When does transplanted hair grow? The stages of growth after a hair transplant

When do the first hairs appear, and when does the result become clear?

The short answer: it takes months. On average, the first hairs start to appear around the third or fourth month, fine and sparse. The hair gets denser over the following months; for most people, it takes about a year for the hairs to thicken and the result to become clear, and sometimes longer at the crown.

These timings are averages. In some people the first hairs come through earlier, in others later; on its own, this does not mean there is a problem. We cannot tell you in advance that you will reach a particular look by a particular month; we review your progress together at follow-up appointments.

The hair growth cycle explains why the process takes months. The follicle (the root that produces the hair) does not work nonstop: it grows for a while, then rests, lets go of its hair and starts growing again. We describe the phases in our article on the hair growth cycle. The timeline after a hair transplant is largely explained by this cycle starting again in the transplanted follicles.

The average growth timeline

The months in the table show the approximate course seen in many people. The stages overlap and do not move at the same pace for everyone; your hair may come through earlier or later.

Topics such as scabbing, redness and the first wash in the first few days come before this timeline; we cover them on the hair transplant aftercare page. The written aftercare instructions we give you always take priority.

What happens in the follicle at each stage?

The transplanted hairs fall out

Grafts (small pieces of tissue carrying one or more hairs) are cut off from the blood supply for a while, from the moment they are removed until they are settled in the channels opened for them. Most of the transplanted follicles respond to this stress by entering the resting phase and letting go of their hair. That is why it is expected for transplanted hairs to fall out in the weeks after the procedure.

Even when a transplanted hair falls out, its root usually stays in the skin. During the same period, some of your own hair in the surrounding area may also fall out temporarily. The temporary loss of both the transplanted hair and the surrounding hair is called shock loss; when and to what extent it happens varies from person to person. However, some of the surrounding hairs that had already become thin may not grow back. You can find the details in our article on shock loss.

The resting period

A follicle that has let go of its hair rests for a while. On the scalp, the resting phase normally lasts about three months. This is why you see little change in the area in the first months after the transplant.

During this period, the recipient area is often at its sparsest since the procedure; if the surrounding hair has also fallen out, it may look even sparser than before the procedure. This can be worrying, but on its own it does not tell you anything about the result.

The first hairs come through

Once its rest is over, the follicle enters a new growth phase and starts producing a new hair beneath the skin. Because hair grows about one centimeter a month, it also takes time for the hair to break through the surface and reach a noticeable length.

The first hairs to come through are often fine, light-colored and sparse. Because the follicles do not all enter the growth phase at the same time, hair comes through earlier in some areas and later in others. That is why an uneven look is common in the first months.

As new hairs push through the skin, some people may notice itching or small, pimple-like bumps; these are often temporary. Do not squeeze the bumps; if they are painful or getting bigger, contact us. We cover the details in our article on itching, redness and pimples after a hair transplant.

Thickening and maturing

Over the following months, the number of follicles in the growth phase increases. The hairs grow longer, thicker and darker. How well hair covers the skin depends on the thickness of the hairs as much as on their number; that is why the area looks fuller as the hairs thicken.

Transplanted hair usually keeps the characteristics of the donor area (the back and sides of the head, where the grafts are taken from); as it matures, its thickness and texture also become more like those of your hair in that area. Check with us before getting a haircut, especially if clippers will be used on the recipient area.

Why does the result take longer at the crown?

With hair transplanted to the crown (the vertex), the result often becomes clear later than at the front. While the result at the front is often assessed at around one year, at the crown this may take longer and can go beyond a year.

The reason for this has not been fully explained. The factors thought to contribute are listed below; they affect how the crown looks more than how fast the hair grows:

• The hair fans outward: At the crown, the hair spreads out from the whorl in every direction and does not overlap the way it does at the front. The same amount of growth looks sparser here.
• Viewing angle and light: The crown is often seen from above, and light from above falls directly on the skin; the sparseness stays more noticeable until the hairs thicken.
• Hair loss in the surrounding area: If your own non-transplanted hair at the crown is still thinning, this thinning may, for a while, mask what the transplanted hair adds.

We describe how the crown is planned in our article on crown hair transplants.

Why does the timeline vary from person to person?

Even in two people who had a transplant on the same day with the same method, the hair may grow at different rates. The main factors that may play a role in this difference are:

• How long your follicles stay in the resting phase; this varies from person to person
• The recipient area: the front, the crown, or between existing hairs
• The characteristics of your hair: thick or curly hair, and hair with little contrast against your skin color, may seem to cover the area sooner
• Your healing and your general health; habits such as smoking can have a negative effect on healing
• Whether your own hair in the surrounding area is affected by shock loss, and how much of it grows back

A transplant does not stop the loss of your own hair in areas that were not transplanted; this hair loss may progress over time. That is why, at follow-up, we look together not only at the transplanted area but also at the overall condition of your hair.

The limits of the timeline: What can we not know in advance?

• Which graft will grow when: While the follicles rest in the skin, we cannot tell from the outside which one will start growing when. An area that looks sparse in the first months may look noticeably different in the months that follow.
• The final density: When the hair grows and how much density is achieved in the end are separate questions; the density achieved also varies from person to person.
• Speeding up the process: The evidence for shampoos, vitamins and supporting procedures said to make hair grow faster is limited. Medications used for hair loss are a separate matter; whether to use them is decided by your doctor, based on an assessment of the course of your hair loss and your health. Ask us before you start using any medication, product or supplement on your own.

What do we look at during follow-up, and when should you contact us?

We review your healing and the growth of new hair together at follow-up appointments; we plan the timing of these appointments with you. In the first months, it is still too early to judge the result.

Checking your hair in the mirror every day can make you more anxious. To see the change, it is more useful to compare photos you take once a month, in the same light and from the same angle.

If you feel your hair is not growing when you expected it to, tell us at your follow-up appointment. For decisions such as whether any further procedure is needed, we usually wait for the result to become clear.

If you notice any of the following, contact us without waiting for your follow-up appointment:

• Increasing pain, redness or swelling
• Discharge, pus or a bad smell in the recipient area or the donor area
• Fever
• Pimple-like bumps in the recipient area that are painful or getting bigger

In an emergency, go to the nearest healthcare facility without delay. The information in this article is general and does not replace the written aftercare instructions we give you. Whether you are suitable for a hair transplant is determined during the examination, and results vary from person to person.