How Long Does It Take for a Hair to Fully Mature from the Time It Sprouts after Hair Transplant Surgery?

This question, from a member of our hair loss social community and discussion forums, was answered by Dr. Blake Bloxham, a staff physician from Feller Medical:

Approximately how long does it take for a single hair to fully mature from the day it sprouts out of the skin, to the day it has fully matured. Are we talking 4 weeks or so, or many months?

Interesting question. So you’re asking: How long does it take for a single hair to fully mature from the day it sprouts to the day it’s fully matured? I’ll start by giving you my favorite answer in all of medicine: it depends. Annoying, right? But please, do read on …

So let’s take a step back and look not at the hairs maturing, but the follicles that produce the hairs maturing — and how this affects the maturation of the hair.

There is a specific reason why most transplanted follicles don’t start growing hair until 3 months after surgical hair restoration. When follicles “rest” and don’t grow hair, they are said to be in the “telogen” phase. Basically, follicles stop functioning in this stage and don’t produce hairs. Telogen can occur for a variety of reasons: as part of a normal hair cycle, as the permanent end result of androgenic alopecia, or as part of post-surgical trauma. But regardless of why it happens, it usually lasts 3-4 months.

So transplanted follicles start growing hairs around 3-4 months because they are basically traumatized into a telogen state. They recover from this shell shock and eventually wake up 3 or so months after your hair transplant and begin growing hair.

But again, it’s not that simple.

When normal follicles wake up from telogen, they begin growing pretty normal hairs. Normal color, thickness, character, etc. But this isn’t what happens with a transplant. As we know, the hairs come in differently and then “mature.”

So, why does this happen? Well a few different thoughts and theories, but I think it basically comes down to several factors:

1) The “hair matrix” at the bottom of the follicle that is in charge of providing a lot of the initial, inner protein of the hair shaft may still be a little “shaken up” from surgery, and may not be putting out the same amounts of hair shaft ingredients that it will be as things normalize.

2) The inner portions of the follicle (specifically something called the “inner root sheath”) is still very jumbled up and distorted from surgery, and this makes the shape of the hair shaft itself odd. This normally results in a hair shaft that looks a little “wiry” or “kinky.”

So now you’re 3 months out of a transplant and you just start growing these hairs. They are coming in a little light in color and thin because the hair matrix of the follicle isn’t quite “up to par” yet, and the shape/texture of the shaft is a little off because the inner parts of the follicle are still jumbled around. As you start reaching the 9, 10, 12, etc, month marks, this begins correcting. It obviously starts closer to the bottom of the scalp because this is where the newest part of the hair shaft is, but this maturation really starts to take effect by this point.

So, is that the answer? 12 months? Well not for everyone. We make generalizations based upon where most people fall in the “normal curve.” But this doesn’t mean people don’t mature at different rates. And if you go back to the above information, you’ll start to understand why.

What if the lower portions of your follicles where the hair matrix lies were particularly sensitive? Then maybe your follicles will “wake up” later than others and you won’t see maturation until closer to the 18th or 20th month mark. What if the central portion of your grafts distort easier than some patients, and your inner root sheaths take longer to correct themselves? Well, then you may be looking at more “unmanageable” hairs until the later months. This scenario or any variation of this scenario could result in later maturation for you.

So, cutting all of this aside: what’s the longest I’ve personally seen maturation take?

Honest answer — and one you probably don’t want to hear: basically 24 months. I can think of one patient in particular who looked so immature when I saw him at 12 months, 18 months, etc. His hair shafts were still lightly colored and thin compared to his donor. And this was a guy who did everything he could to minimize graft trauma — IE FUT with a big staff trained — and watched VERY carefully — in handling grafts. When I saw him at 24 months, it had finally matured to the point where I thought it would at 12 months.

And probably for the same reasons above. So hopefully this overly detailed — and probably somewhat boring — explanation will explain how and why hair transplant patients can mature late. I also hope it instills the idea that later maturation is not unheard of, especially in regions further back in the scalp. Not making any comments on any specific cases here, but it is possible and you very well could be a late maturer.

Hope this helps!

Feller Medical
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

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