How to differentiate a crust coming out if it's with a follicle or without a follicle?
I'm 1 week post HT.
Per my doctor's instructions I started gently with shampoo and conditioner beginning day
3.
Over the past couple of days, a lot of scab and crust came out with washing.
I do not see any hair in the crust.
I have tendency to rub my scalp and more crust comes out.
I noticed few spots with little bleeding.
I'm worried if my grafts are coming out.
Your responses are appreciated.
I'm attaching a photo.
Thank you for your question!
You are one week after your hair transplant.
You submitted a single photo of the top of your head showing scabs and you have expressed
concern about scabs that contain the hair follicle or contain a hair and how to deal
with this situation.
Well, in our practice, we do a fair number of hair transplants and the routine is fairly
straightforward.
First of all, the concern that you have is very common.
Everyone is afraid that they will dislodge the graft.
When you do hundreds and hundreds of grafts in a session, and for us, any from a thousand
to two thousand grafts, it's understandable that you think that they are very delicate.
But I can tell you that the within the first 24-48 hours, the grafts is so well in place
that it would actually take surgical instrument to physically remove the graft from the scalp.
In our practice, we use a material called extracellular matrix which further facilitates
the healing process and actually treats the thinning hair concurrently.
As far as your concern is, it's important to understand that the scabs that you see
are the combination of some old blood, some very dry skin and it's part of a normal healing
process.
In the first week, we have our patients basically wash their hair with a bowl of water and pour
it gently to let this superficial scabbing dislodge as well as spraying the hair with
some saline to keep it just a little bit moist.
By the second week, we encourage our patients to scrub a little bit.
Of course, we do examine our patients before we give them this advice to make sure that
they are not doing anything that can be traumatic.
Understand that seeing a hair in the scab doesn't mean you lost the graft.
The base of that graft is called the dermal papilla.
The dermal papilla is the root.
It's actually the one that does the growing.
Sometimes, what happens is that the hair will break or shed and that is normal.
So I think communicating with your doctor is critically important.
Every experiences hair restoration surgeon will be able to give you advice from their
experience and I'm sure that with a little bit of guidance, you can anticipate what will
happen beyond this initial very early point in your healing process.
So I wish you the best of luck, I hope that was helpful and thank you for your question!