Hair Loss On Donor Area After Hair Transplant

Q:

Hello Dr. Mohebi!

It has been a little over three weeks since my hair transplant and I’ve noticed there is a bald spot that is one inch in diameter roughly two inches to the left of my right ear (when viewed from the right side).

Even though I have been following your post-op instructions, and keeping that area clean for the last three weeks, it hasn’t filled in yet. In fact, it appears to be the same size.  I’m pretty sure it is not getting bigger. The spot is also sensitive to temperature changes as well (like skin on the inside of the wrist). The last scab fell off today while I washing my scalp but it was nearly as big as the spot. I’d say it was 3-cm x .75-cm right at the center of the spot.

There is also some numbness still concentrated right around the bald spot.  This is the first time I’ve ever seen a circular bald spot on the donor area so it is kind of scary. Is there something I should do? Does trauma cause fallout even in donor areas?

I had been taking prescription medication for hair loss daily before, during and after my surgery. In retrospect, except for a few erratic glucose levels (low and high) I actually think I’ve taken better care of my head this time around than my three previous surgeries. I can’t help it but I am worried.

What is the likelihood of it growing back if the area isn’t scarred over? A quarter-sized bald spot doesn’t make sense to me because that makes it seem like the wound healed while it was still gaping open. That area on the scalp was sensitive this whole time but I never noticed any sort of infection or excess oozing after the first few days. It seems like it is only possible that the hair around a fixed point on the wound got shocked and then fell out.

Please advise when you have a moment.

A:

Thank you for the email.

You are correct that the spot without hair is likely due to shock loss around the donor wound area. You have had a tight closure at the donor wound. As such, I feel that the tight closure has caused some shock loss. Plus, the areas on both sides of the scalp are very typical areas for shock loss.

When shock loss does happen, it is usually seen on both sides of the scalp. The shock loss around the donor wound is almost always reversible and your hair will usually grow back. The regrowth of hair, which has fallen out due to shock loss, may take up to six months and the recovery might be a gradual procedure.

There is not much that can be done at this point but you will need to be seen and examined to confirm this diagnosis. The numbness around the donor area, if it does occur, may last for weeks or months and it has to do with the inflammation of the healing area that may impact the fine nerves on the area. The situation generally gets better on its own.

– MA