scabs / crusts fall off and reform after 2 months - transplant hair stuck in crusts

[hammerhead]

Procedure was 10/14/2015 - almost 2 months. I lost over half of my native hair in the area that was transplanted - now it is a mess with scabs, crusts - when one falls off there is a tiny spot of blood - next day it dries and turns into a new scab (or crust) It looks worse with each passing week. When does it finally stop scabbing, losing hair, and begin clearing up so new hair can grow? Just frustrated - getting desperate. I was able to not wear a hat after first week - now it looks like an embarrassing mess and have to wear a hat. Any advice? I'd be happier bald right now - which is a bummer because I didn't look that bad before the procedure. Usually a calm, optimistic person - this is wreaking havoc mentally. Doc office keeps saying it's all normal - but after 2 months? I expected to wait 3 to 4 months before seeing growth - but not months to still see stubborn scabs and crusts.

[jamesst11]

Hey hammerhead,
Hopefully your doctor went over what to expect the first few months after surgery. It is normal for the transplanted hairs to form a scab and then fall out. At two months, however, this should be over with, but it may vary case to case. Did you go back and consult with you surgeon about your concerns? Native "shock loss" is something that happens in most cases I believe and the severity of it is poorly understood and different from patient to patient... It may or may not grow back, and hopefully your doctor told you this. Are you on finasteride and minoxidil?

[hammerhead]

Loss of most or all the transplanted hairs was explained pre-surgery, but didn't discuss native hair loss until I started losing it. I lost a bunch the first 2 weeks, then figured it might be over - but it has continued. They keep saying scabbing will subside, but I'm questioning the 2 month time frame. When a scab finally does fall off (and takes transplanted hairs with it) a new scab forms. When that one falls off, yet another one forms. If I rub on them during hair washing, it hurts - so I'm pretty gentle around them. It was recommended the day of surgery that I start Propecia - but only for crown area prevention - the surgery was frontal and mid to crown - no crown was done as the Propecia was planned to help that. After reading numerous both sides of the side affect argument, I became fearful of Propecia, and never started it. That was probably a mistake - but the arguments over the drug can make you crazy - what if I start it and can't handle it, then stop only to have worse hair fall out along with sexual side affects? So, there we are - in limbo on the Propecia decision. Meanwhile, the issue most in my face are these ugly scabs - and the question of when will this end? Can the transplants grow through the scabs, or do I need to be past all that? So much for being back to where I was pre-surgery - I'd give anything to be back to where I was.

[arfy]

The scabbing is worse now, than it was 2 weeks post surgery? That sounds wrong. Posting photos might be helpful. Has the doctor looked at you in person, since your surgery?

You should be using Propecia before your hair transplant, IMO. I think you should try Propecia ASAP and forget all the talk about side effects. Maybe start with a half a tab for the first month, if you want to ease into it.

[hammerhead]

Doc is about a 12 hour drive away - so no, he hasn't seen it - just discussed it on the phone. I may drive to a closer HT doc about 4 hours away and have him take a look and get a second opinion. Would Propecia help with the scabbing? Does it somehow assist in the scalp healing process? I thought it just blocked 5AReductase from converting T into DHT - not sure how that would address my scabbing situation. Thanks for the advice though - just being cautious.

[arfy]

Propecia doesn't have anything to do with scabbing, it will help prevent shock loss.

I would have somebody reputable look at your scalp, as this seems unusual.

[WHTC Clinic]

Photos from the clinic should be requested if they're not in your possession. Did you elect to use or have any post-op products? Please feel free to share any photos. The scabbing should be gone for good. If you are experiencing subsequent post-op bleeding, you may want to tell your physician.

[hammerhead]

Thanks for responding. Not bleeding like it did the first few days post op - seems to be more like the shedding of what looks like transplanted hair embedded underneath original crusts that dried from the first week. Not sure what is happening - perhaps I should have been more aggressive with washing or scrubbing earlier on to remove it - it's like blood dried from the first week with hairs stuck below that continues to stick to my scalp. I send pics to my clinic, and they say it will resolve - but now I'm almost 10 weeks - just wonder if that is normal. I chose to not start Propecia due to the side effect concerns. I am taking supplements like Saw Palmetto, MSM, etc. and I recently started using Lipogaine shampoo about 3 weeks ago and today for the first time am seeing a slow down on the shedding - can't say what it is due to - could be it's just finally starting to slow down. Also, I may be seeing a few random hairs popping up - but like one here and one there - they're thin and wispy - but, anything good at this point would be enough to crack a cork on champagne! Three new hairs - woo hoo! So, now little bits of the crusts or scabs fall off, and usually leaves a tiny blood spot - like what you get when shaving. Over these 10 weeks I lost a ton of native hair - looks much worse than pre-surgery - but perhaps that's normal. Maybe I just need to adjusts to the new norm until hair starts growing. Gotten to the point I don't even care what people think, even though it looks like a mess. Definitely a journey any one considering embarking on should do their homework and and consider. I'll try posting some pics.

[arfy]

Saw Palmetto has the potential for the same side effects as Propecia (but has never been proven effective). At least Propecia works.

Can you post photos? Do a selfie from the top down, no face.

[hammerhead]

Can't figure out how to insert a .jpg - keeps asking for URL. If you can help me do it, I'll be glad to post photos. If I start Propecia this late in the process, will it begin a new round of shedding? If so, how long will that last? I've read that it is best to take it pre-procedure - but I am now 10 weeks along. Also, do I need to take it for life, or just until all the healing is done and transplanted hair is growing? What happens if / when I stop?

[arfy]

You can upload your photos here:

http://postimage.org

Your questions about Propecia can be answered by a simple Google search, and you can also read the Treatments forum here. You could also ask your doctor these questions - you'll need a prescription from him anyway.

[WHTC Clinic]

Thanks for responding. Not bleeding like it did the first few days post op - seems to be more like the shedding of what looks like transplanted hair embedded underneath original crusts that dried from the first week. Not sure what is happening - perhaps I should have been more aggressive with washing or scrubbing earlier on to remove it - it's like blood dried from the first week with hairs stuck below that continues to stick to my scalp. I send pics to my clinic, and they say it will resolve - but now I'm almost 10 weeks - just wonder if that is normal. I chose to not start Propecia due to the side effect concerns. I am taking supplements like Saw Palmetto, MSM, etc. and I recently started using Lipogaine shampoo about 3 weeks ago and today for the first time am seeing a slow down on the shedding - can't say what it is due to - could be it's just finally starting to slow down. Also, I may be seeing a few random hairs popping up - but like one here and one there - they're thin and wispy - but, anything good at this point would be enough to crack a cork on champagne! Three new hairs - woo hoo! So, now little bits of the crusts or scabs fall off, and usually leaves a tiny blood spot - like what you get when shaving. Over these 10 weeks I lost a ton of native hair - looks much worse than pre-surgery - but perhaps that's normal. Maybe I just need to adjusts to the new norm until hair starts growing. Gotten to the point I don't even care what people think, even though it looks like a mess. Definitely a journey any one considering embarking on should do their homework and and consider. I'll try posting some pics.

More aggressive scrubbing with your fingers could help. Try massaging the scalp without using any finger nails. Hair fragments may need a little bit of help getting freed from the scalp. The scabs should leave, and redness or pinkness will be visible. Bleeding shouldn't occur with the shedding. How do you groom your hair, and with what are you using to groom?

[hammerhead]

I'll get more aggressive with scrubbing when washing my hair. Wherever there are scabs (or crusts) is where the residual transplanted hairs are hanging on - the areas that are clear of scabs is where the transplanted hair shed. Man, I've probably washed my hair over 50 times in the last nearly 3 months - those things must be really stubborn. No real bleeding, just a tiny red blood spot like you get from shaving here and there - maybe 4 or 5 or so whenever the scabs with hair shed. I wash with Lipogaine Big 3 or Pura d'or Argan - and use a biotin conditioner. Dry it with cool air, then just a light combing with a comb when its about 75% dry. Wash my hair every other day. I appreciate any advice you can give - thanks.

[Driver]

Remember, in some people crusting can be really bad and recalcitrant. This does not affect prognosis down the line in most cases. Crusts will all come off with time and good scalp washing in the shower.

[hammerhead]

Thanks - I think that is a reasonable prognosis. Reason being is there is no pain, no itching, no real bleeding - it just stays the same - doesn't get worse. Frustrating that when the crusts do finally come off, they take yet more hair with them - I just thought by nearly 3 months that stage would be over. Worse case scenario is that I may be just a slow healer and it is going to delay the growing phase. I agree with you that in time, may take a year, there will be growth. There are 1,950 grafts sitting under there, I know I had a good surgeon, so they are just waiting to get active and grow. That is the picture in my mind that gives me comfort as I struggle with the spotty mess on top. Hopefully the next update I give will at least be that the crusts / scabs are all gone, and the skin looks healthy again - that's the step I need to get past for now - working on it best I can. Wondering if there is a better shampoo that would help this process - any advice on that would be appreciated. Happy New Years everyone - 2016 is going to be a great year!