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18 MONTHS Post-OP Pimples that bleed after FUE transplant HELP!!!

  • Thread starter London_1_Previous_HT
  • Start date
L

London_1_Previous_HT

member
Main Concerns

  • Surgeon diagnosed Infection immediately Post-Op (last session) later told has gone (no visible infections signs of redness)
  • Pimples recurring over 18 months Post-Op
  • 2nd Surgery booked next week - Could the new transplanted hair be at risk of a possible underlying infection and/or of falling out?

Hi

Has any doctors and/or patients come across pimples (no pus) that form near to and around transplanted hair follicles in the recipient area that initially swell then bleed? The pimples stay for roughly 4/5 days and heal with topical antibiotic gel (applied 2 x per day).

The doctor that I had the hair transplant is supposed to be one of the best in the world, however from Day 2 Post-Op he mentioned I had an infection localised to the frontal (final) part of the surgery. I was on oral and topical antibiotics. The infection in his words was characterised by "Pain, Redness, Sensitivity, Swelling and yellow pouts"(I did not see this latter symptom and are not visible in any of the pre and post operative pics). He blamed the infection to bacteria from the the air (outside the clinic) entering the pores as soon as I left the clinic on the last day of the surgery (the surgery was over 3 days for 3 parts of the frontal recipient area.

The redness (inflammation) subsided over the course of a few weeks, the crusts fell and the area is clear with no signs of infection.

However, of the next few months some mild redness appears to remain in the frontal section only.

5 months post-op pimple type spots start to appear initially localised to the frontal area but then also in the mid scalp area and the doctor issues more topical antibiotic to treat them and the pimples subside over the course of the next few months and remnants of redness in the frontal area seems to subside at around 7/8 months post-op. The topical antibiotic is discontinued as there is no pimples appearing..

11 months Post-Op new pimples appear and topical antibiotic is applied to clear them.

17/18 months Post-Op and there is still pimples appearing and visibly disappearing with application of topical antibiotic.

The Surgeon has now booked me in for a 2nd surgery next week however I am concerned whether there is an underlying cause that could risk the new implanted hair, do I have cause for concern or should it be ok to have the 2nd surgery?

The surgeon obviously is aware of the situation but does not seem to know with certainty why I have pimples 18 months Post-Op. He is saying it could or could not be bacteria and seems to be masking any pimples with Topical and Oral Antibiotics to take before and after the 2nd surgery. I am not sure what to do I have had a mixed response from surgeons.

A phone call to the dermatologist suggests they may never know the true cause of the pimples or if there is some underlying cause and that they certainly won't be able to provide a diagnosis before the 2nd hair transplant surgery.

I have booked 2 weeks in a 5 start hotel and flights are all booked all non refundable. My brother is also going and is also making a loss with expensive flights and lost incomes.

PS:My brother had a surgery with him following week to mine and did not have any issues and appears to be good (however he had prior surgery with different surgeon before)

Please HELP!!
 

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DrTBarghouthi

DrTBarghouthi

member
Hi @London_1_Previous_HT .

Pimples that come sporadically in the donor or recipient area during the process of growth are most likely due to folliculitis-an inflammation around the hair follicle. Most common reason for that is an in-grown hair, or sometimes as the hair is breaking through the skin. It does seem to be more frequent and is lingering longer in your case. We typically use topical and /or oral antibiotics in such cases. In most cases they settle with no treatment or with simple warm pads. I suggest swabbing one of the pimples to culture what type of organism is growing as some bacteria could be more resistant and hence recurring. The results of this could guide you into a better antibiotic choice.
 
L

London_1_Previous_HT

member
Hi DrTBarghouthi

Many thanks for your reply. Is there a test I can buy to swab the bacteria into from the pimples when they form to find out what bacteria it is?
 
DrTBarghouthi

DrTBarghouthi

member
Hi. Swabs are best done by your doctor generally, as they need to send them to the lab for assessment in a sterile tube.
 
R

Risingforehead

member
How many grafts did you get from your first surgery and where about's were they all placed? I was under the understanding that a transplant's growth phase was generally finished by month 12(no expert so correct me if i'm wrong) so with that logic surely it's unlikely the pimples coming at 18 months post op are due to new hairs breaking the skin?
 
L

London_1_Previous_HT

member
Risingforehead Exactly thats why I asked my surgeon why do I still keep getting pimples and he said they may or may not be bacteria...basically doesn't know but erring on the side that it could be some bacteria .....
 
L

London_1_Previous_HT

member
apparently 3000 grafts, in frontal and mid scalp area.
 
JoeTillman

JoeTillman

Valued member
My concern is that it is a stronger bacteria than your current antibiotic can deal with and with it still occuring 18 months later in your recipient, I wonder (fear) how many more from the same clinic have the same issue.
 
DrTBarghouthi

DrTBarghouthi

member
My concern is that it is a stronger bacteria than your current antibiotic can deal with and with it still occuring 18 months later in your recipient, I wonder (fear) how many more from the same clinic have the same issue.

Exactly @JoeTillman that’s why I think swabbing it is what I will do at this stage.
 
L

London_1_Previous_HT

member
He has asked me to change the topical antibiotic that I have been using to date (18 months) to a different one to apply to the scalp 3 days before the surgery in addition to oral antibiotics. So I am assuming pimples will likely not form during and after surgery when I am continuing to use topical and oral antibiotics. Therefore I will only know of any further pimples occurring after stopping all antibiotics and that would only be the time to get a sample and determine whether or not it is some bacteria.

Assuming the topical antibiotic suppresses any pimple formation and there is no infection during or post surgery then I am assuming the grafts will survive.

It’s only when I come off the topical antibiotics and pimples form which I am assuming I could cure with restarting the topical antibiotic and prevent any new transplanted hairs being lost. And only if/when they form again would I be able to get a sample to determine whether it is bacteria or some other cause. Also of consideraton is I may never get to the bottom of why there is pimples from the experts.

I am assuming on the above basis it would be okay to do the 2nd hair transplant?
 
L

London_1_Previous_HT

member
So assuming he doesn't mess up the 2nd procedure with an infection, then the risk to the new grafts of the existing condition could be mitigated with the topical antibiotic to suppress the pimples if there is another cause which gives time to find the cause of the pimples and avoid delaying a 2nd procedure.... This is my thinking anyway.... let me know if makes sense....
 
L

London_1_Previous_HT

member
Topical Antibiotic changed from Clindamicina to Mupirocine 2%

I guess some doctors could comment on the change in topical antibiotic if the latter is more potent or effective than the former? Also given that the pimples appear to be responding to Clindamicina, switching to Mupirocine would not compromise the situation?
 
L

London_1_Previous_HT

member
Also thanks DrTBarghouthi and JoeTillman for your responses so far it did make me ponder further.....hopefully others will respond also.....let me know your thoughts, if what I am saying makes sense.
 
JoeTillman

JoeTillman

Valued member
Mupirocine 2% is usually a stronger antibiotic for staphylococci and streptococci and is normally prescribed for no more than two weeks. If you have something that strong, maybe you should consider having it cleared up first so that you don't need to continuously fight it with antibiotics. Your healing should be unencumbered by your body dealing with secondary, yet powerful, issues. I urge you to reconsider your surgical date and postpone until your scalp is healthy.
 
V

Viking

member
Sorry if I sound blunt but I cant help wondering if you got this infection after having a transplant at this clinic why would you want to go back there?
 
E

EdwardDor

member
London_1 If you frequent the site, did this clear up? I have sore pimples mid scalp that bleed when I scratch or wash my hair. I counted 11 which seems excessive.. has me thinking I could have an infection on my scalp.
 
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