2020-01-16 04:00:142019-11-06 12:50:055 Months on Finasteride on My Hairline (Photos)
Dr Rassman
I recently had transplant surgery at a reputable office to combat thinning hair on top and a receding hair line. I am 48 years old. I was suprised by what I believe was a fair amount of shock loss around the graft areas given my age. I was not on propecia pre-surgery but began taking it a few days following the procedure after reading your column. Now I believe propecia can also cause shedding in the early months. Could you explain the difference between shedding and shock loss and what you believe I am experiencing. Maybe a combination of both.Thank you
It sounds like you experienced shock loss and if this is in the miniaturized hair, the hair may not come back. Treating thinning with transplants is not something I do often. In many people with miniaturized hair, transplanting into that ‘unhealthy’ hair does little to really increase the fullness. I believe that for most people like you, any benefit you will get in the long term may be lost in the short term, making transplants a poor decision. I would think that Propecia should have been used in advance of your hair transplant procedure just to minimize this risk. The transplants done may offset the hair loss and the Propecia may bring some of the hair back. Only time will tell. Once the glass of milk falls and the milk spills out, it may be impossible to bring it back.
2006-05-19 12:36:262006-05-19 08:58:1948 Years Old With Shock Loss After Transplant
Hi Dr. Rassman,
I find your blog to be incredibly informative and helpful to those with concerns after their hair transplants. I decided to undergo a transplant exactly 5 months ago as preventative maintenance. 1,700 grafts to fill-in the thinning top portion of my head. I still have hair on my head, but under direct light you could visibly see through to my scalp. I followed my doctor’s instructions and had no major issues after the surgery.
At 5 months, the incision scar is still pink and I have occasional pimples on the top of my head (with what seems to be a noticeable increase in grease on my head). Also, after the surgery I had shock fallout. But it seems that ever since my surgery for the last five months my shedding has been consistently increased. Not just from the top of my head, but all over (sides and back). I have yet to see any growth from the grafts. But I have noticed white streaks in my hair. I have pitch black hair, and there are now random strips of white developing throughout my hair (I had never had white hair before the surgery). Is it possible that the shock of surgery would cause some of my hairs to begin to turn white?
And I’m also concerned at this point that my grafts will not grow in and that I will continue to get thinner and thinner since my fallout has increased. Thank you for your input and advice.
In my practice, we never recommend a hair transplant surgery for “preventive maintenance”, mainly because most patients would not likely see much of a result as they continue to bald and run the risk of being worse off. There is also a good possibility that the surgically induced hair loss might make it look worse, something we call “shock loss”.
If you are really losing hair on the sides, maybe something else is going on like diffuse unpatterned alopecia (DUPA). Shock loss doesn’t usually cause hair to fall out from the back and sides of the head. White hair does appear with stress on some people, but I really do not understand the cause. It sounds like you need a good doctor to talk with and be examined by. Perhaps the surgeon that did your transplant would be a place to start.
In general it takes about 6 to 8 months before you can see results and I tell my patients that most people can see 80% of the impact from a hair transplant in 8 months. You should notice growth beginning about now and see improvement in the next 3 months. If you are young and had the transplant without taking the drug finasteride, and assuming that your preventive hair transplants were not really needed, then you will most likely not have as much hair as you did before the transplant (based upon what you are saying here). Hopefully though, over the next 3 months you’ll see some gains.
I tell my patients that they can expect to see 80% of the growth in 8 months to styling length so be patient, you still might see the growth
June 2021 vs. today (11.2.2022), 1.5 years on 1mg fin every day, Niz 3x per week, and 1 month on 2.5mg oral min every day.
Nice improvement. Stay on your routine and it will only get better. It may take another full year to see more value of what you are doing and it is even more likely that it will get better if you add weekly microneedling to your routine. If this is not enough and you are over 25, then a hair transplant will give you a normal hairline, something to consider.
Have your patients reported to you that their life improved was improved from getting a hair transplant (E.g. Confidence, more time etc)? I’m thinking about getting it done and I’m really worried about the first day travelling home.
Almost all of my hair transplant patient regret not doing it earlier. The average age for a hair transplant in my practice is mid-thirties. The older the man is, the more they regret not getting a hair transplant and living with balding. Almost 100% tell me hair transplants were a life changing process. I started doing large session transplants in 1991 with follicular units back then. I never did a ‘plug’ surgery