Is it normal to have broken grafts and a lot of shedding at only 5 days?

[rsn]

At only five days out, I have had a lot of shedding. Maybe some is shock loss, but a lot has been from new grafts. Also a lot of the new grafts started to break, meaning the hair used to be 2 inches and is now 2 milimeters?

 

Is this normal? Did I perhaps shampoo to vigorously or apply too much Neosporin on the grafts?

[bonkerstonker]

Heavy shedding at day 5 is normal it can be new ht hairs or shockloss but i'm confused how can you have new graft hairs 2 inches long at day 5? That doesn't makes sense.

[Dr. William Lindsey]

Neosporin....does your doctor know you are putting on neosporin? Check with them.

 

Dr. Lindsey McLean VA

[rsn]

My doc's written instruction said to put on Neosporin both on the scar and on the recipient area. Is this unorthodox advice? I understand scars are supposed to heal better when you put neosporin on because it keeps the area moist. Neosporin is really hard to get out of hair by the way.

[razzy]

Neosporin on grafts? What? Never heard of that..

[Dr. William Lindsey]

I'd check in with your doctor if I were you.

 

Just be on the safe side and give them a call.

 

Dr. Lindsey McLean VA

[gillenator]

The closest thing I hear about to that is applying liqiud vitamin E to the area but never heard of neurosporin and especially so soon post-op.

 

Yes it is advisable to keep the grafts moist as possible especially immediately post-op and for another 3-5 days. Many docs advocate the use of spraying a saline solution to the recipient area and even to the donor strip where the sutures are. Some recommend other products like Graftcyte which also can help facilitate the healing process and keep the grafts moist.

 

But we cannot speak for your own personal physician so possibly you have this clarified by now.

[gillenator]

rsn,

 

Also, shockloss can begin immediately after the procedure from the related trauma. The average experience sets in around 2-3 weeks post-op but everyone responds differently.

 

Normally the hair shafts within the grafts come out when the crusts/scabs come off usually 7-12 days post-op. In some cases, the crusts may come off but the hair shaft(s) remain which is IMHO the evidence that the shaft(s) remained in the growth phase. Eventually the follicles resume their growth cycles and behavior patterns.

 

Hard to say why the breakage of hair. Normally the hair shafts are trimmed before they are implanted in the recipient sites. In other words, the grafts normally are not transplated with lots of hair length.

 

Is it possible that the breakage you are seeing is to the native exisiting hair in your scalp?

[rsn]

The nurse took a look.

 

She told me that the doc indeed recommends neosporin immediately after the transplant, and both on the scar and on the recipient area. I can tell you the scabs almost all came off at day 5, and maybe the neosporin helped with this. I can also tell you that most of the tranpslanted hair stayed on and started growing pretty quickly. She said the short hairs are all transplanted hair and when they put them in, they were very short, but they quickly grew. I can finally tell you that I could not even feel it when they were taking off the stiches because neosporin causes numbing.

 

So IMHO neosporin should definitely be used on the scar immediately, and it should be used on the donors only if you can deal with the great mess. It is really hard to get neosporin out of hair.

[TakingThePlunge]

Being a Dr. Alexander patient myself, I can also verify that he does recommend applying Neosporin after surgery. I did this as well.

[Mercury]

Does any other docs recommend neosporin on the grafts? Reading between the lines, it does not feel that putting a triple antibiotic ointment on newly transplanted grafts is a good thing. Was he worried about infections?

 

I wonder if Dr. Alexander can comment why he recommends Neosporin on the grafts.

[gobble]

My doc prescribed bactroban for the scar but was very specific not to put it on the grafts.

[Mercury]

When my primary care doc does a skin biopsy on me (I had a little too much sun exposure in my teens, but had fun), he also uses bactroban, which is an antibiotic ointment.

 

Looking forward to hearing why Dr. Alexander uses it on the grafts. Maybe we'll learn something new?

[gillenator]

But does Dr. Alexander use it on all of his patients or was this case a special situation where the antibiotic was used?

[Dr. Scott Alexander MD]

When it comes to Neosporin or Bacitracin I only reccomend it being used day 6 post op NEVER immediately after surgery. It is an option to my patients to use it or not. The reason to use it is to soften up the scabs in the recipient area and help them come off. Pts are instructed to apply the neosporin over the grafted area for 30 minutes to an hour before their shower, then use lots of shampoo and water to wash the ointment out. As far as the incision goes, I instruct patients to keep the area clean and dry during the enire week that the stitches are left in.

 

Thanks,

 

Dr. Alexander

[olmert]

1) Why is it bad to use neosporin before day 6?

2) Why is it bad to keep the incision area moist before the stitches come out?

 

(I thought people scar less when they keep the cut moist from day one.)

 

3) How do you get Neosporin out of hair? Shampoo wouldn’t get any out. I used Goo Gone.

[waitforanagen]

1) Why is it bad to use neosporin before day 6?

 

3) How do you get Neosporin out of hair? Shampoo wouldn’t get any out. I used Goo Gone.

 

 

I would guess in response to number 1 that the act of rubbing it in would place the grafts at serious risk of being dislodged and/or damage the newly forming vasculature.

 

 

In response to number 3, I will presume your joking..... needless to say that putting a solvent on wounds, grafts in particular would seriously reduce the possibility they will survive.

[olmert]

In response to number 3, I will presume your joking..... needless to say that putting a solvent on wounds, grafts in particular would seriously reduce the possibility they will survive.

 

I wasn't joking. What makes you think putting solvent on grafts would reduce yield? I doubt much of the solvent gets to the root. I put so much neosporin, and it just wouldn't come out.

[waitforanagen]

I wasn't joking. What makes you think putting solvent on grafts would reduce yield? I doubt much of the solvent gets to the root.

 

Ordinarily I would say yes... but you just had hundreds of slits cut into your scalp and that, I'm sure, provides a quicker path to the dermis. Chemical burns can and do cause permanent hair loss. Not to mention the tissue that has been inserted has been under alot of stress (hypoxia et al)

 

Do I have any studies that show this? No... no research has been conducted on applying petroleum solvents on freshly transplanted hair grafts.... so this is speculative on my part but I would not expect good things to happen though.

 

Having said all that, hair grafts are pretty resilient so hopefully no permanent damage was done.

 

However, I think rubbing any kind of thick ointment immediately post op ( < 4 days) on the receiptent site seems to be a dangerous thing to do. If keeping the site moist is the objective, there are better ways to go about it... (e.g. copper peptide occlusive dressings etc...). Of course, neosporin on the donor suture is no problem at all (I did it myself, but used a "cream" based triple antibiotic - easier than the thick jelly formulation)

 

Myself - I sprayed graftocyte (copper peptide solution) on my receiptent and donor areas. Quite aggressively the 1st 3 days, actually. There is some science that it improves healing but most of it is based upon large wounds, not little slits.....so some folks question whether copper peptides treatments help much at all on receiptent areas.

 

Per my Dr instructions, I didn't touch my scalp in the 1st 4 days or so... then I gently washed it using a cup of water and baby shampoo.... did this until 10 days post op.... at which point I resumed somewhat normal shampooing.

 

Good luck and happy growing!

[olmert]

Man, I am pretty nervous now that I ruined my yield. Doc hasn't looked at me to estimate my yield yet. I knew it was extreme putting the Goo Gone on, but my hair looked doused in petroleum jelly, and nothing else would get it out. I didn't put the Goo Gone on till like day 7.

[s2thoudriver]

Do nothing, apply nothing for the first few days. Literally sit still with your head up, let the wonders of human nature fix the trauma...let your body do it's thing!

 

Don't know about strip scars, but after day 1 FUE, i did nothing to the donor area, just let it heal and dry.

 

Only thing i ever did on the recipient area (after 3 days) is dab on body lotion, leave for half an hour, rinse off. This just keeps the skin supple as it heals and the scabs drop off.

 

No rubbing for a week, no shampoo for a week, certainly no lotions/oils/copper, goo goo (whatever that is) etc for a number of weeks, if at all.

 

Let it breathe and do it's thing.

[gillenator]

I am also of the opinion that one does not apply anything to the epidermis other than a saline based solution which is proven to facilitate wound healing, and other products like copper peptide based sprayes like Graftcyte.

 

Most docs will advise to keep the recipient area moist for at least 3 days post-op. Some advocate up to one week. Maintaining a moist environment does facilitate the healing process.

 

I also believe that it is important to allow the incisions to heal before applying any other products like neurosporin, etc. Most of the tiny recipient incisions heal up pretty good after 5-7 days post-op in most patients.