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Hair Transplant Side Effects

What are the main side effects after a hair transplant? This is a common question asked by our patients visiting The Treatment Rooms London. This blog will aim to inform you about the main side effects you need to be aware of such as:

  1. Pain in the scalp donor and recipient area
  2. Swelling around your hair transplant, forehead and eyes
  3. Itching
  4. Bleeding at the donor or recipient site
  5. Crusting of the implanted grafts or at the donor site
  6. Inflammation or infection of the hair grafts
  7. Temporary loss of hair (shock loss)

Hair Transplantation

Before undergoing a hair transplant you will need to meet with your surgeon beforehand. In these meetings you should address all your concerns including the process of the surgery, what to expect afterwards, side effects to look out for and how your hair will grow in the future.

The surgery itself involves taking hair at the back and sides of the head and moving them to areas you are balding in. These hairs are not affected by the hair loss and thinning process, so when they are moved they remain where they have been implanted.

The surgery sounds simple- so are there any side effects you need to worry about? In short- yes there are.

As hair transplant is surgery you will realise that the process involves pre-operation assessment, anaesthesia, blood pressure control, precise cutting around and accurate implantation of grafts. Your aftercare following surgery is therefore incredibly important. You should expect a detailed breakdown of side effects and how to manage them by your hair transplant surgeon.

The main side effects you will need to be aware of are the following:

  1. Pain
  2. Swelling
  3. Itching
  4. Bleeding
  5. Crusting
  6. Inflammation/ Infection

Pain

Your pain should typically be worst on the evening of your surgery. The pain can be felt in your donor area but also where hairs have just been implanted, (1). It is often described as a graze like pain but shouldn’t be severe.

What is happening? The hair transplant involves many small cuts to your head. After the local anaesthetic has worn off you may start to feel some of these small cuts. By the next day the worst of the feeling should have worn off and you should feel comfortable. In a small number of patients where the transplant has been a large one, you might feel mild pain that persists for 1- 2 weeks.

How can you treat the pain? Any pain you feel can be easily managed using Paracetamol with Ibuprofen (or Nurofen). If you needed something stronger it is worth going back to your hair transplant surgeon to discuss what can be given.

What is your pain isn’t going away? If your pain is persistent following a hair transplant you ought to go back and see your surgeon. The pain might go away with a bit more time but in some cases the pain can be because of another problem. For example, in patients who have been over-harvested with poor implantation of grafts and delayed scalp healing.

Swelling

Swelling can start to develop the next day after a hair transplant (3). This tends to be worse in the forehead and around the eyes. It can last for 7-10 days post-surgery. In most patients this is mild but can in some cases be severe.

What is happening? As you have undergone surgery there will be an element of inflammation from the surgery. This inflammation will cause the skin tissue in the scalp to swell and feel tight. This can sometimes move down the forehead and affect the eyes.

How can you treat swelling? At The Treatment Rooms London, we routinely provide anti-inflammatory medications such as dexamethasone (a steroid). This is a tablet that you take once a day in the morning and it helps to reduce the swelling. In most patients the swelling is kept completely at bay.

What if your swelling isn’t going away? Sometimes in large hair transplant cases your swelling may persist for a bit longer that 7-10 days or might start to affect your eyes. You should at this point make an appointment to see your hair transplant surgeon. They will be able to advise on how to best manage the side effect. Rest assured this side effect should disappear.

Itching

Itching is often the last side effect to develop. It often affects the back and sides of the head where donor was taken. It can also affect the area where grafts have been implanted. Itching may start as early as 4-5 days after the procedure and can last up to a month.

What is happening? Like swelling, itching is secondary to the inflammation and healing processes your scalp is going through after surgery. Itching can also be due to a dry scalp after hair transplantation. In both circumstances the side effect tends to go away with time

How can you treat itching? At The Treatment Rooms London, we have written an extensive blog on this topic. Feel free to read it by clicking HERE. In summary you can use the following treatments:

1. Do not scratch the itch!
2. Salt water spray
3. Taking an anti-histamine
4. Medicated shampoo
5. Steroid scalp solution

Bleeding

Bleeding can occur as a side effect straight after your transplant. The back of the head where your hair follicles have been taken out will bleed on the day of your surgery. This will stop after the procedure and you will develop scabs. The area will heal over the next few days- weeks.

Bleeding in the area where follicles have been implanted is normal on the day of the procedure. You should not be bleeding the day after the procedure. If you are, you may have dislodged or removed an implanted hair follicle.

How can you treat bleeding? If you find you are bleeding the day after the procedure don’t panic. Simply get a clean swab/ cotton bud or cloth and apply gentle pressure to the area. Don’t rub as it might dislodge any follicles. The bleeding should eventually stop. You should notify your surgeon that this has happened as it could mean you have lost a hair follicle.

What if the bleeding isn’t going away? If you bleed despite applying light pressure then you should contact your surgeon who should see you as soon as they can.

Crusting

You may notice some crusts that appear in the donor area-these are scabs and they are normal. Crusts may also appear where your grafts have been implanted- this is also normal.

What is happening? The crusts appear because of dried blood and fluid from your surgery settling around each of your implanted hairs. Crusting can be prevented during your surgery by careful washing and spraying by your surgeon. Crusts may appear after your surgery too.

How can you treat crusting? Firstly- DO NOT pick the crusts off. You risk pulling the grafts out and ruining your hair transplant. We recommend spraying your grafts regularly in the first 5 days after surgery. This helps to prevent hard crusts forming. Once you start washing on the 5th day, soak your crusts for 5-10 minutes and wash the area away. Do not spray the area directly with your shower head but instead let water trickle over and wash the foam away. After 1-2 weeks you should be crust free.

Inflammation or infection of the hair grafts

As with any surgery there is always a risk of infection. Your hair transplant should be carried out in a sterile (clean) surgical room so this risk should be minimal. Infection can start as soon as a day after your surgery. Infection normally causes your scalp to feel hot, painful and itchy. You might even notice small painful yellow bumps in the area you have your new grafts.

What is happening? As the grafts have been implanted into small cuts there is a risk of bacteria settling into these cuts too and causing an infection around the hair (folliculitis).

How can you treat infection? Normally this can be treated easily with an antibiotic tablet. The tablet should start working within 1-2 days and clear your infection in 7 days. There should not be any risk to your grafts if this is done quickly so make sure you visit your surgeon promptly if you notice signs of an infection. Sometimes your surgeon may also recommend a cream to apply on your head. This can also help fight the infection.

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References:

  1. Nusbaum BP, Techniques to reduce pain associated with hair transplantation: optimizing anaesthesia and analgesia. 2004, Am J Clin Dermatol, 5(1):9-15
  2. Avram M, Rogers N and Watkins S, Side-effects from follicular unit extraction in hair transplantation. 2014, J Cutan Aesthet Surg, 7(3): 177-179
  3. Gholamali A, Sepideh P and Susan E, Hair Transplantation: Preventing Post-operative Oedema. 2010, J Cutan Aesthet Surg, 3(2): 87-89
  4. Loganathan et al, Complications of Hair Restoration Surgery: A Retrospective Analysis, 2014. Int J Trichology, 6(4): 168- 172