Redness and Color Normalization

**DrKDSiporin** · 05-20-2010, 02:20 PM

post op recovery

Dear I wantfullfrontal,
First of all, congratulations on a great screen name!! Secondly, I would take a second to heed your own advice, which is realize that it is still quite early in the process, and try to be patient. However, having said that, let me put in my two cents on post operative healing in recipient sites.

The biology of wound healing is divided into three main phases: 1) the inflammatory phase; 2) the proliferative phase ; and 3) the maturation phase. The inflammatory phase is the the body's response to injury, and it lasts for about a week, during which time the body dilates blood vessels in the region of the injury, to deliver cells and proteins which help stop bleeding and set the stage for the repartive processes that occur in the later stages, by delivering the building blocks needed for the repair. Because blood vessels dilate and cells become " leaky " during this phase, redness, or erythema can be noticeable. This is the well known " swelling process " that occurs after injury. Although some of the sequalae of this phase are undesirable, for the most part, we must let it take its couse, to allow normal healling. Having said that, there are things that we can do. Since we do not want to rub the area of the recipient sites for the first week, applying solutions or sprays may be helpful.

In my practice, for the last five or six years, I have been using copper peptide sprays and guazes immediately after surgery, and although I am not aware of any double blinded studies to validate the effectiveness of this treatment, it has been my personal experience that copper peptides have improved healing and lessened post procedure redness significantly. Still every patient is different, and even with copper peptide use, some patients will experience significant post operative redness. It is important to note that this by itself is not abnormal, but if it is excessive, or lasts longer than usual, which can be a few weeks, then it may be a condition called post inflammatory erythema, which can be treated with topical steroids, like hydrocortisone . There are other topical agents which can be used, but I think in your case, it is way too early to begin these treatments, because they are not completely without risk or cost.
You could inquire about getting a copper peptide spray to use now, and another trick is to use vitamin e oil and rub it on to the area. This has not been studied either, and some may worry about the use of Vit E early on because vitamin E may impede healing, but in my mind, the recipient sites do not need much healing, it may treat the color effectively.
Two more comments. I am beginning to use a new water solution, which is normal chlorine water that has been treated to increase your bodies ability to utilize anti oxidants, and preliminarily, I am seeing some nice results in terms of less redness and improved healing, but this water is very new, and I do not have a large number of patients yet.
Lastly, I do believe that use of PRP will also decrease the incidence of redness, and improve healing as well.
So, to summarize: 1. Be patient. 2. Try copper peptides and or vit e. 3. Avoid sunlight. 4. If you do not get improvement soon, ask your doctor about topical steroids or other topical ointments.

Good luck,
Ken Siporin, M.D., F.A.C.S.
Los Angeles, CA.

**CIT_Girl** · 05-20-2010, 02:31 PM

Dr. Cole recommends patients use Hair Cycle Post-Biotin Spray after surgery (you can buy it online). You spray it directly on your recipient area every hour that you are awake and it speeds healing and minimizes crusting and scabs.

**Winston** · 05-20-2010, 03:20 PM

Did your hair transplant surgeon make any suggestions. Who performed your surgery by the way? You should try to get their opinion on the matter.

**Dr. Lindsey** · 05-21-2010, 08:23 AM

Winston is right. Ask your doc what they suggest. I'd be frustrated if you just gave me 5 to 10k and trusted me with your surgery, yet took advice that I may or may not agree with and use it in your recipient area a week out from surgery. You paid for your procedure, you are entitled to postop advice.

Ask your doc before you start trying things, even if recommended by well respected folks.

Dr. Lindsey McLean VA

**amadeus** · 05-23-2010, 12:27 PM

Yeah, I agree with Winston Dr. Lindsey. Talk to the doctor who did your surgery, he should be able to advise you properly. Did he give you any post operative information when you left after surgery, like when to wash your head or what you can put on it if it itches?

**iwantfullfrontal** · 05-26-2010, 08:53 PM

Hey folks -

Sorry it has taken me a while to get back on here - it has been a busy week.

Thank you to Dr. Siporin for the advice and very detailed description of what the skin is doing. We are now at 2 weeks and if the color has improved any, it must be doing so ultra-slowly because it's still noticeable. The color is now a dull pink, but that's basically what it was last week.

I'm sorry I forgot to mention my doc - it was Dr. Feller - I'm going to call their office again tomorrow. I haven't used anything yet on it except for a little skin foundation (yes, unfortunately, women's makeup - only thing I could think of) and it works pretty well but sweats right off when I go to the gym. I didn't think this would be harmful after a full 10 days. It wasn't thick at all, either. Just needed a finger touch of it.

I understand that I am fair skinned, but I have a wedding to go to in a week - I hope it gets better.

Thanks for your comments, folks - I'll keep you posted.

**gillenator** · 05-28-2010, 01:48 PM

IWFF,

For most patients, the lingering redness will resolve itself with time. You should be at three weeks post-op coming up at the time of the wedding you will be attending. I have advised the use of facial make-up post-op whenever the lingering redness is noticable. The key is that the patient is completely healed. There are upper quality makeup products that will hid the redness very well. These are the crystal mineral based products. They work better than your standard facial foundation.

Hope your doc was able to offer you some good resolve and that you had a chance to speak to him by now. Hopefully the redness will have lightened even more by the time of the wedding, but you may want to ask some trusted female(s) about mineral based make-up now ahead of time.

Best wishes to you...

**iwantfullfrontal** · 07-12-2010, 09:02 PM

Hey folks - I just wanted to check in here...

So I'm at the 2-month mark and while ***I think*** the pinkness has improved by a mere fraction, the differential (pink to white skin contrast) is definitely still there, and I'm still having to use concealer to blend the areas.

There is absolutely no doubt in my mind that part of the reason it is noticeable more to me is that unlike the vast majority of other dudes (and girls!) that have done the surgery, I have been shaving my head down to 1/2 inch since to be able to better examine the recipient area. However, with that being said, there has to be a way I can expedite the color normalization process, right?

I have heard that Dr. Feller has treated patients with some sort of hormone/topical treatment (I think). I have a dermatologist appointment at the end of the month - does anybody know if there's something she can do? The aspirin masks, Vitamin E oil, etc has done nothing for me at all.

While I'm going through the painful process of waiting for new hairs to break through, the least thing I can do is get this color situation straightened out, right?

Docs and HT vets - have any advice? Again, just arrived at 2 months.

Thanks!

**gillenator** · 07-16-2010, 01:47 PM

Have you discussed this lingering color with the surgeon who did your procedure?

Some docs recommend steroid based creams, some that can be purchased over the counter. They are usually 1% strength. Or they can prescribe you the 5% product.

But you definitely want to check with your doc first.

**iwantfullfrontal** · 08-09-2010, 08:18 PM

I was recently prescribed Mometasone Furoate cream by my dermatologist for this problem. I believe it is a cortosteroid. It's only .1% - I have been applying it for about two weeks, though only at bedtime and it hasn't really seemed to help much yet. I do notice that in the mornings, after I shower the stuff off my head, it looks like most of the pink is gone but for some reason it slowly comes back during the day. Has anybody had any experience with this???

**gillenator** · 08-10-2010, 12:55 PM

Give it a little more time. You may find that in the next several weeks that there is even more improvement. The pink may be resuming once your activity picks up as you start your day.

**hairtransplantGuy** · 02-19-2012, 03:54 AM

Hi,

I am just over one and a half months post op, and have mild (but quite noticeable if seen from close) redness in a specific region of the recipient area. Most of the recipient area lost noticeable redness around the 3 week mark, except for this region, which doesn't seem to be improving (or might be reducing very slowly in redness but I can't make that out).

Incidentally, I'd got a touch up done on very next day of my surgery since I wanted more density on a particular region than I'd initially planned/received, and it so happens that much of this redone area (though not all) is where the redness has persisted

So I wanted to BUMP this thread to ask the original poster of his experiences with redness and how it changed over time, and also get advice from anyone else.

Thanks

**Winston** · 02-19-2012, 09:37 AM

That redness or pinkness you�re describing is very common and in some people can take several months to fade. It is possible that since your surgeon went into the same area twice in a two day period that area could take longer to return to its normal color. I would not stress about it.

**hairtransplantGuy** · 02-20-2012, 03:53 AM

@Winston
Reassuring to hear that you think it'll go away on its own.

At what point, if the redness is still there, should I be concerned that this is not normal/unlikely to reduce without further intervention?

Redness and Color Normalization

Redness and Color Normalization

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