What are the white cone-shaped things attached to scabs?

[worried22]

12 days after HT, I removed all the scabs by rubbing my finger against my scalp, but some of the scabs that were dislodged had these long, thin white things attached to them. Is this normal, or should I be concerned? What are they anyway, dead skin? I hope they're not HAIR FOLLICLES?:mad::mad::mad::mad::confused::confused::confused:

[justgotfue]

I'm no expert, but having had similar concerns to yourself, searching these forums incessantly and posting many questions myself, I think this is pretty normal.

 

By day 12 the grafts are secure and it's very unlikely you could dislodge them. If you saw a stream of fresh blood run down your scalp when you removed the scabs, that's something to worry about. Failing this, it's just normal shedding.

[worried22]

Thank you for your answer. I also heard that it's pretty hard to dislodge the hair follicles after 9 or so days, but I'm having a very hard time figuring out what these white needle-like things might be, if they are not hair follicles. At first, I thought it was dried-up pus that spilled into the cavity that holds the hair shaft INSIDE the hair follicles, but they simply looked too big for that to me. Failing this, I was not able to find a viable explanation for what they might be. About 50% of my fallen scabs look like the photo, with the other 50% consisting only of the round-looking scabs WITHOUT the white needle-like part. I would greatly appreciate if any of you guys could offer me an explanation as to what these white things are, or at least if anyone has had successful regrowth after shedding scabs looking like this.

[Dr Blake Bloxham]

Worried,

 

Big breath in ... and big breath out! Relax. You're okay.

 

The only time you'd truly see a follicle from a dislodged graft is after it popped out and was followed by a small amount of bleeding. This would also generally be within the first 3 days. At 12 days post-op, those grafts are locked down. There really isn't much you could do to hurt the follicles themselves at this point. What you see there is normal crusting and scabbing coming off with the grafts. The small white dots near the end of the hair shaft are normal as well.

 

You'll likely see a lot of shedding in the near future. Most of the grafts will probably look similarly to this. But you're too far out and there was nothing indicating that you actually lost any grafts -- AKA no bleeding.

 

Always try to double check these things with your clinic as well. They may have specific post-operative instructions for situations like this, and you always want to follow these as closely as possible.

 

I really hope this helped! Happy growing.

[aaron1234]

Yeah, just grafts shedding. They do that a few days post-op.

 

Once, I was picking at a scab like 5 days post-op and the graft was dislodged. It was pretty obvious because blood start streaming immediately. If that doesn't happen to you, I wouldn't worry about it.

[gillenator]

Those small white things are dead tissue from the tips of your grafts that dried out above the scalp line.

 

Perfectly normal and should be removed after roughly 10 days post-op...

[worried22]

Thank you for your answers. Since I may not have been clear enough the first time, I've attached a little diagram that I've drawn to clarify exactly what my concerns are. The picture of the scabs that I've posted in the original thread consists of two parts - the round, darker ball-shaped part (denoted by the blue arrow in the diagram) and the white and long cylindrical "needle" part (red arrow in diagram). Upon close inspection, I found that the darker "ball" has a flat surface where it meets the "needle" part, which led me to believe that the border of these two parts is the scalp line (denoted by the green line in diagram), which could only mean that the white needle is indeed dislodged from underneath the scalp line. This conclusion is what alarmed me of the possibility that the "needle" is part of the follicle tissue. I am perfectly aware that shedding hair shafts along with the scabs is a normal thing in the post-op phase, but I'm only worried because these scabs have something that appears to have come from UNDERNEATH the scalp. Considering this, does anyone have an idea of what the "needle-like" things are? And is it indeed normal for a FUE scab to contain these "needles?"

Any input would be greatly appreciated. :confused:

(And no, I haven't had any bleeding at all when I removed these scabs.)

Edited July 28, 2015 by worried22

[worried22]

A magnified view of the problematic scabs:

[aaron1234]

I'm only worried because these scabs have something that appears to have come from UNDERNEATH the scalp.

 

Nope, they are actually scab formations accumulating alongside the follicle. Two things are happening: 1) the skin attached to the implanted graft is drying out and 2) a new scab forming around the recipient incision site. The new scab sometimes attaches itself to the hair and grows until the scab flakes off or the hair is shed. What you don't see in any of your pics is the hair bulb that is the root for growing hair. So, you're good.

[worried22]

Nope, they are actually scab formations accumulating alongside the follicle. Two things are happening: 1) the skin attached to the implanted graft is drying out and 2) a new scab forming around the recipient incision site. The new scab sometimes attaches itself to the hair and grows until the scab flakes off or the hair is shed. What you don't see in any of your pics is the hair bulb that is the root for growing hair. So, you're good.

 

Thank you for your reply. Your answer does make a lot of sense. I see from your signature that you have had HT yourself, so do you mind me asking approximately what percentage of your shed scabs had this needle-like structure? Knowing that I'm not the only one with these strange-looking scabs would be of great reassurance to me. As for my case, approximately half of all fallen scabs had these protruding needles, and I just couldn't afford the possibility that I've lost half of my grafts, which is why I'm so worried about this.

[pkipling]

A good general rule to follow is if there's no blood, the graft is okay. You really have nothing to worry about, especially at 12 days post-op. You're totally fine.

 

Congrats on the procedure, and happy growing!

[gillenator]

worried,

 

Got your PM and the secondary part of what you are shedding appears to be a part of the graft tissue beneath the scalp line. That's also why it appears to be more white in color because that part is beneath the epidermis.

[worried22]

worried,

 

Got your PM and the secondary part of what you are shedding appears to be a part of the graft tissue beneath the scalp line. That's also why it appears to be more white in color because that part is beneath the epidermis.

 

Thank you for your input. But do you think it's normal that I'm shedding those tissues?:confused::confused::confused: If I'm losing "graft tissues," shouldn't I be concerned about that at all? And most of all, does it happen to other people as well?

[worried22]

If it makes any difference, the procedure I had was an FUE slit. Maybe it has something to do with the slit incision being bigger than the grafts themselves...?:confused::confused::confused:

[gillenator]

worried,

 

Have not really seen that type of shedding although that does not imply it has not occurred to other individuals. Most HT patients do not participate in these online communities. In fact, most of the guys that I hear from privately who are not happy with their results, surf theses communities but do not post their results.

 

In addition, what is coming out of your scalp does not include the follicles that were transplanted so IMHO, that's a good sign. Neither has there been any oozing or streaming of blood from the recipient sites where the grafts were placed right?

 

If the entire grafts including the follicles were coming out, then yes that would be a concern. And there are no signs of infection or any puss or inflammation in the recipient area right? Again good sign.

 

Am curious. Have you contacted your surgeon and sent him the photos? What was his opinion of what was going on?

 

If you have not yet contacted your surgeon, it would be highly advisable to do so for your own piece of mind.

 

So again worried, I think your situation is going to be okay and the real test is to see the regrowth in the coming months. If you have a decent result, then you can put this behind you and know it did not affect your end result.

 

Hang in there my friend, and please let us know what your doctor said and how you are coming along with your results okay?...

[hidetime]

I don't want to hijack a thread, but my query relates to comments made.

 

To paraphrase:

 

The surgeon said if it doesn't bleed you haven't lost the graft. Someone else said, crucially you aren't seeing the bulb so it's ok.

 

I'm a week post op. Every scab/shaft combo I have come out has a small black bulb on the end. I have trawled post after post and there seems to be an equal split of people saying whether the bulb is ok or not ok.

 

I dislodged one graft on night one and caused bleeding, had nothing like that since. If these bulbs were the whole graft I would have to assume they never bonded at all and the recipient slit healed back up without them bonding at all.

 

Like I said I don't want to spear the thread off track, but would appreciate any comment of whether the black bulb is normal shedding.

[pkipling]

I don't want to hijack a thread, but my query relates to comments made.

 

To paraphrase:

 

The surgeon said if it doesn't bleed you haven't lost the graft. Someone else said, crucially you aren't seeing the bulb so it's ok.

 

I'm a week post op. Every scab/shaft combo I have come out has a small black bulb on the end. I have trawled post after post and there seems to be an equal split of people saying whether the bulb is ok or not ok.

 

I dislodged one graft on night one and caused bleeding, had nothing like that since. If these bulbs were the whole graft I would have to assume they never bonded at all and the recipient slit healed back up without them bonding at all.

 

Like I said I don't want to spear the thread off track, but would appreciate any comment of whether the black bulb is normal shedding.

 

Hey there Hidetime. Your best bet is to start a new post with pictures of what you're experiencing (assuming you took pictures).

 

I do agree that a good general rule to follow is that (as has been mentioned before) as long as there's no blood, you're fine. There may be exceptions to this, but as far as I know, that's the best way to determine whether or not a graft was dislodged.

 

Also, if I were you I'd check in with my surgeon as well and explain what you're experiencing. If you live close by, you could even run in for a checkup.

 

Hope this helps.

[corners]

@worried22 and @hidetime, what were your end results? Does this sheath or black speck matter? Is it possible those grafts just didn't take proper root, or were your results definitely good?

 

[hidetime]

Hi,

 

I'm very happy with my end result. 3 years on the rest of my degeneration has made my hair look 'thin' but certainly not exposed, way better than it was before the op. If it bothered me further I'm sure I could still undergo further surgery.

I think immediately after the op you're prone to worry. I don't know for sure whether I lost any actual grafts, but if I did it was a minimal number. The hair itself will shed, so you just have to take it easy and go with it.

[gillenator]

Happy to hear things turned out good for you!...

[duchaine]

On 7/28/2015 at 8:48 AM, worried22 said:

A magnified view of the problematic scabs:

Worried,
last night I experimented the same thing.
The thing that make me worry is the "white cylinder" surrounding the hair