Scabs - The When and How?

[hairyharry]

I'm on my 8th day of FUT post-op. I've been religiously spraying ATP throughout the day and shampooing with the provided shampoo every morning.
My recipient area is still red, tight with several scabs. What should be done and at what point in post-op to try to remove the scabs?

My understanding is after 7-10 days, the grafts are fully secure. I also understand one should not pick the scabs. I've heard you can let shampoo sit on the scalp for 20 mins prior to rinsing. I've also been told I can lay a warm towel on my head for a few mins before shampooing. Are these approaches safe or are there other/better approaches one should take? I also want to confirm when it's safe for the scabs to come off. I assume at least 10 days post-op?

Edited May 11, 2022 by hairyharry

[Rahal Hair Transplant]

Hairyharry,

Every hair transplant surgeon has their own unique set a postoperative instructions. However, personally I showered a couple times a day after the 5th day and while in the shower, I would gently apply shampoo on my scalp, let it sit for a couple minutes and wash it off. Then I would apply conditioner gently, let it sit for a couple minutes and then I would begin working off the scabs with the conditioner still in my hair.

Ultimately, I would use both of my hands and gently massage the scabbed area with my fingertips (not the nails) in a circular motion. I would do this all over the scalp, especially the scabbed area and after several minutes, I would rinse the scalp and then repeat.  I would do this for approximately 15 minutes to a half hour depending on how I felt the progress was going. I was never forceful with any of the scabs and would use logic and common sense to ensure none of the grafts were damaged/dislodged.

The reason I would apply the shampoo first and then let the conditioner sit on my scalp for a few minutes before beginning to massage the area in a circular motion was to allow the shampoo and conditioner to moisten the scalp and loosen the scabs.

I had a total of four hair transplants and by the third one I was an expert at removing scabs quite quickly without causing any damage to the grafts.  But like I said, every surgeon has their own unique set of postoperative instructions and it’s always best to follow them.

That said, the above was my personal technique which seemed to work well for me.

Best wishes,

Rahal Hair Transplant 

[Fue3361]

My clinic had me apply baby oil to the scabs for 30 minutes then gently massage the scabs with shampoo in the shower.  That got rid of them fast.

[hairyharry]

29 minutes ago, Fue3361 said:

My clinic had me apply baby oil to the scabs for 30 minutes then gently massage the scabs with shampoo in the shower.  That got rid of them fast.

How many days post-op?

 

[1978matt]

28 minutes ago, hairyharry said:

How many days post-op?

 

Konior instructions are 1 week post of for gentle massage with fingertips and very light pressure.  You can use a bit more shower water pressure as well.

[JosephT]

When I got my last hair transplant, I just used Aquaphor everyday and I didn't get any scabs.  And I didn't have the shock-loss I had on previous transplants.

[hairyharry]

42 minutes ago, JosephT said:

When I got my last hair transplant, I just used Aquaphor everyday and I didn't get any scabs.  And I didn't have the shock-loss I had on previous transplants.

Interesting! Is this something your surgeon's office told you about?

[JosephT]

20 minutes ago, hairyharry said:

Interesting! Is this something your surgeon's office told you about?

no, they wanted me to use some silver or copper spray thing, that was like a water that would dry. unfortunately, I didn't know about it on my first 2 transplants.  It's the 3rd one when I did the ointment, and didn't have scabs or shock loss. If I recall correctly, I saw it on some forum, years ago, and it stuck with me.

[hairyharry]

8 minutes ago, JosephT said:

no, they wanted me to use some silver or copper spray thing, that was like a water that would dry. unfortunately, I didn't know about it on my first 2 transplants.  It's the 3rd one when I did the ointment, and didn't have scabs or shock loss. If I recall correctly, I saw it on some forum, years ago, and it stuck with me.

It seems like HT post-op is not (yet) an exact science. Depending on who you talk to you get different answers and suggestions for post-op procedures. Some say the grafts are fully secure after 7 days, others say 10 to 14 days. That's a big difference. As far as the best way to manage/treat scabs, I've heard and read at least a dozen different approaches. Maybe it's just me being an engineer. I expect well understood and documented procedures. 🙂 

[John1991]

2 minutes ago, hairyharry said:

It seems like HT post-op is not (yet) an exact science. Depending on who you talk to you get different answers and suggestions for post-op procedures. Some say the grafts are fully secure after 7 days, others say 10 to 14 days. That's a big difference. As far as the best way to manage/treat scabs, I've heard and read at least a dozen different approaches. Maybe it's just me being an engineer. I expect well understood and documented procedures. 🙂 

That plus each person heals differently and each procedure isn't likely to produce equal amounts of scabbing.  The denser the grafts are placed the more scabbing will occur, the longer they take to go away, and the redder the area underneath is after they go away.  In the front of my hairline I had a few scabs that lasted until about the 3 week mark or so.  Ultimately I think gently massaging in the shower after a week is fine and then after 9-10 days or so being more aggressive with the massaging is OK.  Like Rahal said, don't use your fingernails.  

[JosephT]

33 minutes ago, John1991 said:

That plus each person heals differently and each procedure isn't likely to produce equal amounts of scabbing.  The denser the grafts are placed the more scabbing will occur, the longer they take to go away, and the redder the area underneath is after they go away.  In the front of my hairline I had a few scabs that lasted until about the 3 week mark or so.  Ultimately I think gently massaging in the shower after a week is fine and then after 9-10 days or so being more aggressive with the massaging is OK.  Like Rahal said, don't use your fingernails.  

Yeah, everyone is different, but also any event that is rare or costly or potentially deadly has very little research done, because there is very little wiggle room for error, and they'd rather just play it safe.  It reminds me of the concept of antibiotics and their recommended dosage: complete dosage of antibiotics being 10 days (or whatever) even though you may feel great 5 days after you take them.  they want you to keep taking them just to be sure.  Kind of like cutting out extra skin around a tumor, just to be safe.  The best most people and doctors can do is give you advice on avoiding an infection by keeping it clean, and since most things heal faster when wet (mouth, eyes), they want you to spray something on there, like in my case.  But...  ointments, like aquaphor neosporin, vaseline, are all oil based, and so they lock in moisture better than a water based spray, while also being antibacterial, so they work.

[hairyharry]

On 5/11/2022 at 1:13 PM, Rahal Hair Transplant said:

Hairyharry,

Every hair transplant surgeon has their own unique set a postoperative instructions. However, personally I showered a couple times a day after the 5th day and while in the shower, I would gently apply shampoo on my scalp, let it sit for a couple minutes and wash it off. Then I would apply conditioner gently, let it sit for a couple minutes and then I would begin working off the scabs with the conditioner still in my hair.

Ultimately, I would use both of my hands and gently massage the scabbed area with my fingertips (not the nails) in a circular motion. I would do this all over the scalp, especially the scabbed area and after several minutes, I would rinse the scalp and then repeat.  I would do this for approximately 15 minutes to a half hour depending on how I felt the progress was going. I was never forceful with any of the scabs and would use logic and common sense to ensure none of the grafts were damaged/dislodged.

The reason I would apply the shampoo first and then let the conditioner sit on my scalp for a few minutes before beginning to massage the area in a circular motion was to allow the shampoo and conditioner to moisten the scalp and loosen the scabs.

I had a total of four hair transplants and by the third one I was an expert at removing scabs quite quickly without causing any damage to the grafts.  But like I said, every surgeon has their own unique set of postoperative instructions and it’s always best to follow them.

That said, the above was my personal technique which seemed to work well for me.

Best wishes,

Rahal Hair Transplant 

Very helpful, thanks! 

Edited May 13, 2022 by hairyharry

[Steve McQueen]

On 5/11/2022 at 4:26 PM, JosephT said:

no, they wanted me to use some silver or copper spray thing, that was like a water that would dry. unfortunately, I didn't know about it on my first 2 transplants.  It's the 3rd one when I did the ointment, and didn't have scabs or shock loss. If I recall correctly, I saw it on some forum, years ago, and it stuck with me.

Do you remember how soon after the surgery did you start applying the Aquaphor?
Did you apply/spray it on both the donor and recipient? How