2. Hair Growth Cycle
Anagen is the active growth phase of the hair. Usually ~85% scalp hair stays in this active
phase of growth for two to six years.
Catagen phase is a transitional stage and about 3% of all hairs are in this phase at any
time.This phase lasts for about two to three weeks.
Unlike other mammals, human hair growth and shedding is random and not seasonal or
cyclical.At any given time, a random number of hairs will be in one of below three stages :
Telogen is the resting phase and usually accounts for ~15% of all scalp hairs.This phase
lasts for about 3-5 months for hairs on the scalp.About 25 to 100 telogen hairs are shed
normally each day.
3. Shock Loss vs Normal Shedding
Patients often report continued hair shedding after undergoing a hair transplant
procedure. It is important to note that hair shedding after a hair transplant is a normal
occurrence and is the body’s way of responding to the trauma it received during the hair
transplant procedure.
Since tiny openings are created - otherwise referred
to as “stab incisions. Regardless of whether FUT or
FUE is performed, the procedure can be quite
traumatic on the scalp and the surrounding hairs,
and as a result, the hair grafts and the existing hairs
can temporarily shed.This occurrence is called
“effluvium”, and is sometimes referred to as “shock
loss”.
Hair shedding is considered a normal function of the body, as it is quite common to shed
anywhere between 50-100 hairs a day. It is, however, important to clearly distinguish
between normal shedding and the post-operative shedding of transplanted hair grafts.
4. Shock Loss Timeline
Keep in mind that “shock loss” is a normal part of the hair restoration process and is not
indicative of any permanent damage on the hair – though it is unavoidable, it is also
temporary. New hairs will take time to mature and will grow at different rates.
Shedding of hair grafts after an HT can be noticed anywhere between 30-90 days after the
procedure. Patients are often alarmed by the continued loss of hair, however, a few
months after the procedure; they can be assured that new hairs will eventually grow back
again.
6. Shedding or Shock Loss of
Transplanted Hair
This is a common, natural
phenomenon.
Found to occur among 95-100%
patients after getting a hair transplant
procedure done.
7.
8.
9. Shock Loss of pre-existing hair in the
transplanted zone
Commonly seen among male patients
who do not take finasteride.
Post-surgery appearance may look
worse than before-surgery appearance.
10.
11. Shock Loss of pre-existing hair beyond the
transplanted zone
Rare occurrence depending upon a male
patient’s natural progression of baldness
when not taking finasteride ; can lead to halo
effect.
Witnessed more often among female
patients.
16. When we implant grafts (hair follicular unit grafts) in a thinning (non - bald) zone,
then there is a risk of losing the pre-existing hair in that area as they may undergo
shock loss which can be permanent at times.
Permanent Shock Loss
Although implanting grafts in a thinning or non-bald zone is surgically doable and
within the prowess of any experienced surgeon, it is absolutely necessary to take into
consideration the high probability of such implantation causing severe, and in some
cases, permanent shock loss of both the newly implanted as well as pre-existing hair in
the transplanted zone.
For a successful hair transplant outcome, when we're implanting between the pre-
existing hair, the gap between the pre-existing hair should be 1.5 mm or more.
Implanting grafts at a lesser distance, as might be the case in a sparse area, is therefore
not advisable.
17. Anagen Synchronization | Chronological Steps
Hair Transplantation
Forced Telogen Effluvium
(Synchronized Hair Fall, up to 90
days)
Anagen Synchronization (Growing
phase of all hair together up to
10-12 months)
Anagen Desynchronization
(Reshuffling of Hair Cycle by 15-
18 months)
Overall FINAL REDUCTION of hair
mass up to 20% after reaching the
peak of Anagen Synchronization
Anagen Synchronization &
Desynchronization :
Transplanted hair volumize at
first & then the density
gradually decreases. Anagen
synchronization happens when
100% of your hair go into the
anagen or growth phase
compared to 80% naturally.
Natural hair are always
desynchronized.
18. Shock Loss Prevention
Though shock loss is unavoidable, there are a few things
one can consider in order to minimize the amount of
hairs lost after a hair transplant.
Finasteride works by binding to the enzyme 5-Alpha
Reductase responsible for helping produce DHT in the
body. It does not completely stop DHT production, but
rather, suppresses it well enough to interrupt the
development of male pattern hair loss and hair
miniaturization in men. When used regularly, results may
be seen in as early as 3 months.
Timing and Size of HairTransplant
Many patients choose to have a hair transplant at the onset of
hair loss or when they have significant miniaturization & thus
the progression of the hair shedding is not taken into account.
Another approach would be to wait until a later date after the
hair loss has been stabilized.
