Recovering from a potential infection - am I screwed?

[nycshearling]

Hi everyone! Hoping for some help on my situation and curious whether anyone has encountered a similar situation as mine. 

I had a hair transplant back in September of this year with a very reputable surgeon (whose name I am not comfortable sharing right now, but will). Things seemed to be going well until week 2, after my antibiotics were done, and I had severe skin inflammation and what I believe was an infection. Of course, I notified that doctor who performed the surgery, but they told me that it appeared like really bad inflammation versus an infection per se. They took a series of actions to heal the skin, including a topical steroid as well as injectable steroid (kenalog). 

Now, almost four months later, my hair is mostly growing out great! I am very happy with the results generally, except or the areas where that inflammation had occurred. As you can see from my attached photos, there are two very visible gaps and patches where that inflammation was prevalent. Now, I am not completely freaking out just yet since I am not even 4 months post op, but I think we can all agree this is a bit concerning given how well the rest of the hair has grown in. And I know that a lot of this will mean just having to wait and see how things go.

So, this is not a jab at the doctor at all, because they have been incredibly helpful and responsive and even played through the scenario for me if no hair grows from this area (and they are very accommodating!). But, I am curious, do you all think I should be worried just yet? My thoughts are as follows: 

1. That skin could legitimately be taking longer to heal. If that is the case, the hair will also not sprout as soon since the skin is healing, and I need to wait it out a few more months to see whether that is the case. I don't think all hope is lost, just yet, since there are in fact at least some hairs sprouting from that area (very little stubble, very thin strands). 

2. Those areas could be damaged, which means no hair will grow. Has anyone experienced something similar to this, and will infections always cause this sort of outcome? The skin seems almost scarred, but I don't think it has, technically speaking...?

3. Any potential topicals that you would recommend for this? I have been using aloe vera, Mederma, Vitamin E Oil, and CeraVe petrolatum to heal the skin faster. If there is anything else you would suggest, let me know. 

I am speaking with a (separate) hair transplant doctor on Monday to get their thoughts on the skin and see what they think. Will report back what they say too. 

Thanks to anyone who can offer any insight and for taking the time to respond! I really appreciate it.

[digi23]

6 hours ago, nycshearling said:

 

Hi everyone! Hoping for some help on my situation and curious whether anyone has encountered a similar situation as mine. 

I had a hair transplant back in September of this year with a very reputable surgeon (whose name I am not comfortable sharing right now, but will). Things seemed to be going well until week 2, after my antibiotics were done, and I had severe skin inflammation and what I believe was an infection. Of course, I notified that doctor who performed the surgery, but they told me that it appeared like really bad inflammation versus an infection per se. They took a series of actions to heal the skin, including a topical steroid as well as injectable steroid (kenalog). 

Now, almost four months later, my hair is mostly growing out great! I am very happy with the results generally, except or the areas where that inflammation had occurred. As you can see from my attached photos, there are two very visible gaps and patches where that inflammation was prevalent. Now, I am not completely freaking out just yet since I am not even 4 months post op, but I think we can all agree this is a bit concerning given how well the rest of the hair has grown in. And I know that a lot of this will mean just having to wait and see how things go.

So, this is not a jab at the doctor at all, because they have been incredibly helpful and responsive and even played through the scenario for me if no hair grows from this area (and they are very accommodating!). But, I am curious, do you all think I should be worried just yet? My thoughts are as follows: 

1. That skin could legitimately be taking longer to heal. If that is the case, the hair will also not sprout as soon since the skin is healing, and I need to wait it out a few more months to see whether that is the case. I don't think all hope is lost, just yet, since there are in fact at least some hairs sprouting from that area (very little stubble, very thin strands). 

2. Those areas could be damaged, which means no hair will grow. Has anyone experienced something similar to this, and will infections always cause this sort of outcome? The skin seems almost scarred, but I don't think it has, technically speaking...?

3. Any potential topicals that you would recommend for this? I have been using aloe vera, Mederma, Vitamin E Oil, and CeraVe petrolatum to heal the skin faster. If there is anything else you would suggest, let me know. 

I am speaking with a (separate) hair transplant doctor on Monday to get their thoughts on the skin and see what they think. Will report back what they say too. 

Thanks to anyone who can offer any insight and for taking the time to respond! I really appreciate it.

As you said, you need to have patience and just wait it out.

I am using 99% aloe vera gel in my recipient area, not sure it does anything but I bought a large bottle so might just make use of it. I like the soothing effect from aloe vera, I think it also helps with itching.

Maybe @DrTBarghouthi can give you any insight what he thinks aswell.

[HappyMan2021]

Each transplant hair grows in at a different pace, but I would be concerned if there was a defined area on my scalp that had no hair growing in. That does make me think there actually is a tangible root cause to why that specific area is not growing. 

Do you have any pre-existing scalp issues? I would say its uncommon to get a scalp infection such as your pictures indicate. 

You are on the right track by getting a 2nd opinion from a different hair transplant doctor. You're never going to get the operating surgeon to admit a mistake on their end (if indeed there was a mistake made)

Edited December 31, 2021 by SadMan2021

[nycshearling]

12 hours ago, digi23 said:

As you said, you need to have patience and just wait it out.

I am using 99% aloe vera gel in my recipient area, not sure it does anything but I bought a large bottle so might just make use of it. I like the soothing effect from aloe vera, I think it also helps with itching.

Maybe @DrTBarghouthi can give you any insight what he thinks aswell.

Thank you for taking the time to respond! Yes, I have been using aloe as well, I think it helps at least with the appearance of redness. Thanks for tagging that doc.

[nycshearling]

4 hours ago, SadMan2021 said:

Each transplant hair grows in at a different pace, but I would be concerned if there was a defined area on my scalp that had no hair growing in. That does make me think there actually is a tangible root cause to why that specific area is not growing. 

Do you have any pre-existing scalp issues? I would say its uncommon to get a scalp infection such as your pictures indicate. 

You are on the right track by getting a 2nd opinion from a different hair transplant. You're never going to get the operating surgeon to admit a mistake on their end (if indeed there was a mistake made)

Thanks very much for taking the time to respond. Yes, it's a little odd that it's on a very specific section, and I agree that something is going on, although I don't know exactly what. And I am not sure that I would attribute it just to "inflammation."

No, I do not have any pre-existing scalp issues. I do think an infection did occur here, though. 

Yes, I am going to see what the second doctor says and whether they think it's treatable or a lost cause. The operating MD claim that they have never seen this before, but they are very responsive and willing to tackle the issue with me, which I am appreciative of. They haven't been brushing me to the side or ignoring me, which shows their dedication to resolving the matter, for which I am grateful.

[digi23]

8 hours ago, nycshearling said:

Thanks very much for taking the time to respond. Yes, it's a little odd that it's on a very specific section, and I agree that something is going on, although I don't know exactly what. And I am not sure that I would attribute it just to "inflammation."

No, I do not have any pre-existing scalp issues. I do think an infection did occur here, though. 

Yes, I am going to see what the second doctor says and whether they think it's treatable or a lost cause. The operating MD claim that they have never seen this before, but they are very responsive and willing to tackle the issue with me, which I am appreciative of. They haven't been brushing me to the side or ignoring me, which shows their dedication to resolving the matter, for which I am grateful.

They have never seen infection before?

Can you tell us which clinic this is?

Edited January 1, 2022 by digi23

[Gatsby]

I'm really surprised your surgeon didn't prescribe stronger anti biotics after the first course when this began. It could be that the anti biotics prescribed weren't strong enough? Can you tell us who the surgeon is?

[Falconary]

Why did you take antibiotics after the hair transplant?

[WideOpen]

Who was the surgeon?

[DrTBarghouthi]

On 12/31/2021 at 11:13 AM, digi23 said:

As you said, you need to have patience and just wait it out.

I am using 99% aloe vera gel in my recipient area, not sure it does anything but I bought a large bottle so might just make use of it. I like the soothing effect from aloe vera, I think it also helps with itching.

Maybe @DrTBarghouthi can give you any insight what he thinks aswell.

Thanks for the mention and apologies for the delay. It is hard to pin point the real cause. Yes the growth in these areas is less and there has been some level of infection in the area on your post op photos. This “may” have been triggered by an element of reduced blood flow in these areas and an increased demand on the circulation with the new grafts in place. The scalp is rich in blood supply and this is the reason why infections are extremely rare. However, with dense packing, sometimes the blood circulation can be slightly compromised and this makes infections more likely. 
I do believe that this can be fixed eventually with adding more grafts in the area once all grafts grow out. It seems the clinic are responsive and willing to assist you in that too. You can wait until all potential grows happen and then this can be addressed. 

[nycshearling]

Thank you so much @DrTBarghouthi for taking the time to help. Could I run these questions by you? 

1. When infection occurs, is it always a guarantee that the grafts are lost in that area? My infection occurred post the 14 day mark, interestingly, so I am curious whether this absolutely means that no grafts will grow, given that they technically had been "secured" by then. I do see some hairs sprouting the area, so I haven't lose hope completely, but I am realistic that it won't grow from there as much as the other areas. 

2. At what point (month-wise) would you recommend following up to transplant more hairs in that area? My doctor mentioned, in passing, doing 6 months post-the initial HT if nothing seems to grow from there, but I am worried that this would be too soon and that we would not have a full idea of any hairs growing from the affected area. Any thoughts? 

Thanks for taking the time to comment.

[DrTBarghouthi]

2 hours ago, nycshearling said:

Thank you so much @DrTBarghouthi for taking the time to help. Could I run these questions by you? 

1. When infection occurs, is it always a guarantee that the grafts are lost in that area? My infection occurred post the 14 day mark, interestingly, so I am curious whether this absolutely means that no grafts will grow, given that they technically had been "secured" by then. I do see some hairs sprouting the area, so I haven't lose hope completely, but I am realistic that it won't grow from there as much as the other areas. 

2. At what point (month-wise) would you recommend following up to transplant more hairs in that area? My doctor mentioned, in passing, doing 6 months post-the initial HT if nothing seems to grow from there, but I am worried that this would be too soon and that we would not have a full idea of any hairs growing from the affected area. Any thoughts? 

Thanks for taking the time to comment.

Thank you sir. 
Yes considering that it was noted 14 days after, then there will be a good chance that growth can still occur. By 14 days, grafts have their own blood supply and so there is  a good chance that all or some of them have survived. The infection may simply delay the growth or makes the dormant stage longer than in non infected areas. 
 

I would not recommend having another procedure before 12 months have passed at least. I have seen people with growth happening in such areas closer to the one year mark to the extent that even if growth wasn’t “full” the reduced density wouldn’t be too noticeable- and may not require having a procedure at all. I would wait if I were you. 

[Melvin- Admin]

It’s strange your infection started at day 14 given that most grafts have anchored and healed by then. Did you wash the recipient at all during the 14 days? Maybe the dried blood got infected? That’s why it’s important to keep the recipient sites clean. After day 9 you should be using conditioner to soak and gently scrub away scabs. 

[nycshearling]

2 hours ago, Melvin- Moderator said:

It’s strange your infection started at day 14 given that most grafts have anchored and healed by then. Did you wash the recipient at all during the 14 days? Maybe the dried blood got infected? That’s why it’s important to keep the recipient sites clean. After day 9 you should be using conditioner to soak and gently scrub away scabs. 

Yes, I was washing generally continuously//daily. I do think it’s a little odd timeline wise. Time will tell how this heals. 

[DrTBarghouthi]

4 hours ago, Melvin- Moderator said:

It’s strange your infection started at day 14 given that most grafts have anchored and healed by then. Did you wash the recipient at all during the 14 days? Maybe the dried blood got infected? That’s why it’s important to keep the recipient sites clean. After day 9 you should be using conditioner to soak and gently scrub away scabs. 

@Melvin- Moderatorcan you please send me the link to the video for the conditioner use. Can’t seem to find it when I search for it. Thanks 🙏🏻 

[DrTBarghouthi]

1 hour ago, nycshearling said:

Yes, I was washing generally continuously//daily. I do think it’s a little odd timeline wise. Time will tell how this heals. 

Yes there are several reasons why it could get infected. The consequences of this can also vary and only time will tell. Let’s stay optimistic in all cases. 

[Doron Harati]

Are you diabetic?

[Melvin- Admin]

11 hours ago, DrTBarghouthi said:

@Melvin- Moderatorcan you please send me the link to the video for the conditioner use. Can’t seem to find it when I search for it. Thanks 🙏🏻 

I’m actually going to film it today. Will post it once it’s done and edited.

[George Clooney]

Can you get a skin biopsy of the affected area? It could impact your course of treatment and would be extremely helpful in case you need a revision down the line.

[JLars]

Hi @nycshearling, thanks for sharing. I am at day 20 post procedure with an infection appearing on about day 14/15. I was treated with antibiotics from about day 16 and the infection is under control and healing nicely. 

Just wondering if you had a follow up on how you fared over the past 15 months? As you can imagine, I have the same anxiety you did about potentially ruining my transplant and Im curious to see how your hair growed out?

Thanks,