The final stretch is a critical time in achieving your desired results. Now, the ball is in your court and you play a significant part in ensuring that you are setting yourself up for surgical success. Here are hair transplant aftercare tips to get you started.
Normal Things to Expect
Bleeding. This is normal, but it should be minimal.
Crusting. It is normal for crusts to form on the recipient site a few days after the surgery. It is part of the healing process which you should not remove before it is actually ready to fall off.
Swelling. It usually starts around 2-4 days after hair transplant surgery, and it will last about 3 days.
Pain. Pain is a normal response to any trauma to the skin especially during the first week after surgery. The good thing is that it is easily manageable with pain medications and it should subside over the next few days.
General Hair Care Instructions
- On the day after surgery, some surgeons will allow you to wash your hair gently under the shower.
- When showering, do not stand under a power shower as the pressure, especially during the early post-surgical period. Doing so may dislodge the hair grafts, especially during the first 4-5 days. It helps to have a cup in the shower to help rinse the surgical sites.
- Gently dab a clean towel over the area after rinsing. Avoid hair dryers for 1-2 weeks, especially the hot ones.
- Comb gently so as not to dislodge grafts or disturb incisions.
- Since the sutures used during a hair transplant is non-dissolvable, these will be removed from the donor areas around 14 days following surgery. In any case that any sutures are dislodged do not pull it off and just let it fall by itself.
- When heading out, avoid direct sun exposure on the grafts for 4 weeks. If you are going outdoors, be sure to wear a hat. However, be properly advised on how to wear it properly.
- You must stop smoking at least 4 weeks before and after surgery to help you achieve the best results. Smoking interferes with wound healing and it may increase your risk for complications.
- Avoid alcohol especially for the first week after surgery because this can increase your risk for bleeding. You must not drink any alcohol if you are using any pain medications prescribed as these should not be mixed.
- Limit your caffeine fix as much as possible as this can increase bleeding. Keep it to two cups at the most.
- Wear button-down shirts for the first 5 days after surgery. Avoid wearing shirts that you have to pull over your head as it may dislodge transplanted grafts.
- If you have been using hair loss medications before the procedure, it can be resumed days after surgery. Oral medication can be resumed on the 3rd post-surgical day, while topical medications can be resumed on the 7th
- A cold compress (gel or ice packs) can be applied gently on the head or the back of the scalp a few times for the first night or 7-8 times a day for the next two days after surgery. This can help relieve pain and it can also help reduce swelling.
Important Points on Hair Transplant Surgery Aftercare
Pain is a subjective experience, but this is an expected sensation during the first 2 nights following surgery. To alleviate any discomfort on the surgical sites involved, you can always take the pain medication prescribed by your doctor. This should control your discomfort, allowing you to rest and heal better.
Medications prescribed may include:
- Acetaminophen – over-the-counter pain medications to treat mild to moderate pain (ex. Tylenol)
- Non-Steroidal Anti-Inflammatory Drugs (NSAIDS) – over-the-counter medications to treat mild to moderate pain (ex. Ibuprofen, Naproxen)
- Opioids – for moderate to severe pain
In any case that the pain increases in intensity days after your procedure, report this to your surgeon. Pain can be a sign of infection, especially if there is redness on the area, warm to the touch, or if you develop a fever.
Effective wound healing is necessary for effective wound healing on the donor and recipient sites. Hair transplantation is treated much like any other post-surgical wound. It involves days of head dressings, punch grafts healing, and antibiotic therapy.
The wound at the donor area requires much additional collagen formation to close. If a tricophytic closure is used, healing at the donor site will be a combination of full thickness and partial thickness wounds. This needs proper moisture balance to optimize healing and reduction of tension to reduce scarring.
The importance of cleansing the back of the scalp cannot be emphasized enough. To do this you can soak the area first with water for one minute. Unless it is contraindicated by the surgeon, you can massage the donor area with shampoo using the pads of your fingers. Just let the water gently stream over the back of your head and prevent it from directly hitting the top of your scalp where the new grafts are implanted.
The recipient site heals faster than the donor area due to the small size of the incisions created. Good moisture balance is also necessary to maintain optimal healing. While some think that Vaseline is adequate in providing moisture, some prefer to use medicated ointments.
Washing the new grafts must be done very gently. Surgeons suggest that you should not touch the grafts for the first week. You can prepare soapy water over the area. To prepare this you can dissolve a teaspoon of shampoo to a pitcher of water and pour it gently over the new grafts for 20 seconds. Rinse it for a good 20 seconds as well. Avoid doing it for too long or the grafts may absorb water and “pop up.”
After the first week, you can already start to work on loosening the crusts. Remember that excessive crust formation is also linked to potential infections. To carefully loosen these, you may place a bit of baby oil and gently rub it with the pads of your fingers. Follow it up with shampoo or a soapy solution before rinsing it with water. Never use fingernails to pick off the scabs as this can lead to scarring. Shampooing every day can help loosen the scabs until these are ready to fall off.
Every surgeon has their own post-surgical care instructions, but regardless of what they are it must be followed carefully. Also remember that while some of the factors for wound healing is under the patient’s direct control, much of it is not. As a matter of fact, a large portion of wound healing has much to do with the surgeon’s techniques and the patient’s inherent characteristics
There are some disputes among doctors regarding the use of antibiotics after hair transplant surgery. In most cases, doctors prescribe preventative antibiotics (prophylactic treatment), but some believe that there is no need for it at all. They believe that it is only necessary to provide antibiotic treatment only if there is already an infection present.
However, doctors who prefer to err on the side of caution would prefer that they give the medication right after treatment. This is to avoid any potential cause of infection.
Work and Exercise
You are to refrain from any strenuous activities during the first week after surgery. Minimal activity is recommended for the first 12 hours. It is also important to avoid excessive head movements and bending over during the first 24 hours. This is to prevent undue stress on the surgical site especially when it is still highly vulnerable. Some people may return to light work the day after surgery, but some may prefer to take at least 2-4 days off from work. However, due to physical signs of healing such as swelling and crusting, some patients opt to take a week off.
The follow-up check-up is an important step because this is a way for your surgeon to monitor your progress. You will also be set an appointment for suture removal around 2-3 weeks after surgery.
What You need to Do About Potential Adverse Reactions:
You may expect bleeding to occur the night after surgery and a few days after that. This may stop if firm pressure is applied on the area for 15 minutes. You can press it firmly but gently to prevent dislodging any surrounding grafts.
If you are unable to control the bleeding with rest and gentle pressure, inform your surgeon right away. Persistent bleeding is a sign that your surgical site is not healing as it should be.
Swelling is an inflammatory response of the body to the slight trauma created by the surgery. It usually occurs on the forehead around day 2-4 after the procedure. The swelling may descend to the eyelids due to gravity. However, this should be no cause for worry because it will not leave any permanent problems.
You can significantly reduce swelling if you sleep with your head elevated at 45 degrees for at least 3 nights. To do this you may prop up your head on two pillows or use a recliner. Normally, swelling would subside by itself within a couple of days. Therefore, any prolonged swelling, especially if it is accompanied by pain or if it is warm to the touch, may be a sign of infection.
The risk for infection is present in any surgical procedure. While it may be rare in hair transplants, the likelihood of it happening cannot be eliminated.
The telltale signs of infection may include redness, discomfort, swelling, or bleeding. This would mean that the side effects of hair transplant surgery have only gotten worse instead of getting better. This also implies that the surgical site is compromised.
To prevent infection after hair transplant surgery you can follow these tips:
- Avoid touching the surgical site (donor and recipient areas)
- Do not pick on the scabs as they heal, allow them to fall off by itself
- Follow post-op care instructions carefully
- Avoid smoking and alcoholic beverages during recovery
- Make sure that you attend follow-up visits as scheduled by your surgeons
If you think you show any signs of an infection, immediately report it to your doctor so that prompt treatment can be given.
Remember that these are just general information which you can use during your consultation to ask the right questions. You are more than welcome to ask us your questions or concerns. Book your consultation with Dr. Daood today.