• Welcome to Hair loss Experiences hair loss forum.

    Free impartial hair loss advice, hair transplant advice, hair loss medications and hair loss news.
    You can contact us directly at [email protected] if you experience any problems.

Uneven/patchy growth after nearly 5 months post-FUE (detailed picture timeline)

L

lightmare

member
I am almost 5 months post-FUE (2500 grafts). Though overall I definitely have seen a difference, it is very (I could call it extremely) uneven growth, with the areas that were most bald pre-HT still not showing any kind of results (I can't even see/feel hairs there, there are 3-4mm diameter zones with no visible hairs), while areas that were better-off pre-HT are now noticeably thicker than before. I was also a late/long shedder, with shock loss happening between weeks 3 (most bald areas pre-HT) and 8 (least bald areas pre-HT).

Here is my timeline (longer-hair pics with hair parted down the sides):

1633045581116.png

I think overall it looks pretty good, but it is definitely uneven, and these are taken with dry hair. After applying minoxidil, the original bald spots are revealed:
1633045688144.png


Again, the (pre-HT) bald spots are not showing significant signs of hair growth, even when dry. There are several 3-4mm areas with no visible/touchable hair. I have read about alopecia areata but am hoping that is not the case, and know that progressively spreads (vs my balder patches have been that way for the last 2 years). I know

Another thing is that I just began using finasteride (first time) 1mo post op. I have been using liquid minoxidil for 2 years and re-started it 1mo post-op at the suggestion of my doc.

So I am also wondering whether the growth I'm seeing is from the introduction of finasteride + reintroduction of minoxidil, or could it be new hairs from the HT? Especially given my late shed...but the real question is whether this extreme (i.e. lots of growth in some areas with zero in others) un-evenness would be normal at this stage if only considering the HT. I know final results can't be visible for 12 months...6 months is where growth really starts etc etc but this is making me very anxious.

Any feedback / comments appreciated. Thank you!
 
Last edited:
F

Foody

member
I have found out through research more than a dozen conditions are the reason for sub-optimal growth. Some conditions lay dormant, activating after surgery, and that is why the growth is affected. Seeing a Dermatologist could put you at ease if you think something is not right.
 
Bigmac

Bigmac

Administrator
Staff member
The new growth you’re seeing is most likely transplanted grafts. The medications could be helping accelerate the growth or they may have caused early shedding, it’s difficult to know. 5 months could be the start of your growth, not everyone sees an improvement at this timeline.The next 2 months should provide a better indication of growth. Uneven patchy growth can happen due to the various growth cycles the transplanted grafts are going through.
You had a large area to cover with most of the grafts placed in the frontal third and a light dusting going towards the crown. Were you planning on a second surgery to address the crown? With some luck you’ll be a good responder to the meds, strengthen your existing native hair and regrow miniaturised hair.
What does your doctor think of your progress to date?
 
L

lightmare

member
Thanks for your replies! I believe a positive, persistent response to min+fin was my doctor's hope to help the crown too, but we wanted to prioritize the front to make sure it is thicker (they said it should look natural afterward). I showed them that I had a positive response to minoxidil in the past (3 months after starting it in 2019 gave me the optimal result), but the optimal results did not last and oscillated between ~50-80% of my best result for the next couple years before doing the HT. By this I mean that 0% is baseline pre-minoxidil hair growth and 100% is my best growth that I observed while solely on minoxidil. However there was no finasteride during this period, so if I added that, maybe the crown would look close enough to full... They were shooting for about 2500 grafts and completed a bit over 2500 by the end of the day. It was approaching as many as they felt comfortable doing in a day while preserving graft health while out of my scalp.

Regarding my progress, my doctor seemed happy at the 4 month mark. Once I hit 5 full months I'll give another update. However I did not bring up the patchiness at the last check-in as I read that was normal at 4 months...but now near 5 the discrepancy between the good and bad areas has increased a lot, with still no growth in the bad areas, so I am starting to wonder.
 
Bigmac

Bigmac

Administrator
Staff member
The fluctuation between the results/positive response you’ve had is usually down to heavy or lighter shedding. I’m only using Finasteride, some months my hair is noticeably thinner than the previous month and then it recovers. The percentages you’re achieving are still good, maintaining what we have is very important.
If your crown does respond well, that’s a great achievement that saves precious donor hair.

As I mentioned earlier, the growth can be uneven, certain parts growing more than others or one side way ahead of the other. Providing every care was taken during surgery, no underlying conditions, you should be ok.
There are patients who have zero growth at 4 months. Try not to overthink things and try to relax about it.
 
I

Ian888

member
I am almost 5 months post-FUE (2500 grafts). Though overall I definitely have seen a difference, it is very (I could call it extremely) uneven growth, with the areas that were most bald pre-HT still not showing any kind of results (I can't even see/feel hairs there, there are 3-4mm diameter zones with no visible hairs), while areas that were better-off pre-HT are now noticeably thicker than before. I was also a late/long shedder, with shock loss happening between weeks 3 (most bald areas pre-HT) and 8 (least bald areas pre-HT).

Here is my timeline (longer-hair pics with hair parted down the sides):

View attachment 26686
I think overall it looks pretty good, but it is definitely uneven, and these are taken with dry hair. After applying minoxidil, the original bald spots are revealed:
View attachment 26687

Again, the (pre-HT) bald spots are not showing significant signs of hair growth, even when dry. There are several 3-4mm areas with no visible/touchable hair. I have read about alopecia areata but am hoping that is not the case, and know that progressively spreads (vs my balder patches have been that way for the last 2 years). I know

Another thing is that I just began using finasteride (first time) 1mo post op. I have been using liquid minoxidil for 2 years and re-started it 1mo post-op at the suggestion of my doc.

So I am also wondering whether the growth I'm seeing is from the introduction of finasteride + reintroduction of minoxidil, or could it be new hairs from the HT? Especially given my late shed...but the real question is whether this extreme (i.e. lots of growth in some areas with zero in others) un-evenness would be normal at this stage if only considering the HT. I know final results can't be visible for 12 months...6 months is where growth really starts etc etc but this is making me very anxious.

Any feedback / comments appreciated. Thank you!

Hi @lightmare your growth post HT seems pretty normal and what’s expected. With time most people find the unevenness resolves and the slower bits catch up. From what I can see from Dr Bernstein website most people shed over first 3 to 5 months and then growth spurts from 6 to 12 months and then a bit of hair maturing after that. Good luck with your journey.
 
L

lightmare

member
Thanks Ian and Bigmac for your replies. That does put me at ease a bit.

All of my baldest patches are further up scalp from the hairline. My hairline seems to have seen the most growth so far, with my rightmost part looking better than it has in years but still with improvements I'd like to see. I have read somewhere that hairlines and temples typically grow in faster than the top of the scalp and the crown, so if that is true then I am following that pretty closely. However I have seen examples of nearly totally bald patients that had all of the hair grow pretty uniformly, which is what you'd expect of a truly random process (i.e. follicles are plucked at random parts of their growth cycles)...so it appears as though the time dependence is sometimes but not always the case. I have to try not to overthink it at this stage, it is so easy to worry.

5 month pictures to come in a couple of days.
 
Last edited:
L

lightmare

member
Here’s a 5 month photo. There is some difference vs 4 months but not as great as the difference between 3-4. What do you think?

Since yesterday I’ve been noticing (in addition to the 10ish typical thin, longer hairs) a few very very dark, thick, short hairs come out in the shower. They seem to have been approximately the length of the hairs right after my surgical buzz cut. I haven’t seen that happen for about 2-3 months. Could those have been stuck grafts that did not grow or shed? Would the follicle underneath be safe if that’s true?

Going to schedule 6 month checkup with surgeon soon.

C10D0DD3-BD2F-4E16-A7AB-1BD013B5EAFB.jpeg
 
Last edited:
Bigmac

Bigmac

Administrator
Staff member
They could well be stalled hairs. Sometimes they will grow for a short time, then shed but the hair shaft remains stuck in the scalp. It’s nothing to worry about. The new hair once growing should push them out but igs best to remove them. falling out while shampooing is ideal. At 5 months it looks as though your area is beginning to thicken up with the new growth coming through.
 
L

lightmare

member
Thanks Bigmac. I think I feel some new, prickly hairs coming through on the right side which has been coming in slower than the left. The top / worst balding spots are still pretty bare, but hopefully this is a sign of growth to come for both the right and top areas.
 
Kevboy

Kevboy

Valued member
There is an abundance of people that start off slowly in the early months only to pick up around 7-8-9 months.
 
Bigmac

Bigmac

Administrator
Staff member
It’s exciting feeling the hairs coming through. Hopefully, you get a good burst of growth in the next few months.
 
L

lightmare

member
Yeah, it’s like I’m on a roller coaster…it seemed great until the weekend, when I started a massive and sudden shed that wreaked havoc, taking away much of what I seemed to gain on my worst areas. Overall it’s still much better than when I started but the worst areas seem the same as when I started. It’s about 5x my normal daily hair fall.

It’s been about 5 months since I started finasteride. The shedding is purely from the balding areas, none from the sides and back.

My doctor said this is not likely due to the finasteride at this stage, more like seasonal shedding since it’s turning cold. Has anyone hear experienced that? I have also seen some people claiming they go through multiple rounds of finasteride shed but many sources suggest the main shed happens in the first 3 months. I haven’t had any notable finasteride sheds yet.

also minoxidil has started to give my large dandruff again. Doc said to bump up the ketoconazole 2% to 3x a week, and possibly switch to the foam.

99713764-5064-4A20-B628-66A05CA09419.jpeg
 
Last edited:
L

lightmare

member
Thought I'd share a high magnification photos from my baldest spot, for those who are interested. This is on the frontal third region, 3" above the hairline in the center, where the blue circle is.

I have been searching forever for microscope hair transplant diaries before, but with no luck, so I would like to take a rough stab at it...I guess a big question might be how many of these hairs are transplanted vs not...and how many will thicken up...hope to track that over time!

By my measurements for scaling, the image spans approximately 0.1115 cm^2. So this image is about 8 FU/ .1115 = 72 FU/cm^2. It is less than that nearby (some pictures in the nearby area have about 4-5 FU) so maybe somewhere around 40-50 FU/cm^2 on average for this bald area if I had to guess. How is that type of density overall?

47A8137E-A280-4E29-8EBC-D5E105737BA4.jpeg
26514070-9564-47E6-B5E9-574AF40D056B.jpeg
 
Last edited:
Bigmac

Bigmac

Administrator
Staff member
Some people will experience seasonal and/or medical induced shedding. There’s a good chance you are shedding from the back and sides but you don’t notice it with your thick hair.
Try looking for a non alcohol minoxidil option if the dandruff continues. I use Pura d Or gold shampoo, it is very good at clearing up dandruff.
Have you been able to see any difference since this last update?
 
L

lightmare

member
Here I am at the big 6 month update! I feel that overall I look slightly worse than 5 months. It doesn’t feel great to go backwards, and I guess the shed is to blame.

The shedding has stabilized and is consistently at an elevated level. It seems to have fallen a bit from the peak but I am waiting for it to drop back down to normal. Also, a smaller proportion of thick hairs and a larger proportion of thin hairs seem to be shedding now.

I heard about the possibility of shock loss of the native hairs in recipient area at this stage due to competition. Is that possible/common at 6 months?

My hairline and slightly behind it has many thick hairs now, but many of the doubles / triples right behind it haven’t yet thickened or sprouted. Based on counting it seems like more is to come there. The worst areas in the frontal third/right side have fewer thick hairs/multi sprouts but the density is comparable. Hopefully more thickening to come there…

C0B911D6-E736-49BF-AF1D-CB764D86A0FC.jpeg
 
Last edited:
L

lightmare

member
Thanks Bigmac for the suggestion on pura d’or, I will try that.

I haven’t had much luck finding non alcohol minoxidil yet, I might have to go with a less known manufacturer. If anyone has any suggestions that’d be fantastic. The foam still results in some dandruff but is seems to be reduced.
 
bullitnut

bullitnut

4 awesome repairs with SMG
2500 were used to cover a large area…..For a better look i think you should keep the back and sides short until it grows in.
 
Kevboy

Kevboy

Valued member
Finasteride worked great on my crown and lots of others that I see online. Stick with it because sometimes you thinks it’s not working but it is. I saw Bm mention non alcohol Lipogaine on a different post.
 
bullitnut

bullitnut

4 awesome repairs with SMG
The hairline design is age appropriate and has slight irregularities that helps create a natural finish… 2500 grafts may not be enough to provide a density that will meet with your expectations… A second surgery might be on the cards…..time will tell and you still have a long way to go.
 
Top