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Ingrown Hairs / Pimples Months After Hair Transplant

3 months after my transplants i’m still getting ingrown hairs (pimples on my scalp). also i see no hair growth as of yet. do i have anything to worry about yet? also i was told the ingrown hairs is a good sign because it suggest there is growth beginning under the scalp. is that true?

Ingrown hairs are caused by three factors:

  1. Leftover remnants of the hair transplant inside the recipient site, which then go on to produce reactive pustules
  2. Hair grafts that are piggybacked one on the other as a result of a technical problem during surgery
  3. Folliculitis that evolves into abscess formation

Usually, the third one comes about with less than skilled technicians or technicians with poor eyesight. The other two are just the risks of the process. We see an occasional eruption and on some patients more than a few eruptions. The may come from a progressive folliculitis (infection of a hair follicle) or from one of the other causes listed above.

On very rare occasions, the follicular remnants will act like a foreign body and stimulate an autoimmune process (folliculitis decalvans). Fortunately, we have seen less than a half dozen such reactions in the 20 years history of this practice, but when they occur they are very difficult to treat both in time and visible problems at the wound sites.

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Interesting Abstract That Suggests That Plucking Hairs Can Stimulate New Hair Growth

Cell. 2015 Apr 9;161(2):277-90. doi: 10.1016/j.cell.2015.02.016.
Organ-level quorum sensing directs regeneration in hair stem cell populations.
Chen CC1, Wang L2, Plikus MV3, Jiang TX4, Murray PJ5, Ramos R3, Guerrero-Juarez CF3, Hughes MW6, Lee OK7, Shi S8, Widelitz RB4, Lander AD9, Chuong CM10.
Author information
Abstract

Coordinated organ behavior is crucial for an effective response to environmental stimuli. By studying regeneration of hair follicles in response to patterned hair plucking, we demonstrate that organ-level quorum sensing allows coordinated responses to skin injury. Plucking hair at different densities leads to a regeneration of up to five times more neighboring, unplucked resting hairs, indicating activation of a collective decision-making process. Through data modeling, the range of the quorum signal was estimated to be on the order of 1 mm, greater than expected for a diffusible molecular cue. Molecular and genetic analysis uncovered a two-step mechanism, where release of CCL2 from injured hairs leads to recruitment of TNF-?-secreting macrophages, which accumulate and signal to both plucked and unplucked follicles. By coupling immune response with regeneration, this mechanism allows skin to respond predictably to distress, disregarding mild injury, while meeting stronger injury with full-scale cooperative activation of stem cells.

I have not personally seen such responses, but I will reach out to my colleagues and ask for their opinions. I already had a response from Dr. Bernstein in New York when asked about pucking, said: “No… I’ve been plucking for years – and look where it got me.” Dr. Bernstain has a Class 6 balding pattern as you can see on his informative hair restoration site here: https://www.bernsteinmedical.com/

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Balding Pattern is now a Class 5 at 33

I’ve seen balding since I was 20, now 33M, NW V. I took intermittently min/fin for periods of no longer than 6 months, with noticeable results. Then skipped the treatments due to laziness. I now decided to go all-in for the very last time before I decide to get a hair transplant. I am doing religiously min, fin, biotin, zinc, saw palmetto and vitamin D daily; ketoconazole twice/three times a week; dermarolling 1.5 mm once a week. Do you think it will reverse?

At 33, the drugs rarely reverse a Class 5 pattern of balding.


2019-12-11 09:13:59Balding Pattern is now a Class 5 at 33

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Interesting use of peppermint oil compared to minoxidil to grow hair (from Reddit)

This is an interesting study; however, although I don’t want to be a snob, a proper study should be done from a recognized academic institution that would lend credibility to this study. The link does not show this, but some of the science is there. Using peppermint oil certainly will not hurt you if you try it. I would love to hear some people’s response to their use of it reported back here.

This study proves that peppermint oil is more effective than minoxidil, can you guys tell me why it isn’t? from tressless


2019-03-06 09:59:20Interesting use of peppermint oil compared to minoxidil to grow hair (from Reddit)

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6 months on finasteride (photo)

This is an amazing response (left) to the drug finasteride with a complete regrowth of the frontal hair. On the right, this man’s photo suggests good filling of fullness with probably reversal of miniaturization


2020-09-12 06:48:086 months on finasteride (photo)

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Is 20 to early to start finasteride?

I went to the dermatologist recently because I’m really worried that I’m starting to lose my hair. I haven’t really noticed any shedding or anything but the hair above my temples seems to be very slightly higher than I remember . Basically the doctor said she couldn’t tell if my hairline was receding or not. When I asked about Finasteride she said that even if i was receding she wouldn’t prescribe me it because my age and some recent studies that showed sexual side effects later in life. I’m honestly sick of worrying about my hair and considering taking it as a preventive measure (both sides of the family have male pattern baldness even though it didn’t affect them until later in there lives 30+) From everything I’d read and seen it seemed like the side effects for this drug are super over blown but after hearing her say that its making me second guess my conclusion. I’m pretty sure If I went to a different doctor I could get them to give me a prescription but I figured I would put something on here first. If I am losing my hair I would like to do something about it before it gets any worse and sitting here going wondering isn’t making me feel any better.

The drug is more effective in most 20 year olds than 30 year old men as a general rule. A lot of that depends upon the hair loss pattern you have inherited. For example, if your father’s pattern is a Class 7 pattern and you are taking after your father from talking with him, I have found that finasteride might slow down the progression to a Class 7 pattern but not stop it; however, if the pattern you are inheriting was not an advanced pattern, then this drug can often slow, stop and possibly reverse it the younger you are. Now with that said, in your situation I would perform a HAIRCHECK test (https://baldingblog.com/haircheck-test-how-it-is-done-video/) to determine if you are in-fact balding before committing a lifetime of taking the drug finasteride because maybe you are not balding. Yearly HAIRCHECK tests will tell you that story and changes in your hairline beyond a mature hairline, could also indicate some genetic factors in you as well. With this approach, you will have developed a Master Plan for your future and with that plan you can stop worrying.

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Is Cutting a 5mg Finasteride Pill Not Recommended?!

Hi Doc,

So a little background. Have been on finasteride for approximately 8 months. I think its working, since I have not progressed at all and maybe perhaps (don’t know if its my mind playing tricks) have seen very slight thickening.

I asked you a similar question before regarding the generic finasteride from pharmascience. You stated that I should be good with this drug as the company is a reputable one here in Canada.

However today my question is about the 5MG. I take that and cut it into quarters and have been doing so since the beginning of my treatment (so that its cheaper for me)…I read somewhere on your site that this is not recommended….and some people/doctors claim that the ingredients of the pill are not equally divided??? could you elaborate on this…am I fine with what I do or should I switch to the generic 1MG (which is available in Canada)…do you roughly (again roughly) still get 1.25 if you quarter the pill with a pill cutter?? So just wondering if I may be loosing ground with what I do, or that I am infact fine with the above regimen?

Thanks in advance

I am not sure where you read on this site that cutting the 5mg finasteride wasn’t recommended, but I’ve been suggesting doing this for years. You just need a doctor to prescribe the higher dose with the instruction that the pill is to be cut.

Cutting a 5mg tablet of finasteride in quarters is just as good as taking a 1mg pill. In a perfectly ideal world the drug companies would make a 1mg version and sell it cheaper than the 5mg version, but for now the 5mg version is about $30 for 90 pills while the 1mg version is $100 for 90 pills.

So in the interest of cost savings, you can cut the 5mg version into four pieces to make 1.25mg. If you know how to cut a small pill into 5 equal pieces to make 1mg each, go for it! In general, when you cut the pill you will never be precise and you may get more or less 1.25mg. This is alright in my opinion as long as you consistently take the medication on a daily basis. My reasoning behind this is that studies show 0.5mg is almost as effective as 5mg dose, so the daily variation should not matter as long as the drug is taken on a consistent basis.