Hair Restoration Blog

Hair transplant surgery is a meticulous procedure. Even after a hair transplant the need for continuous care won’t stop. At US Hair Restoration, we schedule all patients to come back after the first day for a hair wash, which may take about 30 minutes. We use the most inert shampoos to wash the newly transplanted hair grafts.  On the transplanted areas, we only spread the shampoo foam and dab it. We leave the shampoo for two minutes and then rinse it with water.

The donor area is also washed in the first visit after a hair transplant procedure. We supply the patient with a special sponge and soft brush. The sponge is used for the transplanted area and the brush is used for the donor wound. Washing the donor wound, which is closed with either staples or sutures, can be done a bit more aggressively. The brush can be rubbed on the back of the head with gentle up and down movements, which also help remove all debris and dried blood that is left from the day of the hair transplant surgery. Washing hair should be done twice a day for the first four days, then, patients can reduce it to once a day.

We teach patients how to take care of their transplanted donor area after a hair transplant. This wash is especially important for the first four days after a hair transplant when the grafts could be dislodged if not handled with a special care. After the first four days from the day of the hair transplant, the patient can go back to his old routine and wash his hair more aggressively. At this point, the grafts are considered sealed and part of the scalp even if one tries to move the hair. The follicles remaining are capable of generating new hairs.

The reason we recommend washing after a hair transplant with our meticulous technique is to prevent scabbing. There are several studies that show scabbing may decrease growth of transplanted hair grafts. We should not see any scabbing after day seven from the day of the hair transplant. If scabs are present at that time, it means that the washing was not done properly and the patient needs to get on it and become more aggressive with his or her hair wash. After day four, patients can continue to wash hair twice a day and, also, they need to leave the foam alone for as long as 10 minutes to soften the scabs. Then, they have to use the soft brush that is provided to comb their hair in the direction of the other hairs so scabs can be combed off gently.

We instruct patients to not submerge his or her head into water for the first week after surgery and avoid bending the head too much for the first month. We also ask patients to avoid sun exposure on the transplanted area for about six months after the hair transplant. Later on, when the transplanted hair will grow and will be able to protect itself from the sun.

1.    When can my son start handling his hair after his hair transplant without any caution whatsoever regarding physically touching or handling his hair, for example, with a full shower head, and rubbing his hair dry with a towel.
2.    He uses his comb just a little right now.  For example, he will comb his hair forward in anticipation for going to school.  Once in a while the comb hits his scalp, albeit pretty gently.  Is that O.K., or is it bad?
Thank you greatly.  All my best,

A:
Any time after the first four days from the day of a hair transplant surgery, patient can go back to his or her regular routine for washing and handling of their hair.

At this point (5 days after hair transplant), there is no limitation in daily hair care except in regards to sun exposure.  I don’t recommend excess sun exposure for 6 months after hair transplant to the newly transplanted area.  It should not be a problem for your son since he is combing his hair forward and covering the transplanted area.

Q:

My question is based on a hair transplant that wasn’t successful.  I received a hair transplant at [blocked hair transplant clinic name] and my hair never grew in the area and I followed all the directions carefully. Is there any other solutions to bring back my hair?
A:

The survival of transplanted hair is usually a concern among the patients who undergo hair restoration.  Transplanted hair might never grow or have suboptimal growth in several conditions.  We can categories those into two major groups:  1. Technical problem and 2. Patient factor.

• Hair Transplant Technical Problems:

  • Hair graft preparation and handling problems:  inexperienced technicians may manipulate hair grafts more than what they can tolerate.  That may damage the proliferated follicle cells during slivering, graft harvesting or implanting so the transplanted hair can never grow.
  • Graft maintenance problems:  Hair follicles should be kept in suitable physiologic solutions from the moment they are removed from body till the time that they are placed in their destination.  The temperature of the solution should always be kept between 0 - 4 degree Centigrade to lower the cell metabolism and prolong the longevity of follicular cells.
  • Problems during implantation phase:  If the sites are too tight, technicians may manipulate hair grafts too much that may affect the final potential of hair cells to grow.

• Patient Factors:

  • Many skin conditions may restrict or stop the growth of transplanted hair.  Some of those conditions are Alopecia Areata, Alopecia Cicatricial and many other medical conditions that may have caused hair loss in the first place.  Preoperative microscopic and macroscopic evaluation of hair and scalp is crucial to rule out any condition that may limit the growth of transplanted hair.  Hair transplant surgeons should raise questions for these in atypical hair loss conditions especially in patients who do not have a family history of similar hair loss condition.  The diagnosis should be confirmed by scalp biopsy.
  • Care after hair transplant play a major role in the final results of a hair transplant procedure.  Physical trauma to the transplanted hair may cause losing newly transplanted hair, including pulling hair, scratching head or psychological conditions such as trichotillomania in which patient pull hair due to an obsessive compulsive disorder.

If you experienced less than desirable results from your hair transplant surgery after one year from your hair transplant surgery, you need to see a good hair transplant surgeon to reevaluate your condition and potentially treat the disorder that has caused your less than desirable growth.