Category: Post-Operative

Doc,

I have a similar question to the person who asked “about scarring in the donor area”. I had a hair transplant on 5/16/2006, and had my sutures removed on 5/30/2006. I went to my Dr’s office on 5/25, and showed him my scar which I felt was becoming infected due to me being too agressive in cleaning the area. I felt what seemed like pimples in the area.

At that time my Dr., said it looked fine but on when I went to have my sutures removed on 5/30, the outer level (he stated he stitched below the skin as well) of sutures had become loose in some areas. He again said he had seen this before and it was nothing to worry about and would not cause the scar to be wide or hypertrophic. He popped some of these pimples in the donor area and prescribed me an antibiotic for 10 days as “a precaution”.

It has been approximately a week since I had the sutures removed and the scar is very pink and at times I feel sudden, slight, yet sharp pain the area. I think part of the problem is that this doctor excised a previous scar from a previous HT.

My question is do my symptoms sound normal to you, and have you heard of using an antibiotic as “a precaution”

PS If I ever decide to have a third HT, I think I will fly to California to meet with you in person. I regret not finding your site and this blog sooner.

What you are telling me sounds ok. Recent wounds feel different with different people. You can not really wash too vigorously on the donor wound (reasonable washing is probably what you did). Don’t blame yourself here as everything sounds OK. If there are real pimples in the donor wound, possibly suture abscesses may be occurring. A culture taken by your doctor with follow-up antibiotics are the regular approach to this type of problem. With the sutures now out, most of the pimples should be gone by the time you read this response.

Good luck.

I had a transplant a little over three weeks ago. The scabbing is 99% gone but it’s been replaced by quite a bit of scalp peeling. Why does this happen? I have hardly had any sun exposure on my head at all this month, so it’s definitely not a sunburn. And how long does it take to go away? I ‘ve been shampooing and showering normally and also rubbing my scalp between showers — the peeling skin is coming off (along with the transplanted hairs) but there’s still a lot of flaking left.

It is natural for newly transplanted hair to shed within the first month after the hair transplant. Your scabs will shed and some surrounding skin will also shed as well. Remember, the washing of your hair has probably changed since the transplant. Once you go back to your normal washing routine, the problem should disappear. Try using a moisturizing shampoo and conditioner.

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I had my hair transplant a month ago and i did not touch the grafted area once for the first 10 days except for tincing it with water mixed with shampoo. After the 10 days I started to shampoo the grafted area directly. I also noticed that the scabs where starting to flake off and li looked like I had dandruff so i would vigorously run my hands through the grafted area to get rid of the scabs. I also from time to time pick at the scabs. Sometimes I pick a scab and it has a hair with it a few time i picked a scab and there was a black dot in the center of it. does that mean a graft came out? I am scared no that i may have picked out a graft. How can I tell if I the grafts also come off with the scab or is it generally safe to do so. I have been quite aggressive with rubbing my hair and the little hairs keep falling off. Also during the first 10 days someone touched me on my forehead and the front of the donar area. i felt a sharp pain on the grafted area where the hand was put against the flow of hair but there was no bleeding so does that mean that no grafts where damaged from the front.

These are the questions you should be asking your doctor. At a month, I am certain that the grafts are secure and that what you are seeing is the failure to achieve good hygene. Washing your hair is critical and these flakes that you see are now just shedding skin. You need to see or speak with your doctor and get your washing routine worked out. All of our patients wash their hair the day after surgery, get the recipient area clean and keep it clean with one or two washings per day. By a week, you should just look like your hair is shaved, with no evidence of any transplant visually evident.

Update:

I took this photo yesterday of a patient 12 days after his procedure (around 2100 grafts). I just wanted to show what a typical patient’s recipient area looks like in such a short amount of time.

i had hair transplantation surgery in november2005,all went well and i was satisfied with the results showing up.but now into my fifth month after surgery, iam having problems on my scalp.I have some bulged protrusions which are itchy and painful.they are there for few days and disappear.I noticed am losing more hair than ever before.iam worried i would lose all my hair.please tell me what caused this?or is this common.iam using 1ml 5%minoxidil and propecia since 4months.

The bumps from the recipient area may be secondary to ingrown hairs or an inflammatory process from the sebum which accumulates from transplanted oil glands that survive the initial transplant process. The sebum has no way out from beneath the skin until the hair emerges. I see this problem in a small percentage of patients and generally treat it with warm soaks to soften the skin so that the sebum finds its way out. If these cysts start enlarging, that could reflect a local inflammatory response or possibly an infection (may require antibiotics or drainage) whcih should be something your doctor needs to address. You should have your doctor give you an opinion on this and address the hair loss you are experiencing. Hair loss at 4 months could be some delayed shock loss or acceleration of the hair loss process, which is seen with men who are not protected with Propecia, especially the young men undergoing hair transplantation. The use of minoxidil will not cause this and may help.

I had a transplant one month ago and am now very nervous. I was told that shock was NOT permanent yet on one of your blogs from 2005 there is mention of shock loss in balding areas as most likely being permanent. Yet if you took propecia prior to surgery, this shock could be prevented. I had not been given that instruction and have not only been experiencing shock loss in the frontal area, but still have redness that I thought would be gone after 7-10 days.

Is there a risk that the redness is permanent? Was I given bad advise about the prevention of shock loss (does propecia work in the frontal area). I wish I didn’t sound like I’m going off the deep end but this is all pretty unfamiliar territory for me. Please let me know your thoughts.

Redness will almost certainly go away with time. You might try hydrocortisone cream 0.05% and apply it to the red area in three or four 12 hour applications per week. Do not use it chronically, because steroid creams do get absorbed by your body.

If you are a young man and had transplants without taking Propecia, you run a high risk of shock hair loss that can be permanent. The loss usually commences with surgery or a few weeks after the surgery and runs its course over a few months. If the loss is in the area where the transplants were done, or in an area where you were balding prior to the surgery, the risks are higher. You might try to get a prescription for Propecia and maybe you can still save some of that hair.

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