Hair Transplants and Scarring: What to Expect

Today’s primary surgical methods fall into two categories. Everyone results in a unique kind of scarring. The amount of scalp scarring you have depends on your surgeon’s expertise and experience.

Whichever option you select, both the surgeries and wound-closure methods have advanced and improved. This article will cover the general topics of hair transplant scarring, post-operative care, and techniques to reduce scarring.

Types Of Scars From FUT And FUE

Hair transplant surgery is a popular and effective solution for individuals experiencing hair loss or thinning. There are two primary surgical procedures used for hair transplantation: follicular unit extraction (FUE) and follicular unit transplantation (FUT).

While these techniques can provide excellent results in terms of hair restoration, they also leave scars on the scalp. Understanding the several types of scars that can result from these procedures is crucial for individuals considering hair transplant surgery.

Follicular Unit Extraction (FUE)

FUE involves the extraction of hair follicles from the donor areas, typically located at the back and sides of the scalp. During the procedure, a surgeon uses a micro-punch tool to remove each hair follicle graft individually.

 Each extraction leaves a tiny round scar, measuring up to 1 millimeter in diameter. Depending on the number of hair shafts extracted, hundreds or even thousands of puncture mark scars may be visible. These scars often appear as tiny white dots on the scalp.

The hair follicles extracted through FUE, typically containing 1-4 hairs, are then grafted onto the recipient areas of the scalp. The entire procedure may take many hours, or even days, to complete, especially if a large number of grafts are required. 

In some cases, multiple FUE sessions may be necessary to achieve the desired hair density. FUE is usually performed on an outpatient basis, under local anesthesia. Since no stitches are required for closure, the recovery time after FUE is relatively short.

Follicular Unit Transplantation (FUT)

FUT, on the other hand, involves the surgical removal of a strip of scalp from the donor area. It is typically located at the back of the scalp.

After the strip removal, the doctor sutures the surrounding scalp together, resulting in a linear scar. The length of the scar depends on the size of the strip extracted and may extend from ear to ear.

The harvested grafts are then prepared for transplantation onto the recipient areas of the scalp. Small incisions are punched for each individual hair graft. Similar to FUE, the FUT procedure is performed on an outpatient basis under local anesthesia. 

However, unlike FUE, stitches are required to close the wound created by the strip removal. These stitches are typically removed approximately ten days later.

It is worth noting that the FUT procedure may cause more post-operative pain and swelling compared to FUE, primarily due to the larger incision and the resulting scar.

How To Minimize Scarring

Keloids and hypertrophic scars, although uncommon, can be a concern after hair transplant surgery. A patch test can be done to assess the likelihood of developing noticeable scars in an easily camouflaged area of the scalp.

In the event of keloid or hypertrophic scar formation, these can be effectively managed with intralesional injections of triamcinolone acetonide 40 mg/ml, a medication that reduces inflammation and promotes healing.

Follicular unit excision (FUE) is a hair transplant technique that is less likely to result in wide scars, cross-hatch scars, or multiple large scars. However, complications can still occur, albeit rarely, even with the most skilled surgeons.

Nonetheless, it is crucial to emphasize that these complications are generally avoidable by taking proper precautions and ensuring thorough patient education. 

Both medical and aesthetic complications should be taken seriously, regardless of their impact on the final outcome.

Various procedures exist to lessen or reduce the size of the scar resulting from hair transplant surgery. However, it is crucial to note that the complete elimination of scars is not always guaranteed. 

As individuals age, their scalps may naturally sag, potentially causing scalp reduction scars to become wider or more visible over time. In such cases, alternative procedures may be recommended to address the scar’s appearance.

One solution for minimizing the visibility of scars is grafting hair follicles into the mark from previous follicular unit transplantation (FUT) using the FUE method. 

The effectiveness of this approach depends on the thickness of the scar tissue. Additionally, scar tissue can be thinned using medication to improve the overall results of the hair transplant procedure.

It is worth noting that scarred skin may not hold grafts as securely as healthy skin. Therefore, it is essential to have a thorough discussion with your doctor to determine the most appropriate method for minimizing the appearance of scarring. 

By considering individual factors and preferences, such as the type and location of the scar, the doctor can provide personalized recommendations for optimizing the outcome and reducing visible scarring.

You can quickly watch this video to minimize the scalp scar:

Post-Op Care For Scars

For strip harvesting procedures, the visibility of scars is mainly influenced by the number and width of the wound. After multiple surgeries, there may be a temptation to maximize donor yield by harvesting from virgin donor regions.

If the existing scar is removed along with the new donor strips, it is possible to leave a single scar despite multiple surgeries.

While recipient-hair effluvium is relatively common after a hair transplant, donor-hair fall is significantly less common. Donor-hair effluvium occurs as a consequence of anagen effluvium, which is a response to the interrupted blood supply. 

This issue is more likely to arise when harvesting from donor tissue bordered by scar tissue. However, the problem spontaneously resolves within three to four months.

Saline Water Application

Salinated water is for compressing the scalp. Some physicians also use copper peptide products, although the evidence supporting their effectiveness in speeding up healing is minimal. These products may help prevent crust formation in the donor area.

Medicated Gel

Ointments or gels are prescribed and should be applied twice daily. You must use these products on both the donor incision and the recipient area.

Water-based gels are commonly used as they promote wound healing by retaining moisture and providing a physical and/or medical barrier against infection. Polysporin, mupirocin, Neosporin, and petrolatum are some common ointments used. 

However, some physicians may prefer surgical gels, although they can be difficult to remove from the hair. Topical antibiotic ointments are rarely required.

Supplements and Medications

Minoxidil may be prescribed to decrease postoperative effluvium, although the evidence supporting its effectiveness is limited. Some physicians may prescribe minoxidil postoperatively, but it can cause scalp irritation.

In such cases, the physician advises a topical corticosteroid to hasten the resolution of discomfort. Additionally, hair growth medication like finasteride may be recommended to improve hair regrowth. 

Vitamin supplements, pain relievers, and antibiotics may also be prescribed as part of the post-operative care regimen.

Follow the Physician’s Instructions

It is essential to closely follow the instructions provided by your physician for optimal recovery. Avoid direct sunlight exposure to the scalp and refrain from vigorously handling or scratching the scalp.

Use the shampoo and lotion recommended by your physician. When drying the recipient area, use a soft towel and gently pat it instead of rubbing it. Avoid excessive sweating on the scalp, as it can damage hair follicles and contribute to scarring.

Possible Treatments For Scars

Concealing the scarred area is an option, particularly by growing hair over the donor area. However, this approach may be more challenging for certain types of scars, such as keloid scars, which tend to grow wider than the original surgical scar and may continue to expand over time.

Fortunately, there are several procedures available that can help disguise hair transplant scars and provide individuals with renewed confidence in their appearance.

Scalp micro pigmentation

One notable treatment option is scalp micro pigmentation (SMP). It is known as a medical hairline tattoo or scalp hair tattooing. SMP is a permanent procedure where the expert injects the pigment directly into the scalp, creating the illusion of thicker hair.

Many patients opt for SMP as an alternative to surgical hair transplant procedures, especially when it comes to coloring in scarred areas left behind by follicular unit extraction (FUE) or follicular unit transplantation (FUT). 

The number of SMP sessions required may vary depending on the size of the area being treated, and the chosen ink color is typically matched to the patient’s current hair color. 

It’s important to note that while the hair may naturally gray or lighten over time, the ink used in SMP is unlikely to lighten at the same rate. Discomfort may be experienced during the SMP process.


Another treatment option to consider is tricopigmentation (TMP). It is a temporary form of SMP. TMP involves the insertion of ink into the top layer of the dermis, providing semi-permanent inking.

The duration of TMP can vary depending on the clinic, ranging from six months to three years. Some individuals may find TMP physically uncomfortable.

You can quickly watch this video to know about tricopigmentation:

Laser therapy

In addition to SMP and TMP, laser treatment can also help reduce the appearance of hair transplant scars. This approach is sometimes applicable in conjunction with SMP or TMP.

Laser treatment targets and removes damaged skin, stimulating collagen production in the dermis layer, leading to rejuvenated elasticity and an improved overall appearance of the skin. 

It is important to note that laser treatment for hair transplant scars is not specifically designed for scar removal, and individual results may vary.

ALCS Hair Transplant and Cosmetic Clinic, under the leadership of the internationally recognized Cosmetic Surgeon, Dr. Sunil Arora, specializes in hair restoration and cosmetic procedures. With a focus on quality, ALCS Clinic offers a range of Hair Transplantation and Cosmetic Surgery Services under one roof.

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