Post operative pain, worried about infection?

[JustJax]

Hey all, it’s day 13 post op from an 2nd 913 graft procedure and I’ve having some pain in the recipient area that’s worrying me. It’s a combination of occasional mild burning sensation, itch/tingle, mild headache, general feeling of tightness.  Feels in some ways like it’s been worse since yesterday and today. I did go a little firmer on Saturday and Sunday to get the scabs off, nothing crazy but maybe that’s caused a little inflammation?
 

I’ve been worrying slightly I might have some sort of infection.  Since the 3 days post op I’ve been feeling cold/almost getting the chills occasionally and had a low temp of 35.5 or 35.5-36c a number of times and I spoke to a doctor/GP in the UK and said it’s likely I just picked up some mild viral infection and that it should go away in a 2-3 weeks.  But now with this increase in pain I’m convinced something isn’t right. I’m trying to think back to 2016 and my first HT but I can’t recall if it was like this back then. I keep obsessively taking pics to check for infection. I think it looks okay, but it’s difficult to tell and different lighting or glare from the light doesn’t help to get a proper sense.  
 

what do you guys think?  Just to note I had quite a lot of redness with my first HT.  pics below all taken today but in different locations and lighting. 
 

Edited February 20, 2023 by JustJax
Added pic

[Dr. Guncel Ozturk]

Important to note that postoperative discomfort and pain are common after surgery, especially during the first few days following the procedure, however, if you are experiencing an increase in pain, burning sensations, itching, tingling, and a general feeling of tightness in the recipient area, best to take note and report these symptoms to your surgeon. The fact that you had to go a little firmer to get scabs off might have caused inflammation in the area, which can cause discomfort. Itching, tingling, and tightness are normal sensations that may occur as the transplanted hair follicles start to grow, but they should not be accompanied by significant pain.

With regards to your concern about a possible infection, observe the area closely for signs such as redness, swelling, heat, and tenderness. If you can monitor your temperature and report any significant changes to your surgeon. Based on the information provided, it is advisable to contact your hair transplant surgeon and discuss your symptoms to determine if a further evaluation is needed. The surgeon may recommend a follow-up appointment to examine the recipient area and assess if any treatment is required. Lastly, try to avoid obsessively taking pictures of the recipient area, as this can cause add additional stress and anxiety both to you and your scalp, which may exacerbate your symptoms.

Good luck on your healing journey!

Edited February 23, 2023 by Dr. Guncel Ozturk

[JustJax]

Hi Dr Guncel, thanks for the through feedback.  I have reached out to the clinic and they have advised to use the Terramycin (oxytetracycline) ointment that the clinic provided for pimples for a week.  I did also go to see a GP (family doctor) here in the UK and while she was a bit clueless about HT’s and what would be expected at this stage, she gave me a 5 day course of oral Erythromycin as she suggested it would help with any inflammation and possible infection.  
 

Sadly I do think there is definitely somethings gone awry this time, the skin doesn’t just have redness, but it appears bumpy and I think it might be what’s described on here as cobblestoning? I’ve searched the term “bumpy” and that’s where I saw the term cobblestoning, but I’m not exactly clear on what causes it? Can someone explain a little more about how and why cobblestoning normally happens? 

These are a few pics from today after using the ointment since Friday and antibiotics since Saturday.  Does seem less discomfort these past 3 days but it’s still quite itchy.  Will say the last picture is under very harsh light in the bathroom at my hotel.  

[gillenator]

It certainly is not unusual for you to be having these various sensations in especially at 2 weeks post-op…much of this is related to the trauma from the surgery and we all respond at various levels of pain, swelling, redness, and the like.

I certainly agree with Dr. Guncel to inform your surgeon of your concerns…now, a couple of things come to mind:  try using lots of lotion and/or creams that are highly enriched with aloe vera and apply at least 3 times daily…this will help calm and cool your scalp and also can help with the redness and overall healing process…you will be amazed at how much this will help…IMHO, this is not the time to use any creams with steroids as it’s too early post-op…your surgeon can advise you further on that….wish you the best in your healing and recovery.

[Xanadu]

I believe cobblestoning is from implanting the grafts too shallowly.

[Gatsby]

As others have stated, be guided by your surgeon/doctor's advice. As you are only two weeks post op the grafts are yet to shed but will begin to in the next week or so. You will have a better idea of what's going on then. All the best.

[gillenator]

On 2/27/2023 at 6:36 PM, Xanadu said:

I believe cobblestoning is from implanting the grafts too shallowly.

Cobblestoning can also be the result of the recipient incision sites being smaller than the peripheral size of the grafts and this causes the grafts to be pushed slightly upwards which forms bumps at the base.

[JustJax]

To be fair, I think it is settling down and I’m In hide sight I’m not sure if I do have cobblestoning after all. I think redness and the original hairs growing obese the new transplanted hair make it really difficult to see the scalp plus often the lighting makes it difficult to really see the texture.  Of course it might be that it was inflammation or even a mild infection and the antibiotics (oral tablets and ointment) have helped. Still feels a little itchy, but looking at it today I do feel it’s improving. Just to note the ointment is very greasy and difficult to wash off so all the recent images show the recipient area quite shiny looking, it’s actually a greasy film of ointment that’s there even after I shampoo in the morning and will probably take a few days to wash away the build up once I stop using it (Friday last day). 

[Dr. Guncel Ozturk]

It's good to hear that your scalp is feeling better and that the redness and cobblestoning may have been a result of inflammation or a mild infection. The antibiotics and ointment you were prescribed may have played a role in reducing any potential infection. It's not uncommon for the scalp to feel itchy during the healing process, but it's a good sign that you are seeing improvements.

I'd recommend just continue to follow your post-op instructions and avoid scratching or picking at the area to prevent any further irritation. Once the ointment is washed away, the greasy film should go away as well. If you have any further concerns or if your symptoms persist or worsen, don't hesitate to follow up with your doctor.

Wish you all the best!

[Rahal Hair Transplant]

@JustJax,

Although I agree with your doctor about picking up some miscellaneous viral infection, that would explain any pain in the donor or recipient areas. Where exactly is the burning and itching? Itching is normal 13 days postop. So is tightness if you underwent FUT instead of FUE.

Considering it’s worrying you enough to post about it, I suggest speaking to your hair transplant surgeon. People on this forum can only give you their opinions but they can’t diagnose you.  This includes me as I am not a doctor; I work for a doctor.

So again my best advice is to call your hair transplant clinic and explain what you are experiencing and see what he or she has to say.

Best wishes,

Rahal Hair Transplant

Edited March 2, 2023 by Rahal Hair Transplant