Hair Transplant After 4 Months:
Guide & Aftercare
The fourth month after a hair transplant marks the beginning of visible progress for most patients. By this stage, the scalp has healed fully, the transplanted follicles have passed through their resting phase, and new hair shafts are beginning to emerge. While the changes may still be subtle, this period often provides the first tangible signs that the procedure is working as intended.
This guide outlines the expected changes at four months post surgery. It provides an in-depth explanation of follicular activity, describes the characteristics of early regrowth, addresses common concerns, and outlines appropriate aftercare for this stage.
for a broader guide see our Hair Transplant Recovery Timeline.
Physical Changes in Hair and Scalp at 4 Months After Surgery
Above is a photo taken exactly 4 months after hair transplant surgery, with the new hair growth just becoming noticable.
At four months, the majority of the transplanted follicles have transitioned from telogen (resting) into anagen (growth) phase. This means they are now actively producing hair shafts. Unlike the rapid shedding seen in the early weeks after surgery, regrowth is slow and steady. It begins deep in the dermis, as matrix cells in the follicle bulb generate the structural proteins (keratin) that form the new hair shaft.
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Not all follicles behave identically. Each unit has its own timeline, influenced by vascular supply, local inflammation, genetic predisposition, and site-specific factors. For example, frontal grafts tend to activate earlier than crown grafts due to better perfusion and a shorter hair cycle duration in that region.
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This explains why growth at four months is typically incomplete and uneven. It is normal to see denser areas alongside thinner patches, and this should not cause concern. Full synchrony only occurs gradually, over the coming six to nine months.
Follicular Behaviour and the Hair Cycle at Month Four
Recipient Area
In the transplanted region, patients often begin to see short, fine hairs emerging from the scalp. These new hairs may appear lighter in colour, thinner in diameter, or curlier than expected. This is temporary. As the follicles mature, the hairs undergo a process of terminal differentiation, where they acquire their final colour, texture, and thickness. Early hairs are also more fragile and prone to breakage. They will become more resilient as the shaft matures and sebum production normalises.
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The overall appearance at this point is often described as a “fuzzy” or uneven texture. It is not yet possible to style the new hair effectively. Many patients report that it becomes visible under direct light or when standing close to the mirror, but remains cosmetically insignificant in casual observation.
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Some redness may persist in the recipient zone, especially in those with fair skin or those who received a high graft density. Mild pinkness is not harmful and typically resolves between months five and six.
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Donor Area
By now, the donor area should appear indistinguishable from surrounding scalp unless closely examined. Any textural irregularities or hypopigmented dots from the FUE extraction will continue to fade. Numbness or altered sensation, if still present, should begin improving noticeably. Complete sensory recovery may still take several more months, depending on nerve regeneration speed.
Shedding and Regrowth Patterns
One of the most reassuring signs of progress at four months is the end of the shedding phase. Between weeks 2 and 6, most of the implanted hairs shed. During the dormant period that followed, the scalp often looked unchanged. Now, new follicles are pushing through the epidermis, creating fine stubble or “peppering” across the grafted area.
It’s important to remember:
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Regrowth may begin as early as week 10 in some areas, but often continues into months 5 and 6.
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Crown regrowth typically lags behind the hairline.
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Some hairs will be growing at visible lengths, while others may just be starting to emerge.
Do not be alarmed if certain areas look behind others. This patchy pattern is entirely expected and does not reflect graft failure. It is too early to assess final density or shape at this point.
Expected Results at Four Months
By the end of four months, most patients begin to experience:
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Early regrowth across 20% to 30% of grafted areas
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Noticeable change in hairline definition when examined closely
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Subtle improvements in scalp coverage, particularly in bright light
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Increase in scalp confidence, though not yet enough to change hairstyle
While the cosmetic impact remains limited, the psychological benefits of seeing early growth are significant. This is often the point at which patients start feeling reassured that the transplant is progressing as planned.
Remember, hair grows at a rate of approximately 1 cm per month. Given the short time since follicles entered anagen, the new hair will still be relatively short and uneven in length. The bulk of visible density develops between months 5 and 9, with final maturation by month 12 to 18.
Aftercare Recommendations at Four Months
By this stage, your aftercare routine will be less restrictive, but some practices remain important to support continued regrowth and protect the scalp environment.
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Washing and Scalp Hygiene
Continue to wash your hair regularly — every 2 to 3 days is sufficient for most. Use a mild, sulphate-free shampoo and avoid anything that strips natural oils. If you experience scalp dryness, consider using a light moisturising conditioner.
Avoid scratching or over-brushing the recipient area. The new hairs are still fragile and prone to damage.
Styling and Haircuts
Light styling products are safe to use, but avoid excessive build-up or any products that cause flaking. You may use camouflaging hair fibres if desired, though most patients wait until density improves.
Chemical Treatments
You may colour or dye your hair at this stage if the scalp is fully healed and free from irritation. Always use ammonia-free products and avoid bleach until at least month six. Perform a patch test before applying colour to the recipient zone.
Sun Protection
UV exposure can still affect pigmentation and irritate healing skin. If you spend extended time outdoors, wear a soft hat or use a physical sunscreen (SPF 30+) suitable for sensitive skin. Avoid sunbeds.
Physical Activity
You may engage in all forms of exercise, including contact sports, swimming, and weight training. If wearing helmets or tight headgear, ensure they are clean and fit properly to avoid friction across the grafted area.
Psychological Considerations
The fourth month often marks the shift from uncertainty to optimism. Patients who were anxious about the lack of progress during months two and three are now reassured by early visible change. That said, some may feel frustrated by the slow pace of regrowth or disappointed that density is not yet sufficient.
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It’s important to maintain perspective. You are at the start of a 12-18 month process. Most of the visual improvement will happen in the next 3-6 months. Avoid comparing your results to others online - growth patterns vary greatly by individual hair characteristics, scalp blood flow, and genetic factors.
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Taking monthly photos in consistent lighting conditions can help track progress more accurately. At My Hair UK, we encourage patients to submit photographs at each stage for clinical review and reassurance.
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Four months after a hair transplant, most patients begin to see the first signs of success. New hairs are emerging, shedding has ceased, and the outline of your transplanted area is becoming more defined. While coverage is still developing and the hairs remain fine, the biological process is on track. This stage represents the start of your visible transformation.
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Aftercare at this point focuses on gentle maintenance - keeping the scalp clean, avoiding irritation, and supporting the hair’s transition into mature growth. Normal haircuts, exercise, and light styling can resume, and chemical treatments may be cautiously reintroduced if appropriate.
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If you're uncertain about your progress, speak with your surgical team. At My Hair UK, we offer review at key milestones and can advise whether your recovery is progressing within the expected range. With continued patience and care, the next few months will bring clearer, denser, and more natural results - moving you closer to the final outcome.
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Full Recovery Guide:
Hair Transplant After 10 days
Hair Transplant After 1 Month
Hair Transplant After 2 Months
Hair Transplant After 3 Months
Hair Transplant After 4 Months