Can I Safely Rub Off Loose Hair Two Weeks after Hair Transplant Surgery?

The following hair transplant question was answered by recommended hair restoration surgeon Dr. Tejinder Bhatti:

I had a 2000 graft follicular unit strip surgery (FUSS) done in Australia. My hair transplant surgeon advised that after 2 weeks I actively scrub off the remaining hair instead of letting it fall off, to avoid foreign body reaction/folliculitis. So I gently tugged on them day 14 post op and they all slid off easily without any resistance or bleeding.

Now I am a little paranoid whether I did the right thing, as even though most hair restoration websites and research articles suggest day 9 and day 10 to be the day when you can pull or scrub without actually dislodging the follicle or papilla, there are so few research articles about it. Also very few have advised to actively scrub away any remaining hair after 2 weeks instead of letting it fall off.

Quite often between 5^th & 10^th post procedure days, one notices black scabs falling out from the hair. Sometimes this is accompanied by a small planted hair adherent to the scab. You will naturally worry and feel the planted hair has come out and have lost one root. In reality one can compare hair roots with ice candy where the stick of candy is hair & ice-cream attached to the stick can be compared with soft tissue of hair root with stem cells attached to hair.

Hair in the hair root acts only as a stand to keep the soft tissue in position during plantation. When the planted hair falls off the ice-cream like soft tissue remains buried inside the skin from which new growth will occur. Any hair falling off after 6 days of the procedure does not carry the root with it – so be reassured that the root shall grow a new hair.

Therefore it really does not matter if you let the hair fall spontaneously with time or you rub them off on completion of 2 weeks.

Most Caucasians have crusts falling off at 7-10 days since the punch size used is smaller and hence the skin and serum component that forms the crust is lesser in contrast to darker racial groups where a punch size of 0.8-0.9 mm is used and the greater epidermal and serum load forms thicker crusts which may be more tenacious and can take upto 2-3 weeks to fall off spontaneously.

During the course of recovery, between 8 & 10 weeks, most of the planted hair falls out and the new spurt of fine soft hair is seen coming through the skin 12 weeks after implantation and that hair continues to grow at the rate of 1cm per month. The first result can be expected only at 22 weeks and no earlier than this timeline. 60-85% of the result in our practice is obtained at 6 months after the procedure and the remaining hair growth is mostly completed between 6-12 months depending on your age and other factors.

Dr. Tejinder Bhatti
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David
Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

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