Normal Versus Abnormal Hair Restoration Results| Patient Questions

I have been getting these bumps in the recipient area of my scalp. They look like pimples, but I don’t think this is acne. Why is this happening?

Brandon A.G..

Seeing bumps on the skin after a hair transplant is actually quite normal. This usually occurs around the third or fourth month when new hair is just starting to emerge.

The bumps are usually manifestations of inflammation. This can occur in a few ways:

(1) sebaceous glands attached to the follicles continue to secrete oil forming cysts under the skin

(2) hairs become ingrown

(3) upward growth of the hair shafts is met with resistance by the skin and irritates the underside

(4) picking at scabs and crust at the graft sites

With each of these scenarios, it is possible for the immune system to become triggered. White blood cells are rallied to engulf and attack any protein that is deemed to be foreign. Therefore, it may be possible to even notice pus emerging from these bumps.

Although the bumps may look like acne pimples, they are not the same. With acne, the sebaceous duct (pore) becomes obstructed by environmentally derived dirt or dead cells that are shed from within the lining.

While the breakouts are fairly common, you still may want to have your doctor examine them. Medicine can be prescribed to improve their appearance. In some cases, they may need to actually be removed through surgery.

As a side note, some patients do not notice the formation of bumps around the third month after their hair restoration procedure. And this causes them to feel worried that their hair is not growing. While bumps are common and natural, they don’t develop in 100% of all patients. And they are certainly not a mandatory part of the hair growth process.

I am happy to finally see new hair growth within this last two months. But the grafts that were inserted in the recipient area look much different from my natural hair. They feel coarser. Is this something that happens with everyone, or just me?

Ryan M.

Hello Ryan! Don’t be alarmed by the disparity you are noticing between your original hair and the newly inserted grafts. This is a very common occurrence and happens with other hair transplant patients as well. Besides differences in texture, other people will experience less shininess than what they are used to seeing and different hair color as well.

Although the grafts themselves were follicles taken from your head, they are now in a new environment. This transition obviously has an effect on the hair creation processes. Between the sixth to ninth month, hair tends to look frizzy. Some of the hair follicle cells have gone into a dormant mode. Therefore, only sections of the hair shaft are being produced.

And some time will be needed for the follicles to adjust and return to their normal levels of functioning. This can range from a year to two years. Understanding what hair restoration outcomes to expect will be helpful as you await your final results

But during the 10^th to 14^th month, the dormant cells become activated once again. They are once again able to contribute to the creation of more complete hair shafts. And this causes them to resume a straighter looking appearance.

Keep in mind that your hair grows in cycles. New shafts emerge for some time and then fall out. It may take two to three cycles before you notice a more normal look to your hair.

Patients who have undergone a body hair transplant would undoubtedly have recipient areas with a coarser texture. However surgeons can create a more even looking appearance by inserting both head and body hair.