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As a nurse in the surgical hair restoration field, one of my biggest concerns for my patients post-op is wound healing. Surgical hair restoration consists of transplanting thousands of follicular units into the scalp. These follicular transplanted units are micro-sized, yet they still create a wound, literally thousands of tiny wounds in the scalp, depending on the number of grafts received. Within a couple days after surgery, each of these tiny wounds now has a small scab covering the graft. A scab is merely a blood clot that covers the wound to protect it while the fibroblasts repair the opening working to knit the edges together again. After approximately 5 days, these tiny scabs are ready to lift away. The most critical time after hair transplant surgery is the first 48 hours. The grafts must be treated very carefully with no aggressive handling. After 3 days, those grafts have already been "sewn" in to the skin, so the fragile handling is no longer necessary. Many patients are reluctant to maneuver the scalp at all. Hairwashing by the 3rd day cleanses the scalp to help get things back to normal. By day 10, any remaining scabs can suffocate the newly transplanted graft. The graft by now has established a blood supply, but the scab can act like Saran Wrap to cut off necessary breathing room for the hair. If a scab is left on for longer than 10 days to 2 weeks, the tissue below (new graft) could die simply because it can't breathe thru the skin. The solution is simple. On day 5, moisturize the entire scalp with a rich conditioner and cover head with a loose shower cap. Leave on for 30 minutes, then remove shower cap and shampoo hair. Your own body heat and the conditioner mix to soften the scabs. Gently massage the scabs so they lift.Do not pick or pull at the scabs. Comb hair to remove the scabs. This process may have to be repeated daily until all the scabs are gone. Your skin has pores with which to breathe. The transplanted graft is still in the healing phase, and needs to be able to breathe, not suffocated and choked. The scab was necessary at the onset of the injury. Its purpose has been served…let it go.
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