Possible Causes of Infection after Hair Transplant, and Treatment Options

Thank you for your question. You submitted a photo of the top of your scalp and you described that you have been using – washing your hair twice a day and you’ve finished your course of antibiotics. But it appears your scalp is not improving. You also asked about or mentioned that you're doing a procedure that there was no scalp washing before surgery and it was just a dry shaving. Well, I can probably give you a little bit of guidance about your situation.

I’m a board certified Cosmetic Surgeon and I’ve been performing hair transplant surgery in my practice for over 20 years in Manhattan and Long Island. I’m also the founder of TrichoStem Hair Regeneration Center, a nonsurgical alternative to hair transplant for people with thinning hair. And an additional benefit to helping people who have – who are undergoing hair transplant to improve their overall density. So certainly I’ve a lot of experience with dealing with issues like, as you’ve described. It’s something to understand as far as the medical team that did your transplant is that hair transplant, it’s not really a sterile procedure. The scalp has a lot of natural bacteria and even though what we do is we do clean the scalp before surgery – it’s because I’m also a board certified Cosmetic Surgeon.

I do facelifts, I do eyes. We do tend to do a couple of things that – because we try to maximize the cleanliness. In some ways, it’s comparable in a way to when we do facelifts or brow lift surgery, where we do – we do everything to clean but hair is very difficult to sterilize. Now when you had this surgery, you probably – it might have aggravated some existing issues with folliculitis. I mean this probably is the diagnosis that your doctor has made. And when you are – now that you have completed a course of antibiotics and you’re still not getting better, the bottom line is you need to see your doctor.

Your doctor may want to change antibiotics, may want to look for possibly an area of [parlialence?] [0:02:59] or infection that needs to be opened and drained. The absence of a physical exam, with just a photo is difficult to make a complete assessment. But it is not – it is not unusual for someone with folliculitis to have a difficult course. Folliculitis is very difficult to treat and it often – it can often be a chronic condition. So the bottom line is getting to your doctor is – and communicating with your doctor who I’m assuming is a – is an experienced transplant surgeon. It’s just a matter of finding the right treatment plan.

It might require a change of dosage or change in antibiotic. In our practice, when we – when we use – when we do a transplantation, is the TrichoStem Hair Regeneration System which uses combination of acellular matrix or extracellular matrix combined with platelet-rich plasma. We do this with the intention of improving healing with the transplantation. And there is also a known bacteriostatic or it’s actually antibacterial when we use this material, and it does seem to help.

But the reality is, you know, out at the real world, there are a lot of bacteria and a simple scratch, you know, touching your surface, scratching the scalp. It could – it could be in a lot of different places that you can get an infection. So I wouldn’t necessarily say the source was from the medical team that performed this procedure. So again, it goes back to doing the right thing which is to keep in contact with your doctor. And if your doctor isn’t feeling comfortable, maybe then seeing another doctor to help you with this issue. But I’ve said first most doctors who does this type of surgery are acquainted with dealing with various complications. And that’s what surgeons do: is we deal with things when they go well and we also deal with things when they don’t go so well and know how to manage them. That’s just proper medical care.

So that being said, I hope that was helpful. I wish you the best of luck. Thank you for your question.