How to differentiate a crust coming out if it's with a follicle or without a follicle? (photo)

During initial 10 to 14 days, one should not rub the transplanted area because this much time is generally required for the graft to take up. For washing during this period one should gently pour the shampoo solution over the transplanted area and rinse it with gentle pouring of water. Some crust may come off with the hairs in it that are generally not grafts, they are the hair shafts which breaks from above and comes out and embedded in crust. Grafts have a bulb like structure which is papilla at the end of the hair which is embedded in the scalp. It generally comes off with the bleeding from that spot.

Your concern is very common. Everyone who had a transplant is
afraid that they will dislodge the graft and think that grafts are very
delicate. In our practice, we do a fair number of hair transplants and the
routine is fairly straightforward. We do hundreds or thousands of grafts in a
session and within the first 24-48 hours, the grafts are so well in place that
it would take a surgical instrument to physically remove the graft from the
scalp. We also use a material called extracellular matrix which further
facilitates the healing process and treats the thinning hair concurrently.



The scabs that you see are the combination of some old blood,
some very dry skin and are a part of a normal healing process. In the first
week, we have our patients wash their hair with a bowl of water and pour it
gently to let this superficial scabbing dislodge. We also let them spray the
hair with some saline to keep it just a little bit moist. By the second week,
we encourage our patients to scrub a bit. Of course, we do examine our patients
before we give them this advice to make sure that they are not doing anything
that can be traumatic.



Seeing a hair in the scab doesn’t mean you lost the graft.
The base of that graft is called the dermal papilla which is the root of the
hair. It’s actually the one that does the growing. Sometimes, what happens is
that the hair will break or shed and that is normal. I think communicating with
your doctor is critically important. Every experienced hair restoration surgeon
will be able to give you an advice from their experience. I’m sure that with a
little bit of guidance, you can anticipate what will happen beyond this initial
early point in your healing process. I hope that was helpful, I wish you the
best of luck, and thank you for your question.



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