Folliculitis after transplant: causes and treatment
A few red bumps weeks after surgery are common. What matters is telling an ingrown hair from an infection, and squeezing neither.
Folliculitis after a transplant is inflammation around individual follicles, appearing as small red bumps or pustules, most often between the second week and a few months post-operatively. It is common, usually mild and treatable, but it should be assessed rather than squeezed.
What does folliculitis after a hair transplant look like?
Folliculitis appears as small, raised, red bumps, sometimes with a white or yellow head, scattered across the recipient area or occasionally the donor area. They can be tender and itchy, with numbers ranging from a handful to dozens. Isolated spots appearing weeks after surgery are common and not in themselves alarming.
Why does folliculitis happen after a hair transplant?
Folliculitis after a transplant is most often caused by ingrown hairs, where a regrowing shaft fails to break the surface and the follicle inflames around it; that is not an infection. Less common causes include retained graft fragments, bacterial infection, which does need treatment, and occlusion from sweat, oils or tight headwear trapping moisture.
- Ingrown hairs. A regrowing shaft fails to break the surface and the follicle inflames around it. This is the most common cause and is not an infection.
- Retained fragments. Occasionally part of a graft or a hair remnant provokes a local reaction.
- Bacterial infection. Less common but does occur, and needs treatment.
- Occlusion. Sweat, oils, heavy products or tight headwear trapping moisture against healing skin.
What should you do if you get folliculitis after a transplant?
Contact your clinic with a photograph, since treatment depends on which cause is involved, and keep washing to the schedule you were given. Avoid occlusion from hats, helmets and heavy products until it settles. Do not squeeze or pick, which turns a minor bump into a scar, and do not self-prescribe leftover antibiotics.
- Contact your clinic with a photograph; treatment depends on which cause is in play.
- Keep washing to the schedule you were given.
- Avoid occlusion from hats, helmets and heavy products until it settles.
- Do not squeeze or pick. This is how a minor bump becomes a scar or a spreading infection.
- Do not self-prescribe antibiotics left over from something else.
When does folliculitis need prompt medical attention?
Folliculitis needs prompt attention if redness is spreading rather than isolated, if there is fever or increasing pain, if pustules are widespread, or if anything worsens over 48 hours. Most folliculitis is a nuisance, but the minority that is a real infection is time-sensitive, so photograph and report it rather than wait.
- Spreading redness rather than isolated spots
- Fever
- Increasing pain
- Widespread pustules rather than a few
- Anything that worsens over 48 hours
Most folliculitis is a nuisance. The minority that is a real infection is time-sensitive, which is why photographing and reporting it beats waiting to see.
Most cases settle with the ordinary hygiene measures described in the aftercare guide.
Sources
- Bernstein RM, Rassman WR. Graft Anchoring in Hair Transplantation. Dermatologic Surgery, 2006;32(2):198-204. pubmed.ncbi.nlm.nih.gov/16442039
This article summarises published research and standard clinical practice. It is general educational information, not medical advice, and it does not replace the instructions your own surgical team gives you. Where their guidance differs from anything here, follow theirs.
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