5th year FUE transplant and started to shed (photo)

Question

I had a 4000 graft transplant in 2020 and my hair grew out fine. I had a receding hairline and after the transplant I had a full head of hair. It was great for the first 4 years. The past year I noticed it started to shed a lot. I couldn’t see my scalp after the transplant but right now my scalp is very noticeable. I tried PRP and it helped but now it’s shedding again. Only the transplanted area is shedding. The rest of my head is not. I am going through a lot of stress lately but if it’s stressed related then shouldn’t all my hair shed and not just the transplanted area? Any advice or tips I can follow to regrow my hair?

Yasin Ilgaz, MD · Answer

Based on your photos and the timing, this looks like late miniaturization of transplanted grafts, which can happen when some grafts were taken from areas that are not fully permanent. That’s why the thinning might be occurring only in the transplanted zone, not the rest of your scalp. Stress-related shedding would be diffuse, not isolated to the front.
Yes, PRP can thicken hair temporarily, but it doesn’t protect grafts from DHT. At this stage, the only reliable way to stabilize the area is medical treatment. You can see your doctor and ask if you can use:
• A DHT-blocker such as finasteride (oral or topical) or dutasteride• Minoxidil (oral or topical) to increase hair caliber• PRP as an optional boost
Once the hair stabilizes, many patients need a small density-boosting touch-up of around 800–1500 grafts.
The good news is that this pattern is common, not a sign of rejection or scarring, and usually responds well to treatment.

Caner Kacmaz, MD · Answer

. Shock Loss or Telogen Effluvium (due to stress)
Stress can trigger telogen effluvium, but it usually affects the whole scalp.

If the rest of your hair is not shedding, it could mean that the transplanted grafts are more vulnerable to stress or other triggers — possibly because they’re no longer receiving optimal blood supply or have miniaturized over time.

2. Miniaturization / DHT Sensitivity
If the transplanted hairs were not fully DHT-resistant (sometimes happens with hair from the wrong donor zone), they can thin over time, especially if you’re not on DHT blockers like finasteride.

Even good grafts can be affected by systemic DHT levels over the years.

3. PRP Helped Temporarily, But Not a Long-Term Fix
PRP boosts growth factors and improves blood flow, but the effect is temporary.

If there’s an underlying issue like DHT sensitivity, PRP can’t fully prevent miniaturization.

4. No Maintenance Treatment Post-Transplant
Many surgeons recommend starting finasteride (oral or topical) or minoxidil after a transplant to maintain the results.

If you weren’t on any maintenance meds, your native (non-transplanted) hair or even some vulnerable grafts could start thinning.
 
PRP Maintenance
Since PRP worked for you, doing it every 3–6 months can help keep shedding in check.

5th year FUE transplant and started to shed (photo)

Answers (2)

More FUE Hair Transplant Questions

Does wearing a hard hat/safety helmet for long periods at work affect the transplanted hair?

FUE procedure (2000) grafts split into two procedures?

Hair transplant 6 months ago is super thin & patchy, worried it’s a fail or never going to be thick? (Photos)

Does plucking permanently remove multi-hair grafts from the hairline?

WE SEND PRETTY
EMAILS