How to do Scalp Exercises: Increased Risk of Scarring?

I’ve been doing scalp exercises as recommended for my next hair transplant via follicular unit transplantation  but I have a question I’m hoping those with some knowledge or experience can answer. Do scalp exercises provide only temporary donor laxity?   I’m asking the question because should the scalp exercises permit temporary donor laxity, it would seem that given time, the scalp would normalize and cause even more tightness to the donor area. In turn, there would exist a greater potential for scar stretch and or more ischemia.

This is a great question.     Though a hair transplant doctor would be able to give a better explanation,  here is my explanation from what I understand.

What are Scalp Exercises and How are they Done?

Scalp exercises are what certain clinics recommend to patients who are looking to get a large number of grafts in a single session.   These scalp exercises when done properly and consistently will help increase laxity to the scalp so a larger strip can be removed safely obtaining more follicular unit grafts.   There is a great instructional on the Hasson and Wong website.   Click here to view it.

Risks of Scar Stretching

I do not believe there will be increased risk of scar stretching based on doing scalp exercises.     What CAN increase the risk of scar stretching is if the hair transplant physician takes too large of a strip, stretching the skin too quickly beyond its llimitation.

My Observations of How Skin Works  

Expansion and Contraction of the Skin:

Let me explain…

Skin is extremely elastic and can expand to great lengths over time. Skin ultimately expands and contracts as needed, but this process isn’t instantaneous

Let’s look at an example.   People who gain a significant amount of weight, their skin can stretch to unbelievable lengths to accommodate.   This happens over a length of time as people do not gain weight overnight.   Instantaneous skin stretching is much more limited.   Try pinching some skin on your arm between your finger tips. Pull upwards.    It  is only  able to be stretched  to an extent. This typically can be referred to as “pinching an inch”.     In other words, skin can expand nicely over time, but only to a small extent quickly.

Again, skin can stretch to great lengths to accommodate a need over time  (such as gaining weight) or as it is worked consistently  (via scalp exercises for example). One could compare this with muscle growth. Muscles grow from a consistent workout regime over time – also not overnight (though often we’d like it to work that way).

Limitations of  the skin:

Now, skin has limitations…it can NOT expand forever without problems, nor can it expand too quickly.   Over-expansion of the skin too quickly or stretching it beyond it’s capacity  will cause problems.     In hair transplantation, this is why there is additional risk of scarring if the too much scalp/skin is removed from the donor area in a hair transplant.  

• Example 1: Hair Transplantation Closing the donor area after removing too much skin without proper donor laxity, therefore would cause the skin to stretch too quickly causing possible scar stretching, healing problems, and infection.  
  
• Example 2: Example: WeightStretching skin beyond it’s capacity, even over time, can create problems as well.   Those who have lost significant amounts of weight may be left with extra skin and/or stretch marks.

Reasons to do  Scalp Exercises:  

That being said…

Expanding the scalp skin through scalp exercises should allow a healthy expansion of skin and will allow a slightly larger strip to be removed resulting in more follicular unit grafts. Since it takes time for skin to contract, the donor area will be long healed by then, therefore the risks of additional scarring or problems should be minimal IF that.

Not only that…but this makes a great case for EVERYONE to do scalp exercises even for smaller sessions, since it may indeed help with tightness (maybe even pain) one typically feels in the donor area.

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Bill Seemiller
Managing Publisher
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