By relocating healthy hairs from a donor area (an area either at the back or sides of the scalp) to balding or sparse regions, hair transplant surgical techniques – Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE) – are often permanent treatments for hair loss and thinning. While FUT and FUE techniques are far safer than those of the past, and much more aesthetic in their results, they are still medical procedures and subject to the usual risks attached to surgical intervention.

This article will provide detailed information on the side effects that can occur after undergoing any hair transplant surgery. It will outline the common, short term problems, the rare, long term complications and also indicate ways by which these side effects can be minimized through the recovery period.

Understanding Hair Transplant Procedures

Before getting into side effects, it is important to understand how hair transplant procedures work and there are two different techniques, the first is to take hair from another part of the body namely the back or the sides of the head and implant it on the bald part of the head and this process is called auto-implantation, and its alternative is to take hair follicles from healthy follicles in the balding area and place them on the bald patch.

Follicular Unit Transplantation (FUT): In this procedure, a strip of scalp is directly removed from the donor area (usually the back of the scalp) and then divided into follicular units. These units are implanted into the areas where hair loss is occurring.

Follicular Unit Extraction (FUE): Individual hair follicles are removed with a specific tool from the donor area. Each follicle is then implanted into the recipient area.

Both procedures lead to happy endings, but both also have side effects that can range from bothersome to downright serious if not properly mitigated. Knowing some of the possible pitfalls will help patients go into their surgery with reasonable expectations.

Common Side Effects of Hair Transplants

The procedures are generally safe when executed by a skilled surgeon, but both FUT and FUE may result in a slew of side-effects in patients as their bodies recover.

Pain and Discomfort

Pain is the most common side effect of hair transplant surgery; the first couple of day sitling after surgery can be quite painful. Local anesthesia is used during the surgery so the patients don’t feel anything during the procedure but the anesthesia wears out a day after the surgery and people expect to feel a little bit of pain.

Duration: The pain lasts for a few days or at the most up to a week, according to his pain threshold and surgery type.

Management: Take over‐the‐counter pain relievers like ibuprofen or medications prescribed by your surgeon. Ice the area could help diminish swelling and pain.

Swelling
Swelling can also be a post-operative effect, which is most common around the forehead and eyebrows, and may happen as the body’s natural healing response to the surgery, with some fluid accumulation in the scalp.

Duration: The swelling tends to peak two to three days after the procedure and then subsides within a week.

Management: Surgeons recommend elevating your head while you sleep, using cold compresses and taking anti‑inflammatory medications to help reduce swelling.

Scalp Redness and Irritation
Both procedures involve incisions in the scalp that can lead to redness and irritation throughout the donor and recipient areas; this is expected as the scalp heals itself following surgery.

Duration: Redness may last a few days or up to several weeks, depending on skin sensitivity and the pace of healing.

After this surgery, patients are advised to: Be careful of excessive sun exposure and follow the advice of your surgeon on how to keep the scalp clean and healing.

Crusting or Scabbing
Small scabs or crusts can form around the small transplanted follicles as they heal Small scabs or crusts can form around the small transplanted follicles as they heal; this is normal and not a concern.

Duration: Scabbing generally starts within the first few days and falls off early after 10-14 days following the procedure.

Surgery: Do not peel the scabs or pick at them prematurely because you risk removing grafts before the hair follicles take root and grow. Surgeons may tell you to gently wash your scalp after a couple of days or so to keep the area clean.

Bleeding
Because hair transplant surgery involves making multiple tiny incisions in the scalp, there’s a small amount of bleeding involved – typically, this is limited to the first 24 to 48 hours.

Duration: Any bleeding should subside within the first day or two post-operation.

Management: Apply light pressure to the area to stop bleeding. Do not eat blood-thinning foods such as cranberry or flax seed without first talking to the surgeon. If further bleeding occurs, patients are to contact their surgeon immediately for further advice.

Itching
Often there is significant itching during the healing of the scalp – sometimes because of the formation of scabs, sometimes as part of the same necessary healing that has caused the incisions.

Duration: Fades away after several days or a week, depending on how the skin recovers.

Management: Mild shampoo prescribed by surgeon to help reduce itching; patient to avoid scratching to allow healing or risk infection.

Temporary Side Effects

Although the majority of bothersome effects typically seen with hair transplant surgery are minor and transient, some effects, specifically in the recipient site (the part of the scalp receiving the transplanted grafts), may tend to last one to two months.

Shock Loss
One possible side effect of surgery is shock loss or shedding of existing hair in the donor or surrounding areas. This is thought to be the result of the traumatic hair removal that follows surgery, as this can lead hairs in the telogen (resting) phase on the scalp to shed.

Duration: Shock loss can happen anytime during the first two to eight weeks post-surgery, with hair regrowing over the next several months.

Your physician does recommend… I will give all my patients who undergo surgery and achieve an increased hair count, especially those individuals they find to be more likely to experience shock loss, a prescription for Minoxidil or Finasteride, explaining to them the increased risk when they engage in heavy exercise and the probability that they will experience shock loss which, however, is temporary.

Folliculitis (Inflammation of Hair Follicles)
Folliculitis, a temporary side effect that happens because hair follicles become inflamed or infected, which is common and results in bumps on the scalp (they might be small, red and pus-filled). These bumps may occur because hair has begun to grow through the transplanted follicles.

Duration: The condition of folliculitis usually starts several weeks after surgery and may persist up to a few days or weeks if untreated.

Management: Most cases of folliculitis improve on their own and some never develop a pustule. But if it doesn’t go away, your GP might prescribe a topical or oral antibiotic. You might also be advised to apply warm compresses to ease inflammation.

Numbness or Tingling
In a hair transplant, the patient can be numb or tingle in the donor as well as in the plantation areas because the incisions affect the nerves in the scalp.

Duration: Generally, numbness lasts from a few weeks to several months. It may be less common for this phenomenon to persist for longer than a year. This is also the case in postoperative scenarios.

Management: Feeling typically returns on its own as nerves heal; consult your surgeon if numbness persists more than several months.

Long-Term Side Effects

Although most of these side effects are transient and resolve on their own, some patients may experience long-term or more serious problems.

Scarring
FUT and FUE can both create scars, but the structure and appearance of the scars can be different depending on the method used.

FUT: FUT leaves a linear scar in the donor area where the strip of scalp was taken. The size and visibility of this scar is dependent on the skill of the surgeon, and the patients healing process. The scar also remains visible under shorter hairstyles, and can be hidden visually by growing the hair longer.

FUE: FUE leaves small, round scars where follicles were extracted; FUE scars tend to be less obvious than FUT scars, especially when the hair is cut short.

Management: Good wound care and follow up on post-op instructions minimise the chances of scarring. Even in cases of scarring, the appearance can sometimes be improved with scar revision surgery or laser therapy.

Cyst Formation
In some patients, the implantation process in the recipient area can lead to the development of cysts if some hair follicles are accidentally caught underneath the skin or the neograft inadvertently enters sideways during implantation. These cysts are usually small, benign, keratin-filled bumps.

Management: While most cysts go away on their own, some require drainage by the doctor.

Poor Hair Growth
While most hair transplant surgeries result in positive changes, not all patients get the full wad of hair they might be expecting. This can be the reason for losing a lot of product’s fillers while standing on top of my head. It may be the result of the transplanted hairs failing to latch onto the scalp, or even lacklustre – or one-sided results.

Causes: • Due to damage to the hair follicles from improper handling of grafts following or during transplantation. • Poor surgical technique. • Individual factors such as poor circulation of scalp.

Management: In some cases, patients may need a second procedure to correct uneven growth or add density to the transplanted area.

Infection
While infections are rare in hair transplant surgery, they can occur if the surgical site is not kept clean and if bacteria are able to enter the incisions: signs of infection would include redness, warmth, swelling, pus and fever.

Management: Most infections are easily controlled with antibiotics, as long as you follow your surgeon’s post-operative care instructions, keep the scalp clean and uncontaminated, and watch for any unusual activity.

Minimizing the Risk of Side Effects

Although side effects are possible after receiving a hair transplant, many can be minimized if not mitigated completely when best practices before and after are adhered to.

Choosing a Skilled Surgeon

Most importantly, experience with a top surgeon, who is not only experienced but also highly qualified, is the most important thing in avoiding unwanted side effects. A more skilled surgeon is more likely to produce good results.