Could Minoxidil 5% be causing extreme hair shedding, 7 months after FUE hair transplant? (Photo)
Doctor Answers 7
Extreme hair shedding
Thank you for your post and your photographs. It sounds from your history that the FUE transplantation went well and those been initial graft growth often growth occurs in two phases some shaft from the FUE family start growing immediately, other hairs will shed and start growing at 4-5 months. To have extreme shedding at 5 months is unusual and may in fact be related to Minoxidil, which can cause shedding as well as Propecia. In conjunction with your FUE surgeon you should devise a plan whereby you stop both and see and add additional low-level light therapy and see if some of these shed hairs, which are likely in Telogen Effluvium start to grow back.
If they do not grow back you may add a session of plasma rich protein to the scalp in conjunction with a low-level light therapy and paradoxically increase the concentration of your Minoxidil to prescriptive 8-15% serum with topical nutrients such as copper peptides, zinc and magnesium.
I have been performing FUE automated and robotic transplantation for many years and in general initial Telogen Effluvium of the recipient hairs occurs in the immediate to post-transplantation shock phase and delayed shedding like this points to other topical and physiologic causes.
The worst case scenario none of the hair grows back and you’re looking at doubling down on your density with a second FUE session if you had good FUE growth in the primary procedure. Best case scenario you’re Telogen Effluvium shed hair grows back.
I think these strategies will help you resolve the issue and I do hope you end up with an excellent result.
I hope this information has been of some assistance and best of luck.
For more information, please review the link below.
R. Stephen Mulholland, M.D.
Certified Plastic Surgeon
Shedding 7 months after FUE hair transplant
You could consider Low Level Laser Therapy (LLLT) as an alternative to Propecia. I personally like the wearable devices as offered by LaserCap. These are clinically proven to be effective and are very easy to use.
I would also suggest you ensure that there have been no changes to your general medical health, ie thyroid function, nutrition, etc.
Minoxidil causing extreme shedding 7 months after FUE procedure?
Thank you for writing in with your question. This is a little perplexing, as you should have quite a bit of growth by 7 months following your procedure. This may have something to do with you stopping your propecia. If you stopped your propecia around the time of your procedure or shortly thereafter, this may just be the resulting shedding as a result of stopping the propecia and allowing your DHT levels to increase. That can happen, particularly in younger men like yourself. It’s typically best to taper off of any medication like propecia or rogaine. I don’t think it’s likely that the rogaine is causing your shedding, but as I tell my patients, we need to wait 12 full months for the results of the surgery to be evident. I would stay on the rogaine, and I would consider taking finasteride twice a week to see if you can take it without the side effects. Also, adding low level laser therapy (LLLT) would be a very good idea, as this can really help to slow down hair loss, and in some cases, particularly in men under 35, it has the potential to actually grow hair back. I hope this information is helpful to you.
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Hair loss after transplant
For my patients who shed with minoxidil, I advise continuing minoxidil through the shed. I also advise getting blood work to check iron, thyroid, B12, hemoglobin and sometimes a few other things too.
Keep close tabs on your hair changes through monthly photos. You'll likely know in 6 months what the cause was.
If you stopped Propecia (due to side effects) you can have "catch up" hair loss where you lose all the hairs you gained from Propecia. This happens after several weeks to months.
Minoxidil can cause hair loss during the first month of use.
Hair shedding after transplant
Shedding at 7 months of the original hair
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