You have excessive crusting as a result of poor post-operative washing techniques, or absence of them.  An FUE is treated just like a regular hair transplant with regard to the recipient area, but the donor area has open wounds which require daily washing with soap and water. Within 3 days of surgery, you can resume full activities, heavy exercises if you wish. The recipient area requires daily washes as well to keep the recipient area free of crusts. I generally recommend the use of a sponge and supply my patient with a surgical sponge to fill with soapy water and press on the recipient area daily. By repeating this daily, all crusts can be washed off without any fear of losing grafts. IF any crust are present, use a Q tip and dip it into soapy water, and roll it on the crusts and that will lift them off without dislodging them, but never rub them, just roll the Q tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area gone in 7-10 days with daily washing much like the two patients on the right.

I don’t like the idea of anyone removing grafts that have scabs on them because we have published a paper in a formal medical journal, that when a person pulls off a scab (crust) from a recipient area in less than 12 days, the risk of losing the graft is very high. Put a shampoo on your head and let it sit for 10-15 minutes, then gently work the crusts with your fingers. This will take days to get the crust off so that you do not disturb the grafts. See the medical paper we wrote in a major journal below in the web reference that proves my point. Look at the two patients on the right, both one day after FUE sessions and both clean without crusts.

poor and good wash

It was a 1,000 graft FUE surgery when I was 22. I experienced severe shock loss post surgery and lost plenty of native hair all around especially from the top. However, I did see some results in the front. I want to do another surgery to improve my situation but fear the loss of more native hair. I don’t want to be on medication such as Finasteride due its side effects. Can you’ll suggest me what to do?

Part of the reason I don’t do surgery on 22 year-old men is that they often develop shock loss, lose more native hair (a normal evolution but accelerated from the transplant when you were 22) and then you have to chase it. The real question is what will be your final hair loss pattern and will you have enough hair to follow the loss to its normal completion? I can usually answer this in young men under 26, but not in men 22 or 23.  I consider doing a hair transplant on a 22 year-old like you, malpractice on the part of the doctor.

transplanted at 22, now 23

The single best treatment for this is Scalp MicroPigmentation.  The scars can be hidden so no one will even know you have a scar even with a shaved head.

See here:

smp gallery

Yes, Keratosis Pilaris is a benign condition and it is harmless. Some people describe these bumps as ‘goosebumps’.  If it produces itchiness and dryness it can be treated with lotions and lanolin. If the appearance of these bumps bothers you, soften your skin with lotions.  Treatment can ease the symptoms and help you see clearer skin and have less itch. This is not a contraindication for hair transplants

I will assume from these pictures that your hair is coarse. The arrow I placed on your photo shows the location of the middle of the new hairline and a mature hairline shape.  If I am right, then the number of grafts to do this job would be in the range of 1,200-1,300.  If your hair is finer, then it will take more grafts.  It might take 2,000 grafts to get a reasonable result with fine hair. Everyone is different so the amount of grafts required reflect not only the thickness of the hair itself, but the area that has to be covered. This takes an experienced surgeon to do proper estimates.

lower forehead


I am not sure why you don’t have enough donor hair. I will assume that you had already exhausted your donor area and now want more hair or more fullness. This can be achieved with beard hair but it may have a different characteristic than your scalp hair.  Body hair is a poor choice as it has less quality.  I recommend Scalp MicroPigmentation as a good alternative for more fullness.

See here:

not enough donor

Folliculitis Decalvans is a terribly aggressive disease. I have seen this appear in a couple of patients over the past 27 years in practice and it is difficult to manage.  I would consider an alternative like Scalp MicroPigmentation which will not be aggravated by this disease.

See here:

You seem to keep your hair cut short and that means you would be an excellent candidate for this procedure as it will cover all of the scarring on your scalp.

folliculitis decalvans


What you are seeing is terrible post operative washing. You should have washed off all of the crusts on the day and the day following the surgery. When this is done correctly, within three days of surgery, you can resume full activities, heavy exercises if you wish.

The recipient area requires daily washes to keep it free of crusts. I generally recommend the use of a sponge and supply my patient with a surgical sponge to fill with soapy water and press on the recipient area daily. By repeating this daily, all crusts can be washed off without any fear of losing grafts. If any crust are present, use  a Q-tip and dip it into soapy water and roll it on the crusts.  That will lift them off without dislodging the grafts.  Never rub them, just roll the Q-tip on the recipient crust. I like to see no evidence of any crusting in the recipient area and the crusts from the donor area gone in 7-10 days with daily washing.

cracking head


I am 26 and I lost a lot of hair giving me a huge forehead. How many grafts will this take?

First, what I need is a frontal picture with your hair pulled back and your eyebrows lifted high so that your forehead creases. That shows me the anatomic point that allows me to determine the proper place of the hair line. Once I know this, I can give you a recommendation on the number of grafts you would need for a hair transplant. Keep in mind that fine hair takes more grafts than coarse hair.  In addition to the picture, I would want to know the thickness of the hair in the back of your head.

23 and wants hair transplant

A patient wrote: “Minoxidil does strip the hair color. I am on my second bottle of women’s Rogaine and I have noticed that it does remove the dye from the hair roots when applied along the part. My stylist has stopped coloring my hair because the Rogaine strips the color off.”

Is it a case that the hair is going to shed anyway post surgery and should I wait until I experience hair loss before using Mixoxidil?

It is not automatically expected that you will have hair loss after forehead reduction surgery. It is a complication of this surgery and something that you should speak with your doctor about as this complication is not uncommon in women over 40. Minoxidil might help but maybe not. So a discussion with your doctor is appropriate. Forehead surgeries in women can cause hair loss and we consider that a complication of the process.

That is a lot of grafts for the balding area. At nine months, I would expect to see 90 percent of the growth already out.  I doubt that many more grafts will come in but waiting a full year is a good idea. If you are still concerned at one year, go back and see your doctor and discuss your expectations and your doctor’s expectations for what was done. With 5,400 grafts, the team of technicians must be very efficient and fast, not leaving the grafts open to the hair for more than a few seconds in placing them or they will die and you will get dead grafts placed.

5500 grafts

No, Dandruff is common and more pronounced after a hair transplant because skin turns over more frequently (skin shedding). If you are concerned about the growth and you are at least eight months since the surgery, then go back and speak with your doctor comparing your expectations to your doctor’s expectations.

poor growth

This is a problem when the direction was placed in the wrong angle.  You may have to get FUE on those hairs that are misplaced and then re-implant them in the proper direction. ?

There are studies which say that DHT in blood is increased during and after orgasm for a short period of time. So is it not possible the habit of excessive orgasms over a prolonged period of time can hasten MPB?

Hair loss does not respond to fluctuations in our hormones.