Thank you for your question! I understand you had a hair transplant, but after a year, you noticed fewer transplanted hairs left. You also state that you’re using 15% minoxidil, and you’d like to know if minoxidil can damage or kill hair grafts.Hair transplants have been big part of my practice, so I can give you some guidance on this.I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic surgeon, practicing in Manhattan and Long Island for over 20 years. I’m also the founder of Trichostem™ Hair Regeneration centers, which offers a non-surgical alternative hair loss treatment we developed using wound healing technology.With regard to your question, if we can’t get something which is over-the-counter, like a 5% minoxidil, we believe that there is value in using a higher percentage. I don’t know exactly when you had your hair transplant, but if we’retalking about the transplanted hair one year after transplantation, then it may not just be solely about the minoxidil causing hair grafts to shed and not come back, but it also might bethat you caught the transplanted hair in a particular stage in the growth cycle.It’s important to understand the hair growth cycle, which is comprised of the anagen, catagen and telogen phases. The anagen phase is the active growing phase; the catagen phase is the resting phase when the hair is present but is not actively growing; and the telogen phase is where hair sheds.During the telogen phase, there is a minimum 3-4 month delay before new hair growth occurs.In hair thinning or hair loss, the anagen phase decreases, and the telogen phases increases, which means you are losing more hair than your body is able to replace. When hair does grow back, it grows back thinner. Now, minoxidil helps with hair thinning by prolonging the growth cycle or the anagen phase,which means that the hairs that are progressively thinning at least stay a little longer.In our practice, we treat hair loss with something called Hair Regeneration, and we’ve found that we’ve been much more successful in stopping hair loss progression in people with existing thinning hair. In fact, we’ve been able to do away with hair transplants and drugs like minoxidil. As we’ve been doing this for many years, we’ve been able to gather a lot of clinical data (3-5 years’ worth) demonstrating its effectivity.With respect to transplanted hair, which is harvested from the genetically resistant zone or donor area, by definition they should not be shedding.Those hairs should actually be fairly resilient and be able to grow. However, what people overlook is the fact that sometimes, a certain percentage of hair grafts don’t make it in the first place – they don’t continue to grow. If, for example, you had a standard FUT or FUE procedure, there’s a certain loss involved due to transection.In the case of FUEs, approximately 30% of hairs become transected, which means that those hairs don’t actually have the root when they’re placed so they can fall out. At this point, I suggest that you meet with the doctor who performed your surgery, and thedoctor who is prescribing the 15% minoxidil, so you can get clarification on your situation, and why you need to continue using minoxidil. There is a possibility that the minoxidil itself maybe inflammatory or irritating to the scalp, and it might be causing some breakage or some potential shedding of the hairs, or that these hairs are just temporarily not growing, but as I do not know the details I cannot say this for certain.Again, I advise you to meet with your doctor, review your photos, and try to observe anddocument what it looks like 3 months from now, 6 months from now, 9 months from now.I hope that was helpful and I wish you the best of luck!This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.
