Q:

I had a hair transplant back on October 31, 2009. I started getting red boils along my transplanted area (suspected to be folliculitis) in January and I have been taking Accutane for the last complete month.

My question to you is, why did it happen? Was it due to infected surgical equipment used in the surgery? I was advised to get such a heavy drug which has effected the overall tone of my face somewhat like getting severe dryness. Lastly, sir what do u think there are few patches in the infected area who are now like bald patches. Do you have any suggestions or medicine for the future?

A:

Pimple-like scalp lesions that develop after hair transplant surgery are typically folliculitis.

Folliculitis can typically be seen after hair transplant surgery in both the implanted and donor wound areas in the few weeks to month after hair transplant.

The development mechanism of folliculitis is similar to acnea.  It is usually due to blockage in the exit pores of the sebaceous gland (skin oil glands).  Following obstruction of those pores that can occur after hair transplant surgery, sebum (skin oil) cannot be emptied to the skin surface and instead begins accumulating underneath the skin surface.  The result is red or white head-like pimples.

Recovery is generally spontaneous. Although, if too many of these lesions develop, or if there was any sign of secondary infection (i.e.- redness or swelling around the area), the lesions may need to be drained by your physician and the patient may occasionally be recommended to use antibiotics.

Thanks to the generous vascular supply of scalp skin, the infection of scalp skin after hair transplant surgery is extremely rare.

The growth cycle of hair follicles differs between each individual.  For that reason, transplanted hair grafts also may not follow a universal pattern.  We generally schedule follow up visits for our hair transplant patients on the day 1, day 10, month 5 and month 10 following their hair transplant surgery.  Our five month follow up is to make sure patients are having a smooth early growth without any problems or complications.  In most cases, early growth is seen at five months post op.   In some people who started growing hair earlier we may even see something close to their final result.  However, we have had some cases that we did not see impressive results at month five and patients experienced delayed growth of their transplanted grafts following the procedure.

Delayed hair growth after After a hair transplant procedure - Class VI baldness - Before (left), five months (middle) and ten months (right) after hair transplant with US Hair Restoration

Most of these patients do not have anything wrong with their transplanted hair and will only have to be more patient with their hair growth.  We bring all hair transplant patients back in month 10 after their surgery and the results at that time are much better.  This group of patients may see their final result more than 10 months from the time of their hair transplant and it may take 12 to 18 months to see full result.  If the results are still poor at month 10, more diagnostic tests such as a scalp biopsy may be needed to rule out other causes of hair loss that might have been involved with the growth of their transplanted hair.