4 weeks post op FUE, still have scabbing. Is this normal? When am I allowed to start smoking if at all is it allowed?

Scabbing and washing your hair is always an issue after surgery and different doctors have their opinion.In general scabbing can last several days to weeks.  I've seen scabs fall out in 5 to 7 days with great washing.  I've also seen 3 to 4 weeks with poor washing.  You need to follow up with your doctor for an exam if you have concerns.Smoking is always a bad idea. Not good for your health and hair.  But it should not impact your transplanted hair (realistically). 

Scabbing after a hair transplant procedure should not last longer than 7-10 days if the patient washes his/her hair properly.  Having said that and despite the fact that we review proper techniques of hair wash with our patients regularly, we sometimes see patients who did not wash their hair as thoroughly as they were told because of the fear of losing the transplanted grafts.  Make sure you have followed proper instruction of hair wash after hair transplant.  If you have and still see scabs after 4 weeks, you need to see your hair transplant doctor for evaluation.Congratulations, that you took the plunge and decided to quit smoking after your hair transplant.  I know many patients who decided to quick smoking around the time of their hair transplant and they never went back to smoking.  I hope you stay off of it permanently.  However, smoking a few cigarets especially after the first few days should not impose a big risk on your transplanted grafts.

It depends on what you mean by scabbing and what after care you are doing. It is important to get close follow up with your team.

Be sure to see your team for how they would like you to deal with scabbing AT 4 weeks post FUE your surgeon may ask you to let the shower head stream beat right down on your grafts. To loosen the crust up a bit, you may also be asked to put baby oil on the scalp for 10-15 minutes to help soften and loosen things up.Getting rid of scabbing is a very important goal - be sure to speak to your team.As far as smoking goes, there's one thing which is for sure: 5 weeks stopping is better than 4 weeks and 7 weeks is better than 5. Post transplant hair follicle healing and regeneration is enhanced greatly by stopping smoking. Check with your surgeon. If you can do 3-4 months, that would likely very helpful.  Of course, many patients do return 1-2 months after their transplant and have nice results. But the longer the better, no doubt.

That reflects a failure of your post operative washing technique (see below in the web reference). With the crusts lasting this long, do not pick them off, but follow the instructions below.

In general all scabs in the transplanted area are gone within 7-10 days with appropriate post operative care. Please see you surgeon for review. At 30 days you certainly should be shampooing your hair normally and certainly not have scabbing. It sounds like you may have some shock loss (telogen effluvium) and this should also be reviewed with your hair transplant doctor. As for smoking, their are more than 7,000 nasty chemicals in cigarette smoke. Nitrosamines in the tar of cigarette smoke have been implicated in cancer and are oxidizers, which causes DNA damage that can lead to cancer. Cigarette smokers have an average life expectancy 11 years less than normal. Smoking damages faster growing cells more than slower growing cells in the body, hair follicles are rapidly growing cells. People who smoke generally have less hair in their donor area. Smoking will damage your hair. The nicotine in cigarettes are not implicated in hair loss. Many of my patients have successfully stopped smoking using a nicotine containing gum. And if what I wrote about your hair loss from smoking doesn't scare you, look at some of the British studies implicating smoking and erectile dysfunction. Best of luck with your smoking cessation!