Hair Transplant Side Effects

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.

Still worried about hair transplantation side effects?

Send us an email or Whatsapp us by clicking the icon to ask for our advice. Our Hair Loss Doctors and Surgeons are happy to help!

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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

Telogen Effluvium- What You Need To Know

female hair

Telogen effluvium is a form of hair loss. It is commonly associated with hair loss in a female but actually the diagnosis can affect males too. In most cases the condition self-resolves. However, it can be concerning to lose so much hair quickly. This blog helps to explain what Telogen Effluvium is and what treatments are available to you.

What does “Telogen Effluvium” mean?

Your hair goes through different stages of growth. Telogen effluvium is caused by a disturbance in the normal hair lifecycle. Hair initially grows from the hair root (anagen phase, lasting 2-6 years), then it stops growing and rests (catagen phase, lasting 2-3 weeks). Eventually this resting hair shortens and falls out (telogen phase, lasting 3 months). In the scalp 85% of your hairs are in the active growth phase (anagen) and about 15% of your hairs are being shed (telogen phase).

Telogen– this is the shedding phase of a hair follicle and it comes after two other phases (Anagen- growth phase, Catagen- end of growth phase)

Effluvium- the active shedding of hair

So in a nutshell, telogen effluvium, means you are suffering from hair loss and you are primarily shedding hair that is at the end of its lifecycle. If more of your hair switches into the telogen phase you will notice more hair being shed than is actually grown (less anagen hairs and more telogen hairs). This imbalance and hair loss is called telogen effluvium.

What does telogen effluvium look like?

Telogen effluvium causes hair loss and thinning all over the scalp and differs from Female Pattern Hair Loss where hair is only lost on the top of the scalp. There are two main types of Telogen Effluvium- Acute Telogen Effluvium and Chronic Telogen Effluvium.

Acute- lasting for a short period of time (up to 6 months)

Chronic– lasting for more than 6 months

Acute Telogen Effluvium

In Acute Telogen Effluvium, you will notice you lose hair all over your head. A particularly sudden stressful event normally triggers acute telogen effluvium and it causes more of your hairs to switch from a growing (anagen) phase to a resting (telogen) phase. These hairs will remain in this phase for 3 months and will eventually shed. The process usually resolves after 6 months and you should recover well.

Many different triggers have been found and you may realise you have experienced the following events that are now triggering your hair loss:

  • Going through a severe illness
  • Giving birth or going through an abortion
  • Psychological stress (e.g. death of a loved one)
  • Drastic changes in diet
  • Large blood loss
  • Surgical operation including hair transplant surgery
  • Traumatic accident (e.g. car crash)
  • Medications like Birth Control Pills

Chronic Telogen Effluvium

Although in most cases acute telogen effluvium self resolves after the initial stress event has passed, in some cases hair loss can persist past 6 months. This is called Chronic Telogen Effluvium- a condition where hair thinning and loss continues after 6 months.

How Do You Know If You Are Suffering From Telogen Effluvium?

If you are worried about a diagnosis of telogen effluvium then you should seek immediate advice from a hair loss specialist. If you wanted to book a consultation with the hair loss doctors at The Treatment Rooms London, then please click (here).

For both diagnoses it is important you are seen in person so you hair loss can be examined in detail. In most cases of acute telogen effluvium you should notice your hair grows back as the hair loss is temporary.

For those who may be suffering from chronic telogen effluvium it is important to exclude any common long term causes of hair thinning and hair loss such as:

  • Iron deficiency
  • Zinc deficiency
  • Thyroid disease
  • Kidney or Liver disease
  • Stomach or pancreatic disease
  • Systemic lupus erythematosus
  • Long term viral infections
  • Medications that can cause hair loss

In some cases of chronic telogen effluvium there are no specific triggers and this is called primary chronic telogen effluvium whereby there is diffuse (all over the scalp) hair loss. Mostly women are affected by telogen effluvium (both acute and chronic) as they go through childbirth and can often have iron deficiency.

Can You Treat Telogen Effluvium?

In most cases of acute telogen effluvium you will notice your hair starts to grow back after 3-6 months. However, you can take the licensed medication, Minoxidil, to help treat your hair loss.

In chronic telogen effluvium, you will first need to exclude other causes of hair loss before undergoing treatment. If you are found to have primary chronic telogen effluvium (no specific trigger) then you may notice you benefit from Minoxidil too.

Unlicensed treatments for Telogen Effluvium include PRP injections to help stimulate hair growth and increase hair thickness.

References

What You Need To Know About Finasteride For Hair Loss

finasteride tablet

Propecia® is its brand name. Finasteride is the generic name and it is a medication widely used for the treatment and prevention of hair loss. But how do you, as a patient, decide whether to take it or not? This blog will help you in your decision making process.

Male Hair Loss

Finasteride is primarily a medication for male pattern hair loss. It is not a commonly used medication in females- mainly because there hasn’t been any consistent beneficial effects. The use of finasteride in females may only be limited to conditions like hirsuitism and polycystic ovary syndrome (1).

For the majority of males, the main cause of hair loss occurs in a predictable pattern called male pattern baldness. Male pattern baldness is a type of alopecia caused by dihydrotestosterone (DHT), (2). DHT is a hormone converted from testosterone and it works in your scalp to thin your hair and make it fall out. In most men it is the primary driver for hair thinning and hair loss.

By stopping the action of DHT at hair follicles, we can stop and reverse the hair loss process. This is how Finasteride works. But should you take it?

Taking Finasteride

Firstly- Finasteride is a medication that should be prescribed by your Doctor. Some patients buy it online- at The Treatment Rooms, London we recommend you see a hair loss specialist. The main reasons for this are:

  • Sometimes Finasteride is NOT the correct medication for you as you might be suffering another type of hair loss
  • You should therefore have a hair loss DIAGNOSIS by a specialist before deciding on the best treatment for you
  • Finasteride, like all medications, has SIDE EFFECTS that need to be monitored for
  • You need to check how EFFECTIVE finasteride is- so having an objective analysis of your hair growth whilst on the medication is important. This should be done by a hair loss specialist
  • If you are planning on having CHILDREN then Finasteride should be stopped before & during pregnancy as well as when your partner is breast feeding. This requires meticulous planning on behalf of you and your hair loss Doctor to make sure you limit hair loss during the time when you are not taking the medication

Does Finasteride Work?

At a dose of 1mg taken once a day, Finasteride has been shown to reduce the levels of DHT in the scalp by 60%. In clinical trials this has had the following effects:

  1. Stops hair loss in 86% of males
  2. 65% of men report a significant increase in hair growth

These positive effects can be see in the first year or two when starting treatment. Interestingly, for those who haven’t noticed a change after a year of taking the medication, you should still continue it. Hair growth in clincial trials have been shown to improve even in those with no or little change after 1 year, with great results in growth after 5 years (2).

crown hair transplant with finasteride before and after
Hair regrowth following 5 months of treatment

What are the side effects of Finasteride?

As with all medications there are of course some side effects of Finasteride (3). The two main side effects you ought to know about are:

  1. Low mood
  2. Sexual Dysfunction (2.1-3.8% of males)

For patients who do unfortunately suffer from these side effects- rest assured most patients recover well if they stop the medication. Interestingly, some patients recover despite continuing the medication- this suggests that the medication did not cause the side effect in the first place.

If you are worried about these side effects it is important you discuss them with your hair loss doctor as there are other treatment options available to you. This includes the option of taking the medication on alternate days.

When should you take finasteride?

Finasteride is a medication you usually take once a day. The decision to start finasteride really depends on you. If you are concerned about your hair loss and you have been diagnosed with androgenic alopecia (male pattern baldness) then finasteride is a medication that can prevent further hair loss and help you grow thicker hair.

If you are planning on having a family soon then Finasteride might not be the medication you choose to have. Other treatment options like Minoxidil could be your first line treatment. After you have finished having children you can then think about adding in or swapping to Finasteride.

Some patients may also benefit from having Finasteride to stabilise their existing hair loss before choosing to have a hair transplant. By stopping the progression of hair loss and helping to thicken hair in previously thin areas many patients are able to achieve a very good aesthetic outcome. If they then wanted to have a hair transplant the total number of grafts required for a desirable outcome is less. Overall, the combination of finasteride and a hair transplant to reverse and treat hair loss is the most effective treatment.

Want to know more?

If you would like to find out more about Finasteride then please don’t hesitate to contact our hair loss specialists at The Treatment Rooms London. Our Surgeons and Doctors are happy to take you through a full consultation around hair loss, including a discussion about Finasteride. Feel free to book your consultation today.

References

  1. https://onlinelibrary.wiley.com/doi/abs/10.1111/ijd.14370
  2. https://www.ncbi.nlm.nih.gov/books/NBK278957/
  3. https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1529-8019.2011.01441.x
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3481923/
  5. https://link.springer.com/article/10.2165%2F00003495-199957010-00014
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1622749/
  7. https://thriveglobal.com/stories/what-is-the-role-of-the-pharmacological-use-of-finasteride-in-male-patients/

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British Association of Hair Restoration Surgery

Dr Fernando Hair Restoration Surgeon British Association of Hair Restoration Surgery

Dr Fernando, lead hair transplant surgeon at The Treatment Rooms London, is now a full member of the British Association of Hair Restoration Surgery.

What is the British Association of Hair Restoration Surgery?

The British Association of Hair Restoration Surgery (BAHRS) is a UK non-profit organisation for individuals who have an interest in hair loss, hair transplant surgery and hair research. Its key objectives are to:

  1. Promote the understanding and reputation of hair restoration surgery in the UK and Ireland
  2. Foster the communication of information relating to hair restoration surgery amongst members, other practitioners and other professional bodies
  3. Advance all aspects of the professional practice of hair restoration surgery to high standards of competence, conduct and ethics and to promote education in appropriate skills
  4. Represent members, to assist members to protect their interests, and to offer members support in matters relating to hair restoration surgery practice

BAHRS has a strict code of conduct and standard when it comes to hair transplant surgery. Any member of BAHRS is required to uphold these principles. As a result, if you visit a surgeon who is a BAHRS member, you can expect them to provide you high quality hair transplant surgery as outlined by BAHRS’ professional standards.

Dr Dilan Fernando- Full Member of the British Association of Hair Restoration Surgery

As of January 2019- Dr Fernando is now a full member of the British Association of Hair Restoration Surgery. He continues to work tirelessly to give his patients the highest quality hair transplant surgery. This includes working to BAHRS’ professional standards. It means no corners are cut in delivering hair transplants to patients in London and the wider UK.

Being a full member of BAHRS, Dr Fernando will continue to uphold its code of conduct around the following standards of hair transplant surgery:

  • Consultation process
  • Consent process
  • Transparent transaction processes
  • Record keeping
  • Hair Transplant aftercare
  • Hair Transplant advertising

For more information, you can click the link (here).

References

  1. https://www.bahrs.co.uk/content/large/documents/bahrs_standards/psfhtsv3january19.pdf
  2. https://www.bahrs.co.uk/about-us/bahrs-standards/
  3. https://www.bahrs.co.uk/

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Embracing Baldness

john travolta baldness

John Travolta recently embraced being fully bald- posting a picture on Instagram of him “rocking the look”. And recently in the news an MP was unfortunately “ridiculed” for wearing a wig in the House of Commons. With an increasing number of gentleman looking for hair loss treatment- at what point do you embrace baldness?

Baldness

Becoming bald is a natural process of ageing. For decades we have looked for the one and ultimate cure for hair loss. With FDA and MHRA-approved treatments like Finasteride and Minoxidil; there are proven hair loss treatments for both men and women.

At what stage would you say you are bald? Baldness has several different stages- as represented by the Norwood Scale for men (picture blow).

norwood scale for hair loss
Norwood scale of balding showing the different stages of hair loss

We would describe complete baldness as stage 5a-7, where you have lost all of your hair on the top of your head (if you are male). However, at each stage you can describe yourself as going bald.

If you decided to start hair loss treatment when you at stages 1-5 there is a good chance of being able to restore your hair on the top and crown. The choice of your treatment will depend on a number of factors. Ideally a combination of finasteride, minoxidil and hair transplantation could be an option for you.

If you are stage 5a-7 you have three main options:

1- Have a hair transplant- this is dependant on how much hair you have left on the back and sides

2- Have scalp micropigmentation that will give you the illusion of dense short hair

3- Embrace baldness!

Embracing baldness- what does this mean?

Some gentlemen who we find coming to The Treatment Rooms London are content with not undergoing treatment for their hair loss. They would prefer to style out their baldness. At The Treatment Rooms we have always been led by our patients on their preference for treatment or not. If you prefer being bald and it suits you then why would you bother choosing to have treatment?

Embracing baldness is more a paradigm shift in thinking and perception than it is acceptance. Acceptance suggests that becoming bald wasn’t a choice but it just happened without giving you the chance to do something about it. In reality, there are so many treatments now available that in the 21st century you now have a choice about whether to embrace baldness or not.

Finasteride

A medication that helps to stop any more hair loss and freeze-frame your existing hair loss pattern. Who is on this treatment?

Donald Trump’s famous hair has always caught the media headlines. It is widely rumoured that Donald Trump takes Finasteride. Not convinced of his results? Check out some of the hair regrowth results we have managed to achieve at The Treatment Rooms London in our gallery (click here).

Minoxidil

This a solution, shampoo or spray you apply to your hair. It helps to promote the blood supply to your hair and makes your hair thicker.

Hair Transplantation

The Treatment Rooms London is one of the UK’s premier hair transplant centres, specialising in hair restoration surgery. Thousands of gentlemen choose to have the procedure including rumours about well known celebrities having undergone the treatment too:

References

  1. https://www.telegraph.co.uk/health-fitness/body/like-john-travolta-know-liberation-embracing-bald/
  2. https://www.stuff.co.nz/sport/rugby/all-blacks/110118631/former-all-blacks-fullback-israel-dagg-reveals-effects-of-hair-transplant-surgery
  3. https://www.celebsnow.co.uk/celebrity-news/exclusive-peter-andre-speaks-hair-transplants-775987
  4. https://www.telegraph.co.uk/health-fitness/body/finasteride-does-donald-trumps-favourite-hair-loss-treatment/
  5. https://www.dazeddigital.com/beauty/head/article/43007/1/why-are-more-men-getting-hair-transplants
  6. https://www.thesun.co.uk/sport/8257041/ben-stokes-hair-transplant-steve-bruce-england-first-test-west-indies/
  7. https://www.treatmentroomslondon.com/male-hair-loss-blog/
  8. https://www.treatmentroomslondon.com/male-hair-loss-blog/
  9. https://www.itv.com/news/central/2019-01-25/its-a-wig-tory-mp-michael-fabricant-mocked-by-colleague-during-pmqs/

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