Advice on heavy scabbing at Day 16

[Keith]

Hi
I'm currently on Day 16. I've had heavy scabbing on my recipient area from day 7 and while most of the other scabs have gone there remains a big one which seems really thick and hard to budge ( See photo)

I've already seen my doctor and have been on anti biotics for a week and I have had PRP injections to aid healing

I'm worried that this is not usual and my hair won't grow in this area once the scabs eventually come off.

Has anyone had any experience of this and any reassuring advice?

 

[Bigmac]

Hello Keith. It is possible necrosis.
The scab needs debried which is removing the scab and clean the wound. If necrotic, it will not come off easily. Use saline solution soaked in a compress.
You should probably start on cialus 20mg daily for now. Ask your doctor about it and removing the scab. I would not want you to take this advice and go against what your doctor advises but this advise has been provided by doctors too. Run it by your doctor.
You don’t want the scab spreading. If it is necrosis, as long as it’s controlled you’ll only suffer no growth in that area and it can be re-grafted in 8 months.

 

[Keith]

Hi. thanks for the response. Well i'm pretty sure its healing ok as it has improved to what it was a few days ago. I'm half way through a weeks course of anti biotics already, Co-amoxiclav ( Amoxicillin/Clavulanic acid) 500mg . 3 times per day. The doctor didnt mention about trying to remove the scab but ill mention that to him today. although his advice has to not to force the scab off and let it come off naturally.
Can i ask why you think the scab needs to come off asap and not in due course ?

 

[Bigmac]

The advice I mentioned was from doctors. The scab looks like necrosis was the opinion formed on the information and picture. Although you’re saying it appears to be healing now, so maybe your treatment plan is working.

This link explains why necrosis scabs are removed.
Necrosis scab removal

Hopefully, you heal ok with all the grafts surviving. Only time will tell now.

 

[Bigmac]

How many grafts did you receive? Was it Fue or Fut?
It would be useful to see some surgery pictures and the days leading up to the excess scab formation if you have them.

 

[Keith]

FUE. just less than 3000 grafts

 

[Bigmac]

A decent size surgery. Apart from that scabbing it looks to have healed well. How is the donor looking?

 

[Keith]

Thank you. My donor area is healing quite well thanks although it is still a little delicate and becoming a bit spotty/ pimply since the hair has started to regrow which is making it itchy and a little sore ( photos attached) . Do you recommend anything to sooth the scalp in the donor area?

Thanks in advance.

 

[Bigmac]

Healing looks decent and right where is should be. Once the itching and any soreness has improved I would get a hair cut to blend everything in. Itching can drive you crazy, usually, aloe vera gel or spray helps and some people take anti-histamines/allergy pills. Right now, my only concern would be the scab in the recipient area. Hopefully, it heals quickly from now on.

 

[Kevboy]

Your donor is in pretty good shape and the top looks good with the exception of that big scab. Has it fell off yet?

 

[Bigmac]

Hi Keith, has the scab healed?

 

[Keith]

sorry for late response. yes all but one bit of scab has fallen off ( See photo) . They have come off gradually over the course of the last week although I had to give them a bit of helping hand by mosturising the area after showering with coconut oil. this then helped ease them away from the skin bit by bit. Under the scab there was a bit of yellow discharge which now seems to have hardened forming another kind of scab but not as thick as the black ones. My doctor has been giving me regular PRP (Platelet Rich Plasma) injections twice a week injected into my scabbing area since my scabbing formed. This was to aid the healing of the skin under the scab. The doctor seems like the injections have worked well and is happy with the healing. He mentioned it was too early to tell if the folliciles will grow over this area but is hopeful they will . What do you think?

I am a bit nervous that i will end up with a gap in my hair growth were the scabs are which will look really odd . I'm not sure what happens in this situation or whether my hair transplant company will offer to replace the missing grafts free of charge at a later date.

 

[Bigmac]

At 30 days post-op I do fear this is necrosis. The areas of scalp where the scabs were present does appear to have formed scar tissue. All you can do is wait and see if the grafts survived.
Do you have your pictures from the day of surgery?

 

[Keith]

At 30 days post-op I do fear this is necrosis. The areas of scalp where the scabs were present does appear to have formed scar tissue. All you can do is wait and see if the grafts survived.
Do you have your pictures from the day of surgery?

Hi. See pics that I saved after surgery. Day 0 is day of surgery. Thanks for your help

Do you mind me asking what your role is on here? Are you a doctor or just some one who has seen a lot of hair transplants?

 

[Bigmac]

I own the site, have had a few hair transplants myself, seen a lot of hair transplants, met a lot of patients in person, watched numerous live surgeries , attended many workshops and conferences.
It looks as though the scabs were forming on the 4th day. I wonder if you somehow caught an infection. As i said earlier, you’ll just have to wait now. Hopefully, the treatments worked and all will be ok.

 

[Keith]

Thanks.

Is necrosis the same as an infection then?

Also do you know if many companies offer re doing a small number of grafts at a lower price if some of them fail to grow?

 

[Bigmac]

This link explains it Necrosis scar tissue

Having a small procedure is offered by clinics. Some will have a minimum surgery fee, others may incorporate it with another smaller surgery on the same day.

 

[Bigmac]

Any update Keith? I’d like to see how you're progressing.

 

[Risingforehead]

Was it necrosis or did it heal?