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This patient came into the office with a widened scar from a hair transplant we did over a year ago. The photo at the lower left is following his second transplant procedure (the first was with another doctor). The widened scar risk increases with each additional procedure. Only the central 2 1/2 inch portion of the wound stretched 1cm (as seen here), while the two 1/2 inch wounds on either side didn’t stretch. Donor scarring is a real risk of strip harvesting for FUT but usually the scar is under 3mm in width. After the second surgery, the scar may widen as in this man.

We suggested scalp micropigmentation (SMP) for camouflaging the scar and these photos below were taken 10 minutes after his SMP session was done. This is a typical scar treatment for SMP. Sometimes a second treatment is needed. Click the photos to enlarge.

BEFORE SMP (on left); IMMEDIATELY AFTER SMP (on right):

About a month ago, I sustained two lacerations to the scalp on the back of my head. They were closed with seven staples. The area was not shaved at the emergency room. The largest of these lacerations is about 20 mm long and 1 mm wide. However, the resulting bald area exceeds the wound width by approximately 5 mm (making the width of the bald area 6 mm). I know no hair will grow again within the wound parameters. So I ask you:

1.) Is the prognosis good for full hair regrowth outside the wound?
2.) How many weeks (or months) must pass before I could justifiably believe there would be no more significant hair regrowth?
3.) What are the potential surgical corrective measures (e.g. cutting open the scar and running hair from one hair bearing edge up through the scar tissue)?

Hair loss with laceration repairs is common around the wound. The size of the bald area will vary depending upon the direction of the wound. The scars will be less significant in the normal Langer lines direction (see here).

The regrowth will usually occur within the first 4 months or so and any hair that has not grown in 6 months may probably reflect some permanent hair loss. Scars from scalp lacerations that form are not easily amenable to excision, as they tend to recur (I am assuming that the scars were properly closed and that there were no unusual circumstances present at the time of the closure, such as dirt in the wound).

hello.
My question is, if shock loss is one of the side effects with a HT would the doctor insert more graphs in a particular area knowing that shock loss would occur? This way a patient doesn’t feel as if he or she didn’t get a proper procedure done and it looks as if more hair is there then the patient originally began with.

As well, are the hair line and frontal areas more susceptible to shock loss versus the back, top part (Crown) and sides of the head?

The areas most likely to have shock loss are the areas where miniaturization is present. There isn’t one part of the scalp that is more susceptible than another. The more miniaturized the hair is, the greater the risk over time.

Shock loss doesn’t occur for all patients, and taking finasteride prior to surgery usually protects the body from hair transplant induced shock.

Thank you for your time. I am a 33 year old male and I have used propecia for some time now and my hair loss has been minimal up until the last few months. I have good reason to believe that my ex-girlfriend has been putting nair in my shampoo, conditioner, or styling paste. It has changed in texture and I am losing it in patches and generally all over my scalp. If this is the case then is the damage permanent or will it grow back? Also, what can I do to repair my hair?

Again, thank you for your time.

Yes, if that suspicion is true then it will grow back, provided the assault stops. You might want to have a serious discussion with your ex or threaten to take legal action against her. Or at the very least buy new shampoo, conditioner, and hair product…