Pimples up there? Good or Bad?

[Carlos Wesley, MD]

A common observation amongst patients during the early phase of hair growth following surgical hair restoration (either FUT or FUE) is ingrown hair follicles. The "pimples" that some (but not all) patients experience generally represent focal inflammation (folliculitis) where a newly-ingrowing hairs are beginning to surface.

Patients can often feel reassured knowing that these generally precede more apparent hair growth over the following weeks and months. They can be seen in both the recipient area (where transplanted hairs are coming in) or donor region (especially in FUE where any residual hair fragments may be coming in). They may be more commonly observed in zones where the angle of hair implantation is the sharpest angle (e.g. the vertex or crown as seen in the attached image)

In general, a simple cotton ball soaked in rubbing alcohol can be used to rub on each pimple. The microabrasion allows the nearly-ingrowing hair to surface and resume growth. It's relatively rare that an antibiotic is required, but even a one-week course of antibiotic can have a positive impact. The ultimate appearance is not impacted by the presence absence of a few "pimples" and patients should simply be aware that they generally represent an early phase of growth.

[gillenator]

Years ago, many doctors and clinics required the pre-op use of antibiotics and then continuing through approximately 3 days post-op. Then it seems in the present day, it is rarely advocated.

Infections and folliculitis are rare and certainly not common with HT surgery, but is there a viable reason why clinics have moved away from the use of antibiotics?

Recently, many of us have heard that continued use of antibiotics or over-use can build up a resistance to them when they are clearly needed for other conditions/reasons. Could this be the primary reason why the use of them in HT procedures have diminished?