Shock loss is one of the complications of hair transplantation that typically causes alarm. Though uncommon, it is experienced by both males and females who have undergone FUT or FUE surgery. Fortunately, shock loss after a hair transplant is nothing that you need to worry about.
What Is Shock Loss?
As the name indicates, shock loss is the abrupt loss of hair from the surgical areas following a restoration surgery. It can affect both donor and recipient areas in the following ways:
Shock Loss In The Donor Area
Also known as donor hair effluvium, this kind of shedding occurs in the areas at the back and sides of the scalp. In the case of FUT surgery, it usually affects the areas above and below the linear incision line. In FUE, on the other hand, since the donor site has micro-punches, it affects the whole area.
Shock loss in the donor area is temporary, and you should start growing your hair back in a matter of 3-4 months. It’s possible for this hair loss to be only mild, but it can also be quite significant. Regardless, you should expect a full recovery.
Shock Loss In The Recipient Area
Also known as recipient-site effluvium, it affects the transplanted hair, along with the ones that are already there. Telogen effluvium is the one usually thought to occur. However, it can also be anagen effluvium. In this, the shaft of the hair, still in the anagen phase, is injured, resulting in its shedding days to weeks later. Normal recovery takes place after 3-6 months.
Recipient-site effluvium is more commonly seen in women and those patients whose hair has significantly miniaturised. It should be noted that effluvium can speed up the shedding of the preexisting hair in the balding area that’s already in the last hair growth cycle. That kind of shedding is permanent because it was bound to happen anyway. It should not leave any bald, patchy areas because the surgeons take this possibility into consideration while implanting the grafts.
Causes of Shock Loss
There are many different causes of shock loss after a hair transplant. Some cases are unavoidable, such as:
- Extraction of the graft (cutting it off temporarily from blood supply can shock it)
- Implantation of the hair follicle into a “new” environment
- Inflammation and swelling
However, in some cases, shock hair loss occurs due to the inexperience of the surgeon. It can be due to the following reasons:
- Damage to the vessels supplying blood to the donor and recipient areas (can cause dramatic hair loss).
- Trauma to the hair graft (it can be cut by the punching tool)
- Overuse of tumescent anaesthesia (too much epinephrine)
- Dense packing of hair grafts
- Overharvesting from the donor area
- Skin tension in the donor area in FUT (poor wound closure)
Mainly, it occurs due to reduced blood supply to the surgical areas, which can happen due to overharvesting, dense packing, anaesthesia errors, and sutures that cause tension. Shock loss isn’t the only consequence of these surgical errors. The patient can end up with permanent damage to the donor area. In addition, they can end up with necrosis in the recipient site.
How to Prevent Shock Loss After A Hair Transplant?
There is no way to prevent shock hair loss. It can occur due to the very nature of the surgery. On your end, it is important that you take good care of your health so that you don’t put further strain on your body. In addition, you need to make sure that the surgical areas are clean and that you’re following all the aftercare instructions.
Although you cannot prevent shock loss, you can do some things to promote growth afterwards. One way to do that is to get platelet-rich plasma (PRP) injections. The growth proteins in the concentrate not only help with healing but also increase blood supply to the follicles, nourishing them with oxygen and nutrients. This can ensure quicker growth to take place. Other than that, you should:
- Use gentle hair care products
- Avoid over-styling your hair
- Try stress management (to not trigger another telogen effluvium)
How to Differentiate Between Shock Loss & Donor Depletion?
Because shock loss causes bald patches on your head, it’s easy to mistake it for donor depletion (overharvesting), which also looks the same. Keep in mind that, in general, the donor area will be less dense after the surgery because the hair will not grow from the areas from where the grafts are extracted.
It can be difficult to differentiate one from the other since it can take 3-4 months for the hair to start growing after a hair transplant. However, a closer examination by a hair transplant surgeon can help since the punching tool will leave micro-wounds behind. They’d be more concentrated (less spread out) if over-harvestation is the problem. However, it’d be impossible for you to see that, which is why you need to consult a doctor.
Shock loss is not something that every patient experiences after surgery. However, it is expected because of the way the surgery is carried out. The hair follicles enter the resting phase from the growing phase, and you can experience shedding 2-3 weeks after. It can also occur due to anagen effluvium. Fortunately, this kind of hair loss isn’t permanent. Your hair should start to grow back in 3-4 months.
Although some reasons for this type of hair loss are unavoidable, others that result from the inexperience of the surgeon can cause much bigger problems, such as permanently bald patches and damaged skin. That’s why it’s important to choose the right clinic when doing your research.
Reviewed and Approved by Dr. Hassan Soueid.