Can You Itch Your Scalp After A Hair Transplant?
Can You Itch Your Scalp After A Hair Transplant?
The itching that occasionally follows a hair transplant is most commonly caused by postoperative crusting. Less often it is due to excessive drying of the scalp from aggressive shampooing an infection infectious eczematoid dermatitis an allergic reaction to topically applied agents or a previously existing skin condition such as psoriasis.
As we all know itching is the sensation that causes one to “scratch.” In the “evolutionary sense” scratching was the means by which we removed different foreign objects such as bugs from the surface of our skin. Unfortunately man has not evolved so far as to be able to differentiate the “useful” itch produced by various “critters” from the problematic itch caused by the crusts or scabs that form when the serum that exudes from all skin wounds surgical or otherwise subsequently dries.
Itching should always be prevented after a hair transplant because in addition to being a nuisance for the patient it is invariably associated with scratching conscious or unconscious and this increases the chance of dislodging grafts opening donor incisions and bacterial infection.
We markedly decrease the incidence of itching after a hair transplant by using a strict postoperative protocol whose primary objective was to promote wound healing. This includes using an antibacterial OINTMENT along the suture line to keep it GREASY for 2 weeks after the surgery. With this technique patients sometimes complain of the greasiness but rarely the itch. In the recipient area we decrease the formation of crusts by the irrigation and gentle washing of the recipient area twice a day following surgery and each day thereafter. A mild shampoo is used to facilitate the removal of the crusts. If the crusts are not removed in the first two days they will generally persist until the hairs that they are adherent to are shed.
We perform all of our hair restoration procedures using Follicular Transplantation where the follicular unit grafts fit snugly in a very small site. We do not recommend showering the day after the surgery with other techniques if there is a chance that the grafts may become dislodged.
For the occasional patient that does itch in spite of these measures after infection and contact dermatitis have been ruled out we prescribe hydrocortisone ONTMENT 1 OTC or 2 applied as needed to the suture line and/or the recipient area. If patients complain about the greasiness they can either put less on or use it only at night but this will decrease the efficacy. The key is to keep this scalp greasy after the hair restoration! In fact in a recent publication the authors showed that white petrolatum was as effective as Bacitracin ointment in promoting wound healing and was also less expensive and had no risk of contact dermatitis. With proper patient education the “greasiness” of ointments can be easily managed for the two weeks following the hair transplant procedure.
About the writer: Dr. Bernstein is Clinical Professor of Dermatology at the College of Physicians and Surgeons of Columbia University in New York. He is recognized worldwide for pioneering Follicular Unit Hair Transplantation. Dr. Bernsteins hair restoration center in Manhattan is devoted to the treatment of hair loss using his stateoftheart hair transplant techniques. To read more publications on hair loss visit http://www.bernsteinmedical.com/.
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