Question for Doctors regarding discomfort one month after HT

[DB]

I had a HT one month ago. I had some exsiting thinnig hair on the top of my head. Enough that my HT Doctor thought I already had a HT surgery. My HT consisted of relocating folicles to fill in the thinning areas in the top and crown of my head. My question for the Doctors in this forum is regarding what my HT surgeon referred to as cyst on the top of my head. I have had this lump for several years prior to the HT. Due to the shock loss the top of my head is very visible now and the cyst bump is very pronounced. All the hair that covered it fell out so it is very visible. I can live with the vanity aspect and wear a hat until my new hair grows in but my concern is a constant discomfort of what feels like someone pressing their finger very hard into my skull near the cyst. I cannot say it is the cyst as I lost a lot of feeling in top region of my head so it could be the general area or immediately behind the cyst. I am constantly aware of this discomfort and take headache pills like Advil when I need a break from it. Could the HT have agravated the cyst? The surgeon added hairs into it as it is in the balding area. Probably the answer is I should go to see my family Doctor but I am curious and would like to know if feeling this type of discomfort is normal one month after a HT. Thank you

[DB]

I had a HT one month ago. I had some exsiting thinnig hair on the top of my head. Enough that my HT Doctor thought I already had a HT surgery. My HT consisted of relocating folicles to fill in the thinning areas in the top and crown of my head. My question for the Doctors in this forum is regarding what my HT surgeon referred to as cyst on the top of my head. I have had this lump for several years prior to the HT. Due to the shock loss the top of my head is very visible now and the cyst bump is very pronounced. All the hair that covered it fell out so it is very visible. I can live with the vanity aspect and wear a hat until my new hair grows in but my concern is a constant discomfort of what feels like someone pressing their finger very hard into my skull near the cyst. I cannot say it is the cyst as I lost a lot of feeling in top region of my head so it could be the general area or immediately behind the cyst. I am constantly aware of this discomfort and take headache pills like Advil when I need a break from it. Could the HT have agravated the cyst? The surgeon added hairs into it as it is in the balding area. Probably the answer is I should go to see my family Doctor but I am curious and would like to know if feeling this type of discomfort is normal one month after a HT. Thank you

[Dr. William Lindsey]

My guess is you have a sebaceous cyst or lipoma. It may be irritated from local surgery manipulations with the transplant.

 

Go see your doc, he may suggest you see your family doc, who will almost certainly send you to a dermatologist.

 

The dermatologist down the street from me, sends me 2 or 3 of these a week to remove.

 

Good luck.

 

Dr. Lindsey McLean VA

[DB]

Dr. Lindsey,

 

Thank you very much for taking the time to reply. Would seeing a Physician specializing in transplants be better than my family doctor or a referral to a dermatologist? My HT surgeon suggested going to my family Doctor but my thought processs is that a HT Physician would be able to minimize the amount of loss of newly transplanted follicles that could be damaged during the incision and removal procedure. Thank you again Dr. Lindsey

[Dr. Michael Beehner]

DB,

From the description you give, it is almost certain that the "cyst"/bump on your head is a sebaceous cyst (a "wen"). These are easily removed and the resulting scar should be barely visible. It is important that the entire wall of the cyst is excised or it can come back. I have never heard of one of these causing discomfort though.

My strong hunch is that in the next 2-3 weeks you will see this pain gradually go away as you get further from your surgery. There is one very unusual cause of pain called a "neuroma," which is a bundle of nerve tissue which is in the donor scar and involves usually a suture that trapped a small nerve branch, causing radiating pain from that spot up onto the top of the head. It can usually be reproduced by pressing on an area of the donor scar and then the pain comes on. I highly doubt this is what it is, but it must be kept in the differential, especially if it does not improve.

One last note is that sometimes you be so focused and upset about some cosmetic problem, such as this "lump" being exposed, along with the numbness up there which occurs in virtually every transplant procedure, that you can work yourself up into interpreting the whole thing as pain. This is also unlikely to be your case, but I mention it for completeness.

Mike Beehner, M.D.