since finasteride works by blocking DHT, a hormone that contributes to hair loss, it can sometimes cause a temporary shedding phase known as "shock loss." This is where some of your natural hair may shed before it starts to regrow healthier and stronger. But rest assured, this doesn't affect the transplanted hair, as it’s generally more resistant to DHT.

Can hair transplant fall out it if using finasteride for the 1st time?

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