What is Hair Follicle Shock?
Hair loss after procedures is real. It is important to understand what causes the hair loss, so we can figure out how to treat it. I was recently talking with a medical friend about a patient who felt they had hair loss after a hair loss treatment. They said it was follicle shock. So of course, I researched it.
- There is no “Follicle Shock” in the medical literature. This is not to say that people do not lose hair after treatments, but that is not a medical term.
- Telogen Effluvium. This is when you have diffuse hair loss after a physical or emotional stress (cancer, surgery, stressful life event), This is a non-scarring hair loss (which is good, as non-scarring means the hair follicle is still intact and can make a new hair.)
- Traumatic Alopecia. This is when you have hair loss due to physical or chemical injury from hair treatments, like chemical relaxers, dyes, perms, tight ponytails and braids, the weight of hair extensions, or heat styling. This can lead to hair and scalp damage. This can lead to scarring. Histology studies of the scalp show that “traumatic hairstyling” can cause lymphocytic inflammation and early fibrosis (scarring), which may occur before the hair loss is apparent to the person.
- Hair loss after microneedling is rare, with the medical literature consistently reporting that most adverse events are mild and transient, such as erythema, edema, and post inflammatory hyperpigmentation; persistent or serious hair loss is not commonly documented. Microneedling is primarily utilized as a therapeutic intervention for hair loss, especially androgenetic alopecia, and clinical studies demonstrate improvements in hair density and thickness, particularly when combined with topical agents such as minoxidil or exosome therapy.
Why do treatments cause hair loss?
When doing hair restoration treatments in our clinic, there is low risk of hair loss. We use sterile technique, well researched protocols, and high quality medical products.
But you can hurt your hair if you try to do procedures at home. We do not recommend microneedling or rollers at home (see blog Do not microneedle at home.) These are seen more often with repeated treatments or prolonged exposure to harsh chemicals and heat. This is thought to be from many factors.
- Direct injury to the hair shaft and follicle
- Inflammation
- Follicle destruction
Certain hair types are more susceptible to injury. Textured hair grows at a slower rate (~0.9 cm/month) and has fewer hair follicles (50,000–100,000) compared to Caucasian hair. Also those with curly hair have an asymmetrical shaft prone to breakage, fragile bonds, and difficulty distributing scalp oils. Darker skin types are more prone to post-inflammatory hyperpigmentation and may rarely develop scarring alopecia. Metal allergies like nickel have a higher rate of allergic or granulomatous reactions, which can lead to local hair loss.
Active scalp infection (bacterial, viral, or fungal) increases the risk of post-procedural complications, including folliculitis and secondary hair loss, due to impaired wound healing and increased local inflammation. If you have any kind of scalp infection, you should not do any procedures. Again, this is also part of why we do NOT recommend microneedling at home. We use sterile one time use medical grade needles for injections and microneedling.
What are signs of treatment injury?
Take these with a grain of salt, because these are vague symptoms. But if you are doing a hair treatment which concerns you and you experience these, you may want to stop those treatments.
- Scalp pain
- Itching
- Redness
- Hair breakage *You can tell if it is hair loss naturally vs. breakage by feeling for the small bulb at the end of the hair shaft. If you feel that, your body “released” the hair, it did not break.
- Patchy or diffuse hair loss
What can you do if you have sudden hair loss?
All of our treatments at Biohackr Health in SF or Palo Alto can help if it is non-scarring hair loss.
- First and foremost, STOP the offending hair treatments. Dyes, heat, extensions, tight braids – all these are well known contributors.
- Treat early. The second you start to see thinning, jump on treatments.
- Treatments work in different ways and in different time frames. See our page on HAIR. The treatment plan for you may involve different approaches combined to help combat hair loss.
- Be patient. Hair restoration, even when you are doing everything right, is slow.
MEDICAL CITATIONS:
Hair Loss: Common Causes and Treatment., American Family Physician. 2017
Mechanisms of Impairment in Hair and Scalp Induced by Hair Dyeing and Perming and Potential Interventions.
Frontiers in Medicine. 2023
Prevalence of Cutaneous Adverse Effects of Hairdressing: A Systematic Review
JAMA Archives of Dermatology. 2006
Medical and Surgical Therapies for Alopecias in Black Women. Dermatologic Therapy. 2004;