Very Red at 2 Months. Transplant disaster, health issue, or just #@$ luck??

[JayBandana]

Me, 2 months now after FUE. The pictures don't lie: it really is so red compared to my skin:

 

 

 

 

 

 

I still have a very obvious redness in my recipient area now almost 2 months after FUE surgery. The marks from the incisions are still clearly visible. It improved slowly until the 2 week mark, but it hasn't changed much in the last 5-6 weeks.

 

Everything went great with the procedure. FUE, temples, front hairline. Unshaven in front. I was happy with the doctor. Both donor and recipient areas seemed good, no problems with infection, swelling, or bleeding. No grafts fell out. Everything clean. For the first month, I took care, didn't get any sun, all that good stuff. I was calm and ready for the long wait for growth, totally unstressed, never looked if I had any hairs growing in. Didn't look at forums or read a word about hair. I figured the next time I'd be on a forum would be around 9 months: I'd write a post of glory bragging about my new Samson hair and then hang around giving wise words of wisdom and encouragement to guys who are nervous.

 

Instead, here I am at 2 months with this mess.

 

I saw that my recipient area was red, but I knew that some people stay red longer than others. So I figured it's no problem that I'm red in the first month.

 

After the first month, my doctor checked it. Baaaam, he was really surprised. He said it's the reddest he's ever seen. It's also odd that you can still see almost all the incision marks with no magnifying glass; they're like little pock marks and you can see them clearly.

 

My doctor has no idea what's going on. He said maybe it's because I'm blond, light-skin tone? Maybe just bad luck? Maybe something else? There's no real hair growth obviously, too early for that, but other than the redness, he said it doesn't seem bad. But he's never seen redness like this before and doesn't know what to suggest, other than to give it time. Like... many months.

 

Months more of this extreme redness!? Not one month more or two months more, but many months more of this??

 

That's when I went onto forums for the first time post-surgery to look at people's progress in their first 8 weeks.Compared to the progress of patients I saw, my redness is definitely extreme. Even among the people who come onto forums and create accounts specifically in order to complain, cry and pray for solutions... none of them are near my level of redness. They have what everyone calls "lingering redness":

 

 

Not me: This guy is 2.5 months after surgery. He was concerned, made a post on this forum about it. I'm definitely much more red than him.

 

 

 

Not me: At 2.5 months after surgery, this poor guy was very, very concerned. Made a dozen posts on 5 different forums. My redness is much worse than his.

 

I understand their worries, but oh maaaan, I wish I had their level of redness right now. At their level, some make-up hides it nicely. Or even a little lie about a sunburn. But mine isn't "lingering" like a pesky little intruder that needs to be shushed away, mine is a full-on blood-soaked bandana stitched into my forehead from one side to the other.

 

For what it's worth, I saw lots of comments that fair-skinned, blond-red hair people are more likely to get redness. But at least based on forum pictures and posts, it seems that plenty of blonds and ginger guys have no trace after 4 weeks, while some darker-skinned guys with dark hair also have redness... although none like me.

 

The only example I found of someone close to my level of redness is an Irish patient of Dr. Lindsey mentioned on a forum post:

 

Not me: Irish patient of Dr. Lindsey, the only person I've seen with something close to my level of redness at around 2 months

 

 

It's not clear at what point after surgery this guy's red picture is from, but if it's the 6-8 week period, then it's the only guy even close to my level I've seen. And at least from the picture, he's not as red as I am. He has a more muted off-purple tone which matches much better with his hair ;-)

 

I'm staying positive and trying to laugh it all off, but it's definitely been a blow for me. I thought I'd prepared well when I arranged 10 weeks free from public appearances. But woops, that not looking good enough now. I'd be fine if I just had the lingering pinkness other guys get, but not in my case: my redness is too distracting to get anyone to concentrate on anything coming out of my mouth.

 

And there's no hiding my big redness. Thing is visible from anywhere. If you can see me, then you can see it. Because I didn't shave the front for the FUE, my front hair is medium-length now and can hide some of the redness at the temples, but it's not enough to hide the front recipient area. And no make-up in the world can cover up that bloody bandana I've got stretching across my head. So it looks like there's no way now that I can go out in public and I'll be cancelling work events I had scheduled from week 10 onwards. Which really sucks for life and for career.

 

I have no idea how I'm going to disappear, but with the way I'm looking, I gotta do it. (Unfortunately, not a joke). How long you reckon I'll have to be in hiding? 3 months? 6 month? More?

 

And that's the best case scenario, that it gradually does heal. There's also the chance that something is wrong, either with me, my skin, the transplant, or something.

 

I've had lots of cuts and wounds before, and everything has always healed normally. I made an appointment with a dermatologist, but the earliest I could get is in two weeks. (I could have told the secretary it was an emergency and gotten in right away, but I don't think we're there yet.) (Errr... at least, I hope not).

 

What I want to ask all of you:

 

1. What do you think of my situation? Hair transplant disaster? Health issue? Just bad luck that lots of time will resolve??

 

2. Any similar redness situations you know of, either you personally or patients or someone else? I'd really appreciate any time-line and photos as I redraw my life plan for the future!

 

3. Any suggestions? A topical steroid, like hydrocortisone creme, is a possibility, 1% in a store or 2.5%+ with a prescription. But I don't know if a steroid is a good idea yet - or ever - in my case. If it's a health issue or a bigger problem, steroids could make things worse. I also know aloe vera and witch's hazel get thrown around as ideas, but there's little evidence on them and the evidence that does exist is pretty negative on their helpfulness.

Edited May 30, 2017 by JayBandana
Formatting; added another comparison photo

[TrixGlendevon]

I would think steroids would help to calm it down but you'd have to speak to a doctor (which I am not). Have you tried pure aloe vera gel? Have you been out in the strong sun? I have read this can make the scalp very red in the first few months as it loses its natural ability to protect itself from the sun.

[Mick50]

Yes speak with your doctor it appears you have blonde hair and the fair skin that often goes with it, these patients seem to remain red longer than sallow darker skin , I'm sure it will be fine when the hair starts growing through in the next month or two, but check with doctor for sure

[JayBandana]

Thanks for the suggestions. Yeah, as I wrote, I've been perfect about sun, I've gotten no exposure. About aloe vera and witch's hazel, I looked at the research, and there's little evidence on them and the evidence that does exist is pretty negative on their helpfulness.

 

As I wrote, I spoke to my doctor already. Until then, I was cruising along blissfully unaware of how much redder my scalp is than other guys. Then my doctor took one look and said it's the reddest he's ever seen, much redder than even other patients who are red. It doesn't seem infected, it's just very red and with very visible incision marks still at 2 months. So no one knows what's going on.

 

Anyone have any insight? Similar experiences with yourself?

 

Any doctors out there, I'd love to know what you think: anything similar with patients you've seen??

 

Thanks!

[TrixGlendevon]

Yes, we read that about your doctor. I think what we meant, or at least what I meant, was speaking to your doctor about the prescription of steroids to calm it down. They are not over-the-counter medicine.

[JayBandana]

Thanks for that, Trix, appreciate it. Truth is that my doctor just doesn't know, he's never seen something like this. A topical steroid can help if it's an inflammation issue, and seems to be useful in cases like the guys with lingering redness. But my case is so much more than what he's seen. If it's a different health issue, then it could actually be better to avoid steroids.

 

So who knows. That's why I'm going to a dermatologist at the first availability in 2 weeks. I'm hoping in the meantime, someone on the forum might have some insight or a similar experience. Thanks!

[Dolph1969]

I put on aloe vera gel and witch hazel religiously. Still took a good month or so for the redness to fade.

[TrixGlendevon]

Thanks for that, Trix, appreciate it. Truth is that my doctor just doesn't know, he's never seen something like this. A topical steroid can help if it's an inflammation issue, and seems to be useful in cases like the guys with lingering redness. But my case is so much more than what he's seen. If it's a different health issue, then it could actually be better to avoid steroids.

 

So who knows. That's why I'm going to a dermatologist at the first availability in 2 weeks. I'm hoping in the meantime, someone on the forum might have some insight or a similar experience. Thanks!

 

Good idea going to the dematologist. I would still use the aloe vera and witch hazel. It may not work but it won't hurt anything and I doubt they cost very much. I use aloe vera when I get sunburn and it has a cooling effect. Sorry I can't be of more help. Ideally, as you said, one of the doctors will see this and comment. Maybe PM one of them?

[JayBandana]

Good idea, Trix, thanks. Looks like I don't yet have enough rep points or posts here to PM, but hopefully some doctors or experienced guys will pop in on this thread when they have time. Obviously I'm very interested for myself, but I think it's also a good topic for many guys thinking about HT... and for all the guys slogging through their own months of post-op redness.

 

I've seen some doctors talk about the redness, but it's often mentioned as a temporary effect for the first weeks, maybe a month or two max. And some doctors never have it as an issue in their patients; for example, Dr. Rassman in Los Angeles wrote in a post on his blog:

Redness [in the recipient area] rarely lasts longer than a few weeks in the worst of cases. The one exception that I can recall was a patient that had redness to some degree last around 6 weeks, but that was unusual.

So I guess I'm a lot worse than the worst of cases... :eek:

[TrixGlendevon]

You just need to request them to activiate your PM. Email them! Report back when you know what it is. I hope you get it fixed

[mrfivehead]

Should be no ecause for concern outside of being within a bad situation of the ugly duckling phase.

 

 

Takes me six months to completely have matching skin similirities.

 

That pink tinge tends to longer around for awhile. Redness is usually gone by three half months.

 

 

3 weeks is bullshit. Go stand under a florescent light and tell me it's not pink/red at 3 weeks.

[TakingThePlunge]

Jay, I've notified our webmaster that your PM needs activating.

 

I remained pretty red after my first hair transplant but you are much redder at this stage than I was. After my second procedure I used Humphrey's Witch Hazel Facial Toner, Cucumber Melon which claims to be redness reducing. Not sure how much it helped but I feel like the redness was gone much quicker.

[matt3480]

I was pretty red too for a few months. You have blonde hair and very fair skin.....the red skin is going to stick out like a sore thumb over other people with dark hair or darker skin. I seemed to get over the hump when I started using aloe vera religiously.....I would put a ton on and when it dried in a few hours I put more on. I did this every day for weeks and weeks. You can't over expose to aloe vera....put it on as much as you can as often as you can. It really is pretty amazing stuff.

 

I agree it does not appear to be inflammatory-related so I don't know that I would use steroids....I have heard that can affect yield. By the way, my HT turned out great.

[JayBandana]

Thanks for the feedback, guys.

 

David, thanks for hooking up my PM... You were "pretty red", but I'm much redder than you were at 2 months? Sigh...

 

Mr.Five, yeah, ugly duckling for sure. But I've never seen such a red duck at 2 months! You wrote that your redness had faded away at 3.5 months. Do you have any pics in the 6-12 weeks period? (And btw, yeah, pretty obviously now I agree with your BS comment lol).

 

Matt, thanks for the tip. Same question for you, do you have redness pictures? (I looked around but couldn't find any of yours).

[Dr. William Lindsey]

That's pretty red!

 

I had a recent guy my age who was like that for 4 months for no apparent reason. He was a bit of an obsessive guy... after it faded he asked why he had gray hair in the back.... thought it was from the strip.... Only after he saw it was there preop, did he realize he is gray like me.

 

Good luck on that erythema.

 

Dr. Lindsey

[mattj]

I can't say I've ever encountered anybody who has remained so red for this many months after a procedure. Like others have said, your skin tone will mean that redness shows up more but that doesn't account for the length of time you've had to endure this.

 

Do you find that you're a slow healer in general? Like, if you cut yourself, does the wound stay red for a long time?

 

I do think that in all likelihood, you'll see it start to fade over the coming months. This is nothing more than a gut feeling, but that just seems more likely than it being permanent. I do hope you'll keep us updated.

[JayBandana]

Dr. Lindsey, thank you for looking at this thread. I appreciate your insight and experience. Grey hairs and obsessive in that patient, whoaaa! I definitely have grey hairs, getting more every year since I was 19 lol, but I'm ok with that :-). And obsessive...? Self-analysis is tough, but I think I'm holding up pretty well considering that 2 months post-op I still have a big red bandana stitched into my head! Trying to keep some humour and hope about the whole thing :cool:

 

I'd be very interested in your experience with patients, Dr. Lindsey, regarding their extreme redness. Any thoughts about treatment (medicine? other?), healing timeline, and eventual recovery.

 

For example, any details about the 4-month red patient you wrote about would be great :-).

 

And the Irish gentleman whose picture you posted in an earlier thread...? (He's the ginger-haired guy whose picture I put in my post which starts this thread). How long post-op is that picture of him? Did he have pock marks from the incisions still visible to the naked eye 2 months post-op (I definitely have hundreds of visible pock marks, but it doesn't show up so well in my pictures, so I'm curious if the Irish chap had the same situation)?

 

Thanks Dr. Lindsey! :-)

 

_____

 

Matt J. - Thanks, mate. Yeah, I agree with you that pale skin tone can make the redness stand out more than in someone with darker skin tone. But that's just the subtle part of the effect; the big issue is that my level of redness would look out of place on the skin of anyone who's not Martian!

 

To answer your question, no, throughout my life I've never been a slow healer. As I wrote, I've had all the usual cuts, scrapes, wounds, broken bones, and never had any problems. Always normal healing. As for fitness, I'm in great shape, all blood tests before operation were normal/negative/good (incl. great levels for blood pressure, heart rate, cholesterol and hba1c ). I appreciate your experience from the HT work on your own hair and as a representative for Dr. Rahal; let me know if you have any ideas or insight! Thanks! :-)

[Mick50]

You're very red obviously but as long as there's no infection which could impede the growth

I wouldn't worry too much ,when the transplant hopefully start to grow in the month or so the scalp will be covered .

[Dr Blake Bloxham]

Jay,

 

Thank you for reaching out. As you said, I think it would be best if I respond publicly. It's good to have this on record because it may help a patient out in the future.

 

First and foremost, yes, this is quite red. I generally tell my patients the longest I've personally seen the redness last -- in a patient I performed surgery on -- is 4 months. But even then, I wouldn't define it as "red." Much more of a fading pink that is still slightly visible.

 

If this were sooner post-op, I'd probably be a little suspicious about an infection. It's quite rare, but certain spots there really do have that somewhat taut, hot-red look that is pretty classic for skin infections. But at 2 months out, it seems unlikely that you would have an infection from the procedure. Now, this does not mean you couldn't have developed a little superficial dermal infection in another manner.

 

So a few questions:

 

1) Have you been scratching or picking in any manner?

2) Have you been excessively sweating with anything covering your head?

3) Have you been wearing any sort of hair piece over the transplanted area?

4) Do you work in a healthcare setting or any sort of environment where you could be exposed to more unique -- let's say -- types of bacteria?

5) Any hot tub exposure lately?

 

Another possibility may be non-infectious irritation from some type of exposure.

 

-Any new salves, creams, or ointments up there? Even something like witch hazel that is supposed to fight the redness? You may have some unknown allergy or sensitivity to something like this?

-Do you use minoxidil? If so, liquid or foam?

-Any new soaps, shampoos, or laundry detergents?

-Any new head coverings you've been wearing?

 

This may also be related to an exaggerated effect from new blood supply in the area. Have you noticed that it's worse when it's hot or when you get out of the shower? Are you a big exerciser? If so, is it worse after?

 

Also, some FUE protocols -- in my humble opinion -- do cause a bit more of that lingering redness (I actually did a video on this once). Do you know if the clinic trimmed your grafts before they were implanted? Also, what type of method was used to place the grafts?

 

Something in the above questions may cause a light bulb to illuminate and clarify this a little. If not, I still wouldn't be too concerned. I'd still say the most likely explanation is simply that you're quite fair skinned and it's just taking a while for the redness to go away -- especially if the FUE grafts weren't trimmed.

 

I truly hope this helps. Look forward to your reply.

 

Dr. B. Bloxham

Long Island, NY

[JayBandana]

Dr. Bloxham,

 

Thank you very much for such a thoughtful response. I really appreciate your analytical insight.

 

Your questions are very good ones. Bottom-line, though, is "no" to all your questions.

 

I've followed as close as possible what I think (or thought, at least!) is good post-op care: no scratching, no picking, no sweating. I'm inside all the time and have gotten zero sun exposure on my scalp. No hat or anything else on top of my head (no hair piece, etc). No creams, no Minoxidil or any other topical gel. No exercise for the first month, very little in the second month (sigh..).

Swelling wasn't bad post-op and went away quickly, scabbing was minimal and the recipient area in the immediate days after surgery looked nicely clean just as pics I've seen of other guys, albeit maybe a bit redder. No shock loss at all that I've noticed.

 

My shampoo and soap are the same I used for the last year before the treatment (and never has affected my skin before or after the surgery).

 

Hot shower... maybe the recipient area is a little more red after the shower. Tough to say, though, as my face is also a wee more red for a few minutes after finishing a hot shower. (Is that somehow key to all this? But aren't most people a bit flushed after a hot shower?).

 

I burn quickly in the sun if I don't use sun cream, although I've been fanatical for a long time now about sun cream since I learned the hard way when I was a kid. But lordy, fair-skinned guys who burn quickly in the sun, that's gotta represent a big percentage of HT patients, and it doesn't seem like they all get this HT redness. So I don't get it...

 

About health, as I wrote earlier, I'm in good shape. Pre-op blood work was all wonderful: complete blood count normal, great heart rate, cholesterol levels very good, etc. I've never had an allergy to anything in my life that I know of. Almost never get sick. Don't take and never taken any medicines or supplements. Any cuts, bruises, broken bones from sports and life have always healed normally with no problems or issues (no nasty raised scars, nothing).

 

And thanks for the respect, Dr. Bloxham, but I'm not cool or interesting enough to be exposed to any exotic bacteria . Or to any non-exotic bacteria, for that matter, since I've been locked-up inside for 2 months anyway. And unfortunately I haven't gone hot tub frolicking since 2015. My red-bandana avatar is way more loco than me nowadays .

 

Regarding trimming the grafts, no idea. I'll check with the clinic. Fwiw, my doctor is legit and recommended by many, including here, and I'm pretty confident that I was treated in exactly the same way as all the many other patients he's done this year and all the years before.

 

(I'm not bringing the doctor's name into this because - at least so far - it doesn't seem like it has anything specifically to do with him and his techniques, and I don't want to unfairly paint him with a (red-stained) brush. We'll see how the results are in many months, but at least at this point, I still think he's a good doc and the operation seemed to go well. And I respect that he's been good about my redness situation, hasn't dodged it or pretended anything, and he's given me his best ideas. But he really is just as baffled by this as anyone and that's why I'm asking on the forum).

 

I understand your thinking about an infection. As you write, at 2 months post-op, it doesn't seem likely to be infected, but who knows.

 

The best way I'd describe the recipient area is that it's just unhealed. The incision marks are still visible to the naked eye; they look like hundreds of little craters on Mars. As for the redness, it corresponds very directly to the incisions: at places of a greater number of incisions (like on the front hairline, where there are lots of singles), it's a bit redder; in the back at places of fewer incisions scattered among existing hairs, it's a bit less red; and there's no redness at all more than a few millimetres away from the incisions.

 

Any suggestions for treatment? Ideas I've gathered:

 

- Topical steroids. Hydrocortisone is for the typical lingering redness, so HT doc recommended short-term use of a class II (high potency, 100-150x) corticosteroid like Difluocortolone valerate.

 

- V-beam laser. Targets blood vessels and generally used for rosacea, vascular lesions, scars, etc. Supposedly very precise in only being absorbed by the blood vessels, so follicles are fine. Supposedly. A forum poster here, harryforreal, had redness for 4 years and finally solved it quickly with V-beam, although they made him shave first.

 

- Aloe vera, witch's hazel.

 

- Wait. If you've waited two months, then wait four. If you've waited four months, then wait eight. If you've waited eight months, then...

 

 

I don't want the redness obviously. I could get away with the lingering pink tone you described which your patients have had, but there's no way to hide my full-on red bandana. I'm joking as much as I can about this bloody red bandana - gotta stay positive, right! - but it really is going to be a life-changing pain in the @$$ for both work and life if I'm still like this for months more.

 

At the same time, I'm also concerned about the future hair growth. I don't want to jeopardize a good HT result... at least, if there still is a good result possible in my case. Sigh...

 

Thanks for your insight and observations, Dr. Bloxham. I really do appreciate it for myself. And I'd guess - or hope, at least - that I'm not alone and that there are/will be other guys out there who will definitely benefit from your suggestions about redness! :-)

[mattj]

I'm sure there probably are other HT patients out there somewhere who have had a similar experience to you, but like most patients they aren't forum posters like you and I. You're definitely a rare case, that's for sure, but I think you'll find that time is on your side. I wish I could provide more than the mere advice to be patient, but I think that's really all anyone can offer at this time. I'll be eagerly awaiting your future updates. I reckon you'll be fine.

[JayBandana]

Thanks for the positive thoughts, Matt :-)

___________

___________

 

The photos in my first post show the redness accurately, but it's hard to see the incision marks well. I took close-up pics to show what I mean by unhealed incisions:

 

 

 

 

To be fair, these close-ups really exaggerate the redness and disgustness. Close-ups can make anything look horrible. And the bloody red marks on the hairline in the second photo are pimples or the remains of pimples (I've had a couple, which I've read is normal). My scalp really isn't as scary looking as this haha! The pictures in the first post are more accurate about how it looks in general.

 

But these close-ups are a fair view of the pock marks still visible from the incisions. The reflection of light helps show the depth of the little craters. There are hundreds of them still 2 months post-op.

[Shera]

Hi Jay,

 

It's still early days in your procedure, I wouldn't worry too much about the redness. I have seen similar in a very fair Irish patient where it took nearly 4 months to fade out. I'd probably put it down to your complexion and nothing else. As mentioned by other posters, just give it time and try not to worry too much about it.

[biolizard]

My redness lasted well over a year. Still have some discoloration to this day. You (like myself) unfortunately have sensitive skin that doesn't respond well to the trauma created during an FUE.

[TrixGlendevon]

You think FUT would have been kinder to the skin?