Thanks again for your rapid reply. I have a question regarding “telogen effluvium” mentioned in an article authored by yourself and Dr. Bernstein, ‘Follicular Transplantation, Patient Evaluation and Surgical Planning’. (This was a very informative and helpful read) In the article you mention that existing hair in the recipient area could potentially be shed as a result of transplant surgery due to telogen effluvium. You conclude that “it is probably important to transplant enough hair to overwhelm any possible telogen effluvium that might occur so that the net effect of the transplant will be a positive one.”
My question is what exactly causes “telogen” effluvium? And whether there is anything one can do before, during or after the surgery to reduce this side effect and hence achieve better denser results. Since
this article was published in 1997, I was wondering if there has been more studies in this area and if anything can be done to prevent or reduce it.
The telogen effluvium that we have seen with what we used to call ‘Hair Transplant Shock Hair Loss’ can be largely prevented today with Propecia, with which we had little experience in 1997 when the articles were written. We have found that this drug will protect much of the hair that is impacted by genetic balding against the ‘shock hair loss’ we used to see. If the hair that falls out is the permanent hair (which happens rarely), it will usually come back. If “shock hair loss” occurs in women, I have never seen it not return. The cause of telogen effluvium is not known. Most of my views on it are empirical ones that, from a scientific viewpoint, are not proven but it allows me to explain the process to patients and to myself.