11 Hair Transplant Side Effects

Swelling

Swelling is a very common side effect following hair transplant surgery, especially around the forehead and eyes. It affects a large percentage of patients, particularly within the first few days after the procedure. While it is alarming in appearance, it is usually temporary and not a cause for concern. Most patients report that it resolves within 5 to 7 days on its own.

Swelling occurs as a result of the body’s natural inflammatory response to surgery. During the procedure, the scalp is subjected to micro-trauma through incisions and injections, which cause fluid buildup in the tissue. This fluid gravitates down from the scalp to the forehead or eyelids due to gravity, especially while sleeping or resting in a horizontal position. This claim is supported by the study titled A meta-analysis of pre- and postoperative corticosteroids for reducing the complications following facial reconstructive and aesthetic surgery (2022).

To manage it at home, patients are advised to keep their head elevated while sleeping, apply cold compresses (not directly on the grafts), avoid bending over or intense activity, and follow all post-operative care guidelines. Staying well-hydrated helps reduce swelling faster.

To prevent excessive swelling, clinics often prescribe anti-inflammatory medications or a short course of oral steroids.

Itching

Itching is a very common and expected side effect after a hair transplant. It affects the majority of patients, particularly in the donor and recipient areas, and is typically a sign of healing rather than a complication.

This sensation is primarily caused by the formation of scabs, dryness of the scalp, and the body’s natural wound-healing response. As micro-incisions close and the skin regenerates, nerve endings are stimulated, which lead to persistent itching. Use of certain shampoos or not rinsing thoroughly intensifies the itchiness.

Patients usually begin to feel itching around day 3 to day 5 after surgery, with the peak occurring within the first two weeks. For most people, it gradually subsides by the end of the second or third week, once scabs fall off and the skin stabilizes.

In most cases, itching goes away on its own and is managed at home. Surgeons often recommend using a saline spray or moisturizing shampoo, which helps soften the scabs and soothe the skin. It’s essential not to scratch the scalp, as this dislodge grafts or cause infection. Light tapping or gently patting the area helps if the urge becomes intense.

To prevent excessive itching, follow your clinic’s aftercare instructions closely. Using mild, pH-balanced shampoos and keeping the scalp hydrated significantly reduce discomfort. Proper scalp hygiene and regular moisturizing significantly help manage pruritus (itching) during the healing phase of hair restoration procedures, according to a 2014 article in the Journal of Cutaneous and Aesthetic Surgery.

Bleeding

Bleeding is a common but usually minimal side effect after a hair transplant surgery. Small amounts of bleeding are expected, particularly within the first 24 to 48 hours, and are a normal part of the healing process. However, in rare cases, some patients experience excessive bleeding, which requires prompt medical attention. Excessive bleeding happens to 0.2% of the patients according to the study “Surgical complications in hair transplantation: a series of 533 procedures” conducted in 2009.

Bleeding typically happens due to micro-incisions made during the extraction and implantation of hair follicles. It occurs if a patient accidentally scratches or bumps the scalp, or if post-operative care instructions (such as avoiding strenuous activity) are not followed.

Normal bleeding appears as minor spotting or light oozing on the gauze or pillowcase, especially during the first night. It feels like slight dampness or appears as small red patches. Normal bleeding typically stops after gentle pressure is applied and resolves completely within the first few days.

Excessive bleeding, on the other hand, is when the scalp produces persistent or heavy blood flow that does not stop with light pressure. It soaks through bandages, continuously drips, or is accompanied by swelling and throbbing pain. Excessive bleeding usually occurs within the first 48 hours, but if it continues beyond this window or worsens, it must be addressed.

In cases of minor bleeding, home management includes gently applying sterile gauze and light pressure for 10–15 minutes without rubbing. Keeping the head elevated, avoiding bending over, and refraining from touching the scalp helps prevent bleeding. Alcohol, blood-thinning medications, and vigorous physical activities should be avoided during the recovery period.

Preventing bleeding starts with choosing an experienced surgical team, strictly following all post-operative guidelines, and avoiding trauma to the scalp.

Infections

Infections are a rare side effect after hair transplant surgery, occurring in a small percentage of patients. Thanks to modern surgical techniques and strict sterilization protocols, the risk is minimal, but it is still something to be aware of during recovery. Infection rates following hair transplant surgeries are low, typically less than 1%, particularly when patients follow post-operative instructions closely according to Complications in Hair Transplantation (2018).

Infections typically happen when bacteria enter the micro-incisions in the scalp. This occurs if the scalp is touched with unclean hands, if aftercare instructions are not followed, or if there is excessive sweating or exposure to dirty environments during the healing phase.

An infection usually presents with increased redness, swelling, warmth, pain, and sometimes pus or discharge from the scalp. It feels tender and sensitive to touch, and patients notice a fever if the infection is more severe.

Infections most commonly develop within the first week after surgery , often around day 3 to day 7. Early identification and treatment are crucial to avoid complications or damage to the newly transplanted grafts.

Minor infections sometimes resolve with prescribed antibiotic ointments and proper scalp hygiene. However, moderate to severe infections require immediate attention from your surgeon, who prescribes oral antibiotics or other treatments. Delaying medical care risks the survival of the transplanted grafts.

To prevent infections, patients should avoid touching their scalp unnecessarily, follow cleaning routines carefully, stay away from crowded or dirty environments, and refrain from strenuous activities that could cause sweating. Clinics often prescribe prophylactic antibiotics immediately after surgery to further minimize infection risk.

Scarring

Scarring is a common but highly variable side effect of hair transplant surgery. How much scarring occurs depends on the surgical technique used, individual healing responses, and the skill of the surgeon. For some patients, scarring is barely noticeable, while others develop more visible marks.

Scarring happens due to the incisions and extractions made during the procedure, which are necessary to remove and implant hair follicles. In Follicular Unit Extraction (FUE), tiny circular scars form at each extraction point. In Follicular Unit Transplantation (FUT), a linear scar is left at the donor site where a strip of scalp was removed.

Typically, scarring feels like small bumps, faint lines, or smooth patches on the scalp. Visually, FUE scars resemble tiny white dots scattered throughout the donor area, while FUT scars appear as a thin line, usually hidden under surrounding hair.

Scarring becomes noticeable once the scalp heals, usually within the first few months after surgery. Over time, scars often fade and become less visible, especially if the patient follows good aftercare practices and if the surgeon closes incisions meticulously.

Most scarring is permanent but fades over time. No scar is completely eliminated without surgical revision, but many patients find that scars become barely visible within 6–12 months according to the study Hair follicle transplants rejuvenate scars (2023). Proper home care, such as avoiding sun exposure, following wound care instructions, and using silicone gels or sheets, help minimize scar appearance.

Preventing prominent scars involves choosing an experienced surgeon, understanding your risk factors (like a personal or family history of keloids), and adhering strictly to post-operative care guidelines. A review published in the Facial Plastic Surgery Clinics of North America highlights that patient factors like skin type, genetic predisposition, and compliance with post-operative instructions greatly influence scarring outcomes after hair transplant surgeries.

Shock Loss

Shock loss is a relatively common but temporary side effect after a hair transplant surgery. It refers to the sudden hair shedding of transplanted hair, existing hair, or both, following the procedure. While it is alarming, it is generally a normal part of the healing process.

Shock loss happens because the trauma of surgery temporarily disturbs hair follicles, pushing them from the growth phase (anagen) into the shedding phase (telogen). It results from swelling, inflammation, or disrupted blood supply in the treated areas. Both donor and recipient sites experience shock loss.

Shock loss typically looks like thinning hair patches or sudden shedding of hair around the implanted or donor zones. Patients notice hair falling out while washing their scalp or see visible thinning in previously dense areas.

Shock loss usually occurs within 2 to 8 weeks after surgery. It is most commonly observed between the third and sixth weeks, although timing varies based on individual healing responses.

In most cases, shock loss resolves naturally without treatment. Hair usually starts to regrow within 3 to 6 months, as the follicles enter a new growth cycle. Managing at home involves being gentle with the scalp, avoiding stress, and following surgeon-recommended hair care routines.

Preventing shock loss entirely is not possible because it is a biological response, but minimizing scalp trauma, using prescribed medications like minoxidil, and closely following post-operative care reduces its severity.

Shock loss is a transient phenomenon commonly associated with hair transplant surgeries, especially in patients who already have miniaturized (weakened) hair before surgery according to the research Localized Telogen Effluvium of the Donor Area After Hair Transplant Surgery in 12 Patients (2020).

Cysts

Cysts after a hair transplant are uncommon but not rare. Cysts usually happen when grafted hair follicles fail to properly break through the skin surface or when dead skin cells, sebum (oil), or debris clog the follicle openings during recovery. Trauma to the scalp or improper handling during surgery contribute. Another factor is the improper technique according to the study Complications in Hair Transplantation (2018).

They typically feel like small, soft or firm lumps under the skin. Cysts are usually painless unless they become infected, at which point they turn red, swollen, and tender.

Cysts most often appear between 1 to 3 months after the surgery, once healing is underway and hair shafts are trying to grow through the scalp.

In most cases, minor cysts resolve on their own within a few weeks. Applying warm compresses several times a day helps the body naturally reabsorb them. Good scalp hygiene and avoiding squeezing or picking at them are important.

To prevent cysts, it’s crucial to follow aftercare instructions, keep the scalp clean, and avoid wearing tight hats or putting pressure on the healing area during the early recovery phase.

Folliculitis

Folliculitis after a hair transplant is fairly common, but it usually appears in a mild and manageable form. Depending on the source, its incidence ranges from about 12% to 23% among hair transplant patients, as reported by the study Characterization and Risk Factors of Folliculitis after Hair Transplantation: A Multicenter Retrospective Study (2023).

Folliculitis happens when hair follicles become inflamed or infected, typically due to bacterial growth, clogged follicles, or improper scalp hygiene during recovery. Sometimes, irritation from new hair growth through healing skin triggers sterile (non-infectious) folliculitis.

It usually looks like small, red bumps or pustules around the transplanted hairs. The area feels itchy, tender, or mildly painful.

Folliculitis is most likely to occur within 2 weeks to 2 months after surgery, although it appears during the period of active hair regrowth several months later.

In most cases, mild folliculitis resolves on its own within a few days to a week. Warm compresses and gentle cleansing are usually enough to soothe the area if no signs of serious infection are present.

To prevent folliculitis, it’s essential to keep the scalp clean, avoid scratching or rubbing the area, and follow aftercare instructions strictly. Using sterile saline sprays, prescribed shampoos, and avoiding heavy sweating activities reduce risk.

Bumps

Bumps after hair transplant surgery are relatively common and usually not a cause for alarm. They typically occur as part of the healing process but sometimes signal other underlying issues.

Bumps usually happen because new hair follicles are trying to grow through the healing skin, or due to trapped sebum (oil), small infections like folliculitis, or ingrown hairs. In some cases, excessive swelling or poor post-operative hygiene contribute to their development. Bumps generally happen because of folliculitis according to the study Complications of Hair Restoration Surgery: A Retrospective Analysis (2018).

Bumps feel like small, firm pimples or lumps beneath the skin. They are slightly red or skin-colored and tender to the touch if inflamed.

They are most likely to appear within 2 to 6 weeks after surgery, although some patients notice them even a few months post-transplant, especially as hair regrowth starts.

In most cases, minor bumps go away on their own within a few days to a few weeks. Gentle scalp hygiene, warm compresses, and following the surgeon’s aftercare instructions usually help manage them at home.

To prevent bumps, it’s important to keep the scalp clean, avoid scratching or picking at healing areas, and follow prescribed aftercare. If bumps result from folliculitis, a surgeon recommends topical antibiotics or mild antiseptic treatments.

Nerve Damage

Nerve damage after a hair transplant is as rare as less than 1%, but it happens in certain cases, particularly after larger surgeries or when deeper incisions are made according to the article ‘Complications in Hair Transplantation’, Amit S Kerure et al., (2018).

Nerve damage typically occurs when small sensory nerves in the scalp are accidentally stretched, compressed, or severed during the harvesting or implantation process. It is more likely with techniques involving larger strip harvesting (FUT) but occasionally happens with FUE if the punches are too deep.

Patients usually notice numbness, tingling, a burning sensation, or a feeling of reduced sensitivity in the donor or recipient area. In rare cases, some people report shooting pain that comes and goes.

Nerve-related symptoms are most commonly reported immediately after surgery and persist for weeks to several months. Typically, they gradually improve as the nerves heal.

In the vast majority of cases, minor nerve damage heals naturally over 3 to 6 months without the need for intervention. Gentle scalp massages (after your surgeon clears you), avoiding trauma to the area, and following post-op care instructions support nerve recovery at home.

Preventing nerve damage involves choosing an experienced surgeon, minimizing unnecessary trauma to the scalp, and using precise harvesting and implantation techniques.