With Tricho closures, how long does it take for hair to start growing thru the scar ?

[EpilepticSceptic]

I'm 1 month post-op. I know all patients are different, but am I looking at 3 months, 6 months, 1 year ? What's the usual time period to see hairs growing thru the scar ?

 

I've seen a few blogs where it seemed to take months for this to happen.

[Blake Bloxham]

EpilepticSceptic,

 

As you may very well know, trichophytic closure occurs when one side of the open donor area is slightly trimmed before the area (specifically the outer layer in a double, deep layer closure) is closed with sutures or staples. Only around 1 millimeter of the epidermis (outermost layer of skin) is removed, which trims the tips of the existing hairs without transecting the follicle (or its ability to produce new hairs). By removing this thin layer of epidermis and superficial hair shaft, the hairs will ideally grow through the scar and minimize its appearance.

 

Now, because the hair follicle is not damaged in a trichophytic closure, the trimmed hairs should continue to grow and cycle at a normal rate. According to cumulative averages, human hair grows around 13 millimeters (1/2 an inch) a month or approximately 0.44 millimeters a day. Unless something is stunting or blocking the hair shaft (which could be a possibility), it should grow through at a fairly normalized rate.

[Dr. William Lindsey]

It all depends on shock loss of the hair on either side of the strip. I posted a case with "5 month 1 week results" last year on a marine that followed NO instructions. We cauterized a fair amount on the left side of the strip as his blood pressure was up, he wouldn't take valium, and didn't believe me that it wouldn't hurt. After the left half was done, he believed me that it wouldn't hurt and his blood pressure went down. He had no bleeding on the right, we didn't cauterize, and there was no shockloss along the scar.

 

At 2 months, he shaved his head, and the scar looked fine...except he had shockloss on the left side. The right side looked great.

 

At 5 months, the scar was covered and filled with hair.

 

SO, it does to some extent depend on when that hair starts to grow through the scar itself.

 

Dr. Lindsey McLean VA

[Tsakalos]

around 3 months

[Blake Bloxham]

EpilepticSceptic,

 

I wanted to add to my original reply and state that it can, in some cases, take around 3-5 months due to scalp trauma from the procedure. I hope this information helps!

[EpilepticSceptic]

Thanks everybody, especially Dr. Lindsey !

 

I was asking because there's one small area of my scar (about 1/2" in length) at where it ends on the left side of my head that doesn't seem to have any hair growing thru it. This area must have undergone some scalp trauma shock loss to that immediate area below and above the scar line. The rest of the scar line is really hard to even find because the hair is growing all around it and thru it. I assume the area with the shockloss will resolve itself over time and hairs will appear there too ?

 

It's weird, but I look for a scar line (even a pencil line) under bright & soft light and it's very, very hard to even see anything -- even in this area that has the shockloss and is just bare skin. My girl even pulls the hair back with a comb and can't seem to see much of a line either. It looks like the skin just mended back. Of course, my hair is about 1.5 inches right now. I guess if I shaved it down to a #2 clip the line would become alot more visible.

Edited June 24, 2010 by EpilepticSceptic

[jonathanb]

hi- does the hair going thru the scar eliminate the scar if you shave down?

[Tsakalos]

hi- does the hair going thru the scar eliminate the scar if you shave down?

 

no way

[Dr. William Lindsey]

Because the scar's straight line is camouflaged by even stubble of protruding hair.

 

Spex is right, you don't know the result until 6 months and I'd venture to say a full year. Friday I saw an Indian fellow we did 3400 on 8 months ago. At the 2 month scar check, he looked PERFECT. He is moving back to India, and came in for a final check, with about 50% growth. Hopefully he'll send pics at a year. Anyhow, his scar was not the perfect scar that I saw at 2 months. It was not awful, but I'd certainly have expected a better scar and told him that.

 

Could it be that the tricho hairs aren't yet growing? Or my deep sutures dissolved too quickly and he widened? Or he just scars bad? I don't know, but I did ask him to email a scar pic at a year, so if its the first theory, he ought to have pretty good coverage.

 

But unlike math, surgery is not the same in every person. Individual characteristics influence results to a varying amount. This might sound like a doctor cop-out, but its true.

 

Dr. Lindsey McLean VA

[TC17]

Dr. Lindsey,

 

When you speak about deep sutures, how exactly are those done, and how does that reduce tension on the surface level sutures?

[schandler11]

Hi Dr. Lindsey, Future_Doc, and everyone else,

Can you guys possibly offer your input about this trichophytic closure? It was performed about 8.5 months ago. Does it appear at all that the hairs have all popped through? Thanks,

 

Edited March 20, 2011 by schandler11

[Cam Simmons MD ABHRS]

hi- does the hair going thru the scar eliminate the scar if you shave down?

 

no way

 

Let me expand on Tsakalos' accurate and concise answer.

 

The human eye is very good at noticing colour differences. A scar is almost always a slightly different colour than the skin beside it. Even a 1 mm wide scar with hair growing through it will be visible if the hair is shaved right down.

 

It is more important for the scar to be narrow than hair-bearing but a narrow hair-bearing scar is easier to hide with shorter hair than a narrow bald scar. I routinely do 2-layer trichophytic closures but tell my patients to expect to have to keep their hair at least 1 inch long for the first 6 months until the pinkness fades then at least 1/2 inch long. A number 4 clipper cuts hair 1/2 (4/8) inches long. Occasional patients are comfortable going down to a #3 clipper (3/8 inch) but they are the exception and not the rule.

 

I usually see patients 10 days, 1 month, 5-6 months, and 10-12 months after their hair transplants. At 1 month there is usually some hair growing through the scar but there is more at 5 months.