How Can I Help My Strip Scar Turn White Faster?

/by William Rassman, M.D./0 /,

Hi,
Are there any ways to speed up the process of the strip scar turning white? I have had mine for just over 2 years and although it is slowly fading it is still a light pink colour. Does vitamin E or steroid cream help as I have heard people mention these.

Thanks!

I would ask your doctor first for an examination and a diagnosis for the correct treatment plan. Sometimes, just giving it time may be the best treatment. It generally takes over a year for a scar to settle, but if it has been over 2 years, I would consult with a doctor. Most of the time the redness is very difficult to treat.

Some doctors may recommend over-the-counter steroid creams, but the redness is sometimes due to superficial blood vessels, in which case a cream would likely not be effective. Be careful, as this type of medication can be absorbed by the body with prolonged use.

Tags: scarring, scar, hair transplant

Dot Scarring from a Large FUE Procedure (with Photo)

/by William Rassman, M.D./3 /, ,

I (Dr. Rassman) have had a total of 2200 grafts in three strip surgeries over the past 20 years, the last one being 6 months ago. If you were to look at my single linear scar, most people (even with a comb in their hand looking for it) can’t locate it. My strip scar is certainly far less significant than the mottled scars from follicular unit extraction (FUE) in this patient below. To be fair, if the patient had let his hair grow slightly longer, the scars would be less visible.

This is not my FUE patient, but I was told that he had 2500 grafts extracted in one session four years ago (and saw extremely poor growth). FUE scars like these are very common, and as most people get FUE procedures because they want the option of cutting their hair very short without a linear scar, many of them can’t do so when these dot scars are so detectable. Click the photo to enlarge:

 

I grant that some patients will have visible scarring from a traditional strip procedure, but now with Scalp Micropigmentation (SMP) the linear scars can be made undetectable. The same treatment can make these ugly FUE scars undetectable.

My point for this post is that scarring occurs with all types of surgery. Scarring should not be the motivator for the choice of FUE over strip surgery. Considering the cost differential between strip and FUE surgery, this is just part of the calculation each person must do in making the decision between strip and FUE surgeries.

Tags: follicular unit extraction, photo, hair transplant, scarring

Can I Have Hair Transplanted Into a Scalp Scar I Got From a Machinery Accident?

/by William Rassman, M.D./0 /,

My question is, can a hair transplant be successful on an scar that has no hair follicles? I got a 2 inch area on my head that was literally ripped from the top of my skull in a machinery accident. The top of my skull was literally exposed. Skin and tissue has grown back, but the problem is the hair follicles did not. So I now have about a 2 inch radius area on my head that is bald, and on me it looks really strange and dumb since I ain’t balding in any way. I have a full head of hair and it’s long hair even, except that one area that is just a bare bald spot now.

So can a hair transplant work on an area with no hair follicles?

There are many types of solutions for this type of problem, but I would need to know more about your specific issue before suggesting a transplant as the solution. As a start, send me good quality pictures and I will try to assess what the problem is (please reference this post when sending). The photos alone may not be enough though, and possibly an examination would be critical.

Transplanted hairs can grow into scars, but I don’t know enough about your case — when the injury occurred, your age, if you have any genetic hair loss (or family history), etc. Until I make an assessment, I couldn’t say whether a hair transplant would be the best path for you to take.

Tags: scarring, accident, hair transplant

I Cut My Head and Had Stitches — Will Hair Regrow There?

/by William Rassman, M.D./0 /,

Hi.

I cut the back of my head quite badly a few weeks back. I had stitches put in and now they have been removed. The cut is healing well but the problem is that there are 2 cuts with a gap in between. Currently I have a large-ish bald patch covering the whole area.

My questions are:

A) Will the area between the 2 scars ever grow back the hair

B) Is there anything I can do to encourage the hair to regrow.

Thanks.

Without seeing you, I can not tell you the answers to your question. The scalp frequently scars and the scar can widen. If that is the case, you may end up with a bald area where the scar forms.

Sometimes there is an area around the scar which has temporary hair loss. If that happens, it usually regrows in about 6 months. Best to see a doctor who knows about hair for an examination if you’re concerned.

Tags: scarring, scar, hairloss, hair loss

How Bad Would a Thin Strip Scar Really Look If I Shaved My Head?

/by William Rassman, M.D./0 /,

Hello, thank you Dr. Rassman and Dr. Pak, for maintaining this fantastic site.

You’ve explained that once transplant surgery has been performed, a patient cannot shave his head without scarring (either a FUT line or FUE dots) being visible.

My question is: If someone had a thin scar from FUT, would it really look so terrible if they shaved their head in the future (if Finasteride’s effectiveness waned and hair cloning treatments fail to emerge, and they become an advanced Norwood 6/7)?

Obviously, there are pictures of strip scars online, but it’s difficult to imagine what they would look like on a shaved head. Do you know of any patients who have done this?

You can look at how bad strip scars may look on our scalpmicropigmentation.com website (see some of the before photos of scalp scars). Unless you shave your head, even the wider scar is not visible with long hair. My scar, after three strip surgeries, can barely be seen; however, if I decided to shave my head, everyone would see the 1-2mm scar I have. Now unless you are wanting to completely shave your head, you should not have to worry about the strip scar.

In general, you can keep your hair cut as short with a number 2 to 3 guard on hair clippers without the scar being noticeable in most cases.

Tags: hairloss, hair loss, hair transplant, scarring, scar

What Can I Do About a Scar On My Forehead?

/by William Rassman, M.D./1 /

Hi Dr. Rassman,
I am still waiting to do my first surgery with you in the LA office. An off-topic question today:

I have a 0.7cm scar in my forehead that resulted from a home accident by opening a door. Do you know of good doctors, laser surgery or other means, in the Los Angeles area who can remove such a scar?

I am thinking to do it along with my first strip surgery on a trip to California. All the best doctor.

There is no such product that exists that removes scars. Some scars can be modified in the hands of a good plastic surgeon. There may be ways to minimize the appearance of scars, but this is very specialized to the individual and the type of scar.

We will look at you when you come in and we’ll be able to give you an opinion then.

Tags: scarring, scar, scalp scar

I Had Brain Surgery and Want to Fill in the Scar, But I Also Have Early Balding

/by William Rassman, M.D./0 /,

I have a scar from a previous brain surgery. I went to hair transplant surgeon and he estimated that it would take about 300 to 400 grafts to adequately cover the scar.

However, I am 18, and I’m already experiencing balding. My dad (and most of my male relatives on his side) are diffuse NW6s, so I’ll probably be heading in that direction. Furthermore, I have straight black hair and brown skin, with a lower-than-average density.

Would it be smart to put off the filling in of the scar?

Basically, I don’t want to unnecessarily deplete my donor supply.

At NHI, we have good experience in addressing brain surgery / craniotomy scars with hair transplants. In general, patients usually need more than one surgery to be adequately satisfied, so be prepared.

If you are balding to a Norwood class 5 or 6 it may not be advisable to fill in the scar unless you plan on having a full hair transplant surgery and have adequate supplies of donor hair.

Tags: scarring, brain surgery, hair transplant, hairloss, hair loss

I Have Scars from Where My Plugs Were Removed — Can I Do Anything to Smooth Them Out?

/by William Rassman, M.D./0 /,

Is it possible to smooth out just a small area where old hairline used to be that was damaged from surgically removing old plugs? I am a 45 year old male who had a hair transplant in 1984. I had one session (47 plugs, about 8-10 hairs each plug) around the frontal-hairline part. I did not like it as the result was not what I had expected so did not go back for another one.

In 1988 I had all of the plugs surgically removed. For the most part it looks ok except for the right side above the right temple but close to the forehead. In certain lighting you can see the scarring and tell that it was where the old transplant hairline was as they fall in or pitted is the word used to describe it (where 5 plugs were removed on this side). So instead of having cobblestones I now have the opposite.

I would be interested in seeing if just this area can be improved by either laser therapy to smooth it out or to do a surgical scar repair and pull the skin tighter on these 5 only or any other recommendation? If it improved just 50% it would be a great improvement. I would not be interested in another hair transplant. I keep my hair long enough so the donor area is ok as is.

Also, would massaging this area help smooth it out or make it worse? Thank you and your site is amazing and very much appreciated.

In general, scalp scars (or any scars really) are very difficult to treat. If there is something that can be done, it would involve understanding that the outcome will not be perfect.

You are asking a very specific question for a case that is likely quite unique. You would need to visit a doctor one-on-one and have him/her examine you for their assessment and recommendations. Since you indicated that you’re in New York, you could check with Dr. Robert Bernstein.

Tags: scarring, hair plugs, repair, hairloss, hair loss, hair transplant

5 Weeks After My Hair Transplant, I Think My Scar Is Going to Be Too Obvious

/by William Rassman, M.D./0 /,

Hi,

I had 3050 grafts taken from my donor hair to create a hairline and add density to frontal area. so far so good, but 5 weeks after surgery and my first hair cut ( just blending in etc ) i have noticed that the donor hair area does not match up and its very obvious that i have had a procedure! now im worried that too many grafts were taken from certain areas at the back and It looks like Im going to have a constant “horse-shoe” shape on the back of my head! please tell me this is normal and it will grow and blend in to the rest of my hair

Your doctor should have described what your scar will look like and how wide it may be. Many doctors and patients forget to address the potential scarring from hair transplant surgery. Some believe that only a strip procedure can leave a visible scar, but even a 3000 FUE surgery will leave a significant series of scars (3000+ dots).

It’s also possible that perhaps you just got your hair cut too short, and that is why your scar is visible.

Tags: hair transplant, scarring, scar

Could FUE Move Hair and Skin to Eliminate Scarring?

/by William Rassman, M.D./0 /, ,

Dear Dr Rassman, please excuse my question if it is stupid. I’m not medically trained!

What is normally discussed is the movement of hair follicles *from* the donor site *to* the recipient site. And this inevitably leaves some form of scarring in the donor area. But is it technically possible (in FUE) to also implant skin *from* the recipient area *to* the donor area, in such a manner to “eliminate” scarring? i.e. for every follicle the surgeon would swap tissues A and B, where A would be the tissue originally at the recipient site, and B the tissue originally at the donor site.

I’m sure this would be more costly for the patient, buy I’m wondering: has this ever been tested? And would it eliminate scarring?

A number of years ago, a well-known doctor preached that small punch extractions of scars would produce “mini-scalp reductions”. It never worked. This sounds like what you are asking about, and if one removes scar from a scarred area, you just get scar to replace it. Not such a good idea.

By the way, there are no stupid questions. Your question reflects an inquiring mind.

Tags: fue, scarring, surgery, hair transplant

When Can I Stop Sleeping On My Stomach After Having FUE Into My Strip Scar?

/by William Rassman, M.D./0 /,

I had fue into strip scar, 300 grafts were implanted to the scar. I slept 17 nights on my stomach post-op. I’m aware of the graft anchoring study from 06, but it was on a virgin scalp. My question is that was that 17 nights post-op enough for the grafts to secure in the scar? My doc said one week is enough and then I can start to sleep normally. The grafts were all singles and doubles. I’m white male, 26yrs.

I agree with your doctor. A week should’ve been fine. Once the eschars are gone, the grafts are stable.

Tags: hair transplant, fue, scarring, sleep

I Have a Lot of Scabbing a Week After My FUE Procedure (with Photo)

/by William Rassman, M.D./0 /, , ,

Hi Doc,

I had a FUE done with 3000 grafts exactly 8 days ago (photo attached).

My concern is that there seems to have been a lot of scabbing or crusting (what is the difference between the two anyway?).

The scabbing/crusting started coming off in places near the restored hairline and it now looks like a river delta (i.e. lines where there is no hair/crusting/scabbing with pockets of crust/scab/hair).

Is this normal? Or is it due to trauma (e.g. scratching) or bad surgery? I know when I am awake, I do not touch the area (I have worn a bandana lightly from the day after the surgery, but only for a few days and first 2 nights). Sometimes at night, I inadvertently brush my hand against the recipient area and wake up.

My doctor advised me to start washing once a day from Day 2 onwards with a spray bottle with a mixture of baby shampoo and water (and rinsing with plain water from the spray bottle) which I have done.

Should I be trying to get rid of the scabs/crusts with light finger pressure when shampooing or should I wait for the 10th day before trying any of this? It is difficult to see the hair due to the black scabs/crusts, but the transplanted hair is there.

Thanks!

 

The crusting is very bad, which means that your management of your scabs was not good. We rarely, if ever, see this degree of crusting. How is the scabbing in the donor area at the back of your scalp?

Be very careful not to rush to take these crusts off. Use a shampoo and leave it on for 10 minutes and then gently, very gently rub in the shampoo. The crusts will slowly loosen and eventually they will come off. Give it another 10 days and hopefully the problem will be gone.

The scabbing/crusting (interchangeable words) is pretty intense, but hopefully there is no problem with the grafts because of it. Of course, follow up with your surgeon if you are concerned.

Tags: hair transplant, aftercare, hairloss, hair loss, surgery, crust, scab

Could Hair Regrow on My Son’s Scalp Scar?

/by William Rassman, M.D./0 /

my son got a big scar on his head from one ear to other due to head operation. his age is just eight years. can hair grow on on that area?

Hair won’t regrow on its own into scar tissue in most cases (depending on the wound closure technique done). I don’t know what kind of operation he had or how big the scar is, but when he gets older a hair transplant could be an option. I wouldn’t expect any non-surgical treatment will get the hair to regrow on the scar tissue.

At 8 years old, I wouldn’t suggest a hair transplant as the route to take just yet, but if it’s something very bothersome you can take your son to a surgeon to see what options might be available.

Tags: scarring, scalp scar, hair loss, hairloss, hair growth

Strip Scar Length and Graft Numbers

/by William Rassman, M.D./1 /,

If I don’t require to have a lot of grafts placed on my scalp, and I want a strip surgery, can the doctor cut a small strip of hair, lets say, 3-4 inches in length so the linear scar is not big and doesn’t go from ear to ear?

My other question, if a person doesn’t require to many grafts placed on the scalp, why do the surgeons still cut a long strip that is from ear to ear?

Thank you

This is one of the things the doctor should go over with you during a consultation. There are many patients who do this! Requiring a small number of grafts will give you a shorter scar. Some patients wait a year after their first small surgery for another small surgery, and they end up with a single short scar (replaced from the old). Many patients are not informed about this opportunity prior to coming to see me, but learn of the option during the first consultation. This is a part of the Master Plan we create with every patient.

On the flip side… if you want to have as many grafts as possible in one surgery, a larger scar is necessary to obtain the grafts needed.

Tags: hair transplant, hairloss, hair loss, scarring