Sun Exposure after Hair Transplant

[dandy]

Hi everyone,

I had two FUE sessions in early December 2011 to lower my hairline and have practically stayed indoors since then to avoid exposing my scalp to the sun. I live in a sunny and hot country and it is very challenging to do this but i try to persevere until the hair starts to grow out to get the best possible result.

However earlier this week i decided to break the monotony and take a short walk in the sun after applying SPF 45 sunscreen and somehow managed to get the recipient scalp area red/pinkish after only 5-10 minutes in the sun. The redness toned down after a couple of hours and returned to its normal color the same day however it had a slightly darker tone as i could clearly see the new hairline where the transplant was done. I did not experience any pain only a hot feeling and tingling sensation like a minor sunburn which also faded away the same day.

The next day i had no unusual sensations but the darker tone was still there and now several days later i can still see a slight difference in tone between the recipient area and the forehead if i look closely.

Im becoming worried that i permanently discolored my scalp and that the grafts might have been damaged if it was a sunburn which im not sure of because i also suffer from sun eczema when exposed to the sun which makes my scalp red in the same fashion. I am hoping it was only a reaction to the intense heat and that i avoided a sunburn because it faded away so fast afterwards but the darker tone makes me confused.

Is it possible to get a tan in the recipient area without experiencing a sunburn just two months after the procedure and can it affect the outcome of the hair growth?

I would still like to be able to take short walks in the future without a cap and i purchased a sunscreen with even higher SPF than before but wont take any risks until someone qualified answers my questions.

[Paul Straub, MD]

Dandy,
It is unlikely that you caused any permanent damage from your short exposure to the sun however I would advise you not to repeat the experience. The grafts are from the sides and back of the head, areas of skin which have never been exposed to intense sunlight. There are tiny areas of skin at the surface of each graft. When they are first exposed to sunlight they take a different color than the surrounding skin which has been exposed to strong sunlight for many years. The new grafts usually become red because the tiny blood vessels in the skin dilate and the red blood shows through the skin. You have only a short period of time to wait until you can expect to see some growth. Perhaps you could wear a cap in the sunlight or a stronger sunscreen. SPF 45 is usually enough but you may have very sun-sensitive skin and require SPF 80 OR 90. Also studies on sunscreens have shown that most people use a much lower dose of sunscreen than the amount which was used to measure the SPF (sun protection factor)
Dr. Straub

[dandy]

Thanks for your reply, Dr Straub.

I feel a lot better knowing that you believe it has not caused any permanent damage. I will follow your advice and avoid the sun until the hair grows out.

How long after the hair transplant do you believe it is safe to be outside in the sun for longer periods like hours or a full day with sunscreen applied to the scalp?

[gillenator]

Thanks for your reply, Dr Straub.

I feel a lot better knowing that you believe it has not caused any permanent damage. I will follow your advice and avoid the sun until the hair grows out.

How long after the hair transplant do you believe it is safe to be outside in the sun for longer periods like hours or a full day with sunscreen applied to the scalp?

Many docs will advise their patients to wait at least 9-12 months post-op yet many if not all of them will still advise the use of sunscreen.

[dandy]

Ok, so you mean it is not advisable to be longer periods in the sun for 9-12 months post-op regardless of sunscreen or not?

[Paul Straub, MD]

The use of sunscreen is advisable for all skin for long periods in intense sunlight. Strong sun will bleach your hair. Rarely is the hair thick enough to prevent all the sunlight from reaching the scalp. After the hair grows only damage to the scalp, such as a sunburn, could cause hair loss. If you are going to spend long time in the sun, for example a day at the beach, by all means apply sunscreen to your face, body and the scalp but after the hair grows you will not have to worry about hair loss for minor sun exposure such as walking across the parking lot to the car.

[gillenator]

Ok, so you mean it is not advisable to be longer periods in the sun for 9-12 months post-op regardless of sunscreen or not?

Exactly!

[John P. Cole, MD]

Sun Exposure

Nobody knows the answer to your question, Dandy. What i can tell you is that I once had a patient who stayed out in the sun all day sailing. He did not wear a cap. As the day went by, he knew that he had burned his scalp. He had a procedure fewer than 3 months before he burned his scalp. Nothing grew.

In over 10,000 procedures, however, I don't know a single patient who did not have good growth due to sun exposure. Most people are far more careful and do not allow their scalp to become burned.

It really does not sound like you were out long enough to have any damage. SPF is supposed to multiple your normal time to burn by the SPF number. Of course, you need to have plenty on for it to function properly. However, unless you normally get burned in 20 seconds, it is not likely that you burned your scalp with an SPF of 45. Scalps also get red when we rub them. When we are worried about our scalp and grafts, we tend to rub the scalp.

it is more likely that you simply got a little sun and then a touch of tan.

The honest response regarding sun exposure and grafting, however, is that no one knows how much sun is required to impair graft growth. A little sun exposure is not going to hurt you, but over doing it will.

Most people get the most sun exposure walking from the house to the car each day. We know this is not much, but everyone is best off putting sun screen on every morning before they leave the house. If your head is bare or thinning, you should put it on there even if you need to apply with a hair spray.

You should be seeing some growth by now, and that probably means you are just fine.

[gillenator]

I have only heard of maybe a half dozen cases in three decades where a patient's yield was impacted from the sun. Several of them had areas of regrowth in a very inconsistent pattern, but not being a doctor nor having any credible research available, it is still very subjective and why I always recommend to protect the skin whether with sunblock or a hat or both!

[dergol]

Question about Hats

I'm 8 months post HT and have basically always worn a baseball cap when outside except for 2 short 10-15 minute exposures that took place at 4 and 7 months (no burn, not discernible effect).

But I was wondering about the actuall efficacy of standard thickness baseball caps and if it mattered what color they are. I know that white reflects the light and is cooler while black absorbs it and is warmer. But beyond that is there any other outcome from wearing different color caps? Do the sun's rays (and UVA and UVB) penetrate one more than the other?

Lastly, when I hold all of my caps up to a ceiling light, I can definitely see that they do not block out the light fully. If I put my hand behind the hat I can see the shadow outline of my hand.

What does this mean as to the extent to which sunlight is actually blocked out (or should one actually separate the small amount of light that appears to be getting through from the UV radiation that is blocked?).

Also every one of the hats (including the black one I got from the HT doc's office) has a certain gossamer effect when held up to a strong light, in that one can see a vague needlepoint background or shimmering pincushion bleed through of light. Like a very fine mesh of a thousand fine but weak needle points of lights. I repeat, this occurs with every baseball cap I have (all of them seemingly normal thickness, dark color or light).

So to a degree, one has to assume that not all light is blocked out by a standard cap. Question is: is enough of the light blocked out?

I'm sure someone will ask: well how have your results been? I would say, pretty good so far (after 8 months). But I guess it is all relative. Could the small amount of light getting through the hats (if it is indeed penetrating them) be making a difference...i.e., cutting into the results...let's say potentially cutting down the percentage of regrowth by even 5%-10%-20% percent?

Or am I overthinking it? Something I've never been accused of doing before

Dergol

[gillenator]

IMHO, as long as you wear the cap when in direct sunlight, you'll be fine. That minute amount of light coming through the seams is neglible. The color makes no difference except to the degree that the darker colors are more heated than the lighter ones.

It is more beneficial for us to cover our scalps with sunblock. That's really where you can make the difference in protecting the tissue and the grafts. The higher the rating, the better.

I personally recommend utilizing both whenever in direct sunlight especially in the summer months when the UVs are especially high.

[topcat]

I would disagree with the sunblock advice completely. Using sunblock is a good way of increasing your risk of cancer. Just a small amount of reading and you will realize most of the chemicals in that crap are estrogenic.

Vitamin D actually decreases your risk for cancer. Maybe it’s time for people to start analyzing all the crap they have been shoveling down their throats that is not real food. But it’s always easier to blame it on something that doesn’t make money for anyone like the sun.

[dergol]

IMHO, as long as you wear the cap when in direct sunlight, you'll be fine...It is more beneficial for us to cover our scalps with sunblock. That's really where you can make the difference in protecting the tissue and the grafts...I personally recommend utilizing both whenever in direct sunlight especially in the summer months when the UVs are especially high.

So Gillenator, I'm a bit confused by your reply. Are you saying that a hat by itself is ALONE sufficient to protect from the sun, or that you need sunblock in addition?

I've never heard that both were necessary; rather that a hat alone was sufficient and that sunblock was necessary if the hat were left off. Problem with sunblock is that you don't really know if you're using enough and if you're replenishing it often enough.

Addionally, I've generally stayed away from sunblock as I fear clogging up my pores or damaging the grafts in any way by adding foreign substances to the scalp, at least for the first 6-9 months. I've even stopped using styling gels for this reason. Just to play it safe. Though, I could really use them as my hair is quite wavy and I tend to grow it out.

[gillenator]

Dergol,

What I am saying is that using both (cap & sunblock) is the best ultimate protection that one can possibly utilize, especially throughout the regrowth period. I am not saying that you "must" do both.

Many doctors concur that a cap in "direct sunlight" is sufficient enough to block out the harmful rays when outdoors in direct sunlight for prolonged periods. Others advocate sunblock/sunscreen. Opinions vary.

I favor the cap because then one does not have to keep applying the sunscreen. It's easy to apply it and then forget about it later. I especially see this with golfers, swimmers, etc. And yes IMHO I think the cap is sufficient to block out the harmful effects.

Hope that adds some clarification for you!

[dandy]

Well, its nice to see that this thread is still active because i just had another FUE session and feel that there is a lot of research to be done concerning the effects of sun exposure and hair transplants.

I started getting growth after 3 months since my first session in December and the hair just thickened for every month but the yield was not very good so i decided to increase the density after only 5 1/2 months. The problem is i cant be sure if its the procedure itself or the sunburns i got earlier that are the reason for the poor yield so this time around i wont take any chances at all.

Im also worried about the chemicals in the sunblock but then again its either that or wear a silly hat or cap for months.