Some surgeons stop finasteride before transplant surgery to reduce operative bleeding, while others allow continuation throughout the perioperative period. Either way, medication changes around your transplant date create a tracking variable that myhairline.ai helps you document so you can separate medication effects from transplant outcomes.
Why Peri-Transplant Medication Tracking Matters
A hair transplant moves grafts from the donor area to the recipient area, and the grafts themselves are the primary focus of post-transplant tracking. But your native (non-transplanted) hair is also affected by what happens around the surgery date.
If you stop finasteride or minoxidil before surgery and do not restart promptly afterward, your native hair loses its pharmaceutical support. DHT-sensitive follicles that were being maintained by finasteride may begin miniaturizing. Minoxidil-dependent follicles may enter telogen shedding.
Without tracking, you might attribute native hair loss during this period to "transplant shock" when it was actually caused by the medication gap. Separating these effects requires data.
Common Peri-Transplant Medication Timelines
| Medication | Pre-Surgery Protocol | Post-Surgery Restart | Impact Window |
|---|---|---|---|
| Finasteride (1mg) | Stop 1-2 weeks before (some surgeons) | Restart 2-4 weeks after | DHT rebounds in 7-14 days |
| Minoxidil (5%) | Stop 1 week before | Restart 2-4 weeks after | Telogen shedding in 2-8 weeks |
| Dutasteride (0.5mg) | Stop 2-4 weeks before (longer half-life) | Restart 2-4 weeks after | DHT rebounds in 2-4 weeks |
| Biotin supplements | Usually continued | Continue throughout | Minimal direct impact |
| Blood thinners | Stop per surgeon's instruction | Restart per surgeon's instruction | Bleeding risk, not hair density |
Your surgeon's specific instructions take priority over any general timeline. Always follow your surgical team's protocol.
Step 1: Document Your Pre-Surgery Medication Baseline
Begin tracking 8 weeks before your transplant date. Take weekly myhairline.ai photos of both your transplant target area and your native hair zones (areas that will not receive grafts).
Log every medication you are taking in the treatment journal:
- Drug name and dosage
- How long you have been on each medication
- The date your surgeon tells you to stop each one
- Your current density readings for each tracked zone
This pre-surgery baseline is critical. It shows what your hair looks like while fully supported by medication, giving you a reference point for any changes that occur during the medication gap.
Step 2: Track the Medication Stop Period
When you stop a medication before surgery, note the exact date in myhairline.ai and continue weekly photos. Watch for these changes in your native hair zones:
Week 1-2 after stopping finasteride: DHT levels begin returning to baseline. No visible hair changes expected yet.
Week 2-4 after stopping finasteride: DHT is now at pre-treatment levels. Miniaturization-susceptible follicles begin responding to the renewed DHT exposure.
Week 4-8 after stopping finasteride: Possible increase in shedding of native hairs. This is the window where medication-gap hair loss is most likely to appear in your tracking photos.
If you stop minoxidil, the timeline shifts. Minoxidil-dependent hairs typically enter telogen 2 to 8 weeks after discontinuation, with visible shedding following 2 to 3 months later.
Step 3: Separate Transplant Zones from Native Zones
This is the most important step. In your myhairline.ai tracking setup, create separate photo zones for:
- Recipient area: Where the new grafts were placed. Expect shedding of transplanted hairs (shock loss) at weeks 2-6, with new growth starting at months 3-4.
- Native hair zone (near transplant): Native hairs adjacent to the recipient area. These are susceptible to both shock loss from surgical trauma and medication-gap effects.
- Native hair zone (away from transplant): Native hairs in areas far from the surgical site. Changes here are almost certainly medication-related, not transplant-related.
By tracking these zones independently, you can determine whether density changes are caused by the transplant procedure, the medication gap, or something else entirely.
Step 4: Track Medication Restart and Re-Response
Most surgeons allow restarting hair loss medications 2 to 4 weeks after surgery. When you restart:
- Log the exact restart date in myhairline.ai
- Note the dosage (it may differ from your pre-surgery dose)
- Continue weekly photos of all three zones
Finasteride takes 3 to 6 months to rebuild its protective effect after a gap. The 80-90% efficacy rate for halting further loss and 65% regrowth rate apply to continuous long-term use. After a gap, your follicles need time to respond to renewed DHT suppression.
Minoxidil also takes 4 to 6 months to reach full efficacy after restart. Expect possible shedding in the first 2 to 4 weeks of restarting (initial minoxidil shedding) before regrowth begins.
| Tracking Milestone | What to Document | Expected Observation |
|---|---|---|
| Surgery date (Day 0) | Photos of all zones | Fresh graft placement |
| Week 2 post-surgery | Medication restart date | Early healing, possible shock loss |
| Month 1 post-surgery | All zones weekly | Transplant shedding, native stability |
| Month 3 post-surgery | All zones biweekly | Early transplant growth, medication re-response |
| Month 6 post-surgery | All zones monthly | Visible transplant growth, native recovery |
| Month 12 post-surgery | Final comparison | Full transplant maturity, native stability |
Step 5: Build the Complete Peri-Transplant Report
At your 6-month and 12-month follow-up appointments, export a complete timeline from myhairline.ai showing all three zones across the entire peri-transplant period.
This report gives your surgeon objective data about how your native hair handled the medication gap. If native density dropped during the gap and recovered after restarting, that confirms the medication was actively protecting those follicles. If native density remained stable despite the gap, those follicles may be less DHT-sensitive than expected.
Either finding is valuable for your long-term treatment plan. Learn more about tracking transplant recovery in our hair transplant progress tracker guide and medication-specific monitoring in our finasteride progress tracking guide.
Planning a hair transplant and want to track your medication changes? Visit myhairline.ai/analyze to start your pre-surgery baseline photos today.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Always follow your surgeon's specific instructions regarding medication changes before and after hair transplant surgery. Do not stop or start any medication without professional medical guidance.