The Hair Transplant 'Ugly Duckling' Stage - When Does It Begin and How Long Does It Last?

The "Ugly Duckling' stage is the term given to the period of time after hair transplant surgery when the patient may experience redness in the recipient area, pimples, shock loss, etc. During this period, the patient's hair may appear thinner or "uglier" than it did prior to the procedure. When Does It Begin? When follicular unit grafts are transplanted from the donor supply at the rear and sides of the head to the balding areas of the scalp, they still contain very short hairs that give the appearance of instant coverage. However, within the first few weeks these follicles go dormant and fall out, leaving the recipient area bald once again. During this time, the recipient area may be very red in appearance. In addition to the temporary loss of the transplanted grafts, the patient may experience shock loss of the existing hair, further adding to a bald appearance. This shock loss may appear in the donor area as well as the recipient area and is normally temporary. This hair will typically regrow around the same time that the transplanted grafts begin to sprout new hairs. Approximately 3 to 4 months after surgery, new hairs will begin to sprout. This growth activity beneath the skin will sometimes cause ingrown hairs or pimples throughout the recipient area. Though unsightly, this is perfectly normal. However, it's important to follow up with your hair restoration physician if these pimples are severe or become infected. When Will It End? Just how long the ugly duckling stage might last depends upon the individual patient's physiology. The amount of existing hair available to hide the donor extraction and recipient sites as well as the individual's healing characteristics are factors that affect the duration of the ugly duckling stage. But, many patients will have significant new hair growth between 6 to 8 months post-op and this typically marks the end of this period. What Can You Do about It? Allowing existing hair to grow longer during this time may allow some patients to effectively hide donor sutures or staples as well as redness in the recipient area. Some patients also make use of hats or bandanas during the healing period. Hair loss concealers like Toppik may also be of use in masking a red or pink scalp. Conclusion It's important to note that not all patients will experience an extended ugly duckling stage after hair transplant surgery. If you feel ugly in the weeks after your hair transplant, try to remain positive. Focus on the desired outcome. Great things are on the horizon! David Forum Co-Moderator and Editorial Assistant