Washing Scabs One Week After Surgery

I just had a FU mega-session 7 days ago. I have been very careful with daily washing of the 3000+ grafts that I had. I have been washing and rinsing only through a washcloth. I have been using the post-op copper peptides etc. I have been so careful that I have not really lost any of the scabs or crust associated with grafts. I even have been sleeping with moistened guaze under a surgical cap at night.

I am needing these (scabs etc.) to be gone so that I can return to work. In a previous posting you mentioned advocating “aggressive washing”. How should I be washing the grafts at 7 days post-op, in order to expedite the scab removal. I haven’t been picking at them but maybe I have been too careful…….Please help.

Your sight and advice are very valuable and I thank you for them……

Washing is something that must be started at the time of the surgery so that when the patient leaves the surgical suite, the recipient area should be clot and blood free. A good thorough washing the morning following the transplant is critical as it will impact the appearance on all subsequent days. Good washing protects most people against folliculitis and infections of the donor wounds so daily or twice daily washes are critical. There is a washing art form, one which we teach our patients at the time of the surgery and on the day after, when most patients return for a hair wash administered by us. After 5-7 days, the scabs should be gone. If they are present to a significant degree, then you must be gentle with them for if you pull one out, the graft may come off with it. Mostly, if the wounds are small and the scabs are already shedding, you can wet your hair, cover it with a good conditioner when wet, leave it on for 10-15 minutes to allow the scabs to soak up the moisture, and then wash your hair using your finger tips to gently try to get the scabs off. Dr. Robert Bernstein and I just wrote a scientific paper on this to show that when the scabs are off, the grafts are safely anchored. The scabs anchor to the grafts, so if you pull on a scab the graft can come out with it. If you follow the washing technique I just outlined the scabs should come off in a day or two, providing that they are not anchored too tightly to the scalp.