In rare cases, a hair plug infection can develop after a hair transplant. Symptoms include pain, a discharge and discoloration of skin, and a fever. Antibiotics and other strategies can help treat it.

Hair loss affects up to 85% of males and 40% of females, and the potential for hair loss increases with age. The incidence of infection is rare at less than 1%.

A hair transplant involves moving hair follicles from one part of the scalp to a balding area. It is generally a safe procedure, but sometimes rare complications can develop, including infection.

Surgeons perform hair transplantation by numbing the scalp and removing a portion of the scalp that contains hairs. They then close this wound with stitches while individually removing follicular units from the donor skin.

The surgical team will then clean the area of the scalp where they will transplant the hairs. They make tiny cuts in the areas receiving the donor hairs. The hairs surgeons place into the cuts are known as hair plugs.

This article will explore the symptoms and causes of hair plug infection, as well as information on other possible complications of a hair transplant.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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The incidence of infected hair plugs is extremely low at less than 1%.

People who are immunocompromised, smokers, older adults, or people with diabetes may be at increased risk.

Infection can lead to symptoms including:

  • reddening or discoloration of the skin at the site of the transplant
  • pain
  • fever
  • smelly discharge at the site of the transplant
  • problems with wound healing at the donor or recipient site

Difficulty sticking to hygiene recommendations or not following aftercare instructions can increase the risk of infection following a hair plug procedure. Following recommendations to wash hair on a regular schedule and care for wounds will lower the risk of developing an infection.

If someone suspects their hair plugs are infected, they should remove wound dressings and carefully examine the wound for changes in color, smell, closure, and discharge.

Having a sample taken by a healthcare professional to evaluate the cells under a microscope may reveal more about the problem.

There are two common types of hair transplant procedures: follicular unit transplant (FUT) and follicular unit extraction (FUE).

During FUT, the doctor cuts a strip of skin from the back of the scalp. From this strip, they harvest individual follicles of hair or small rows for transplant to the new area.

During FUE, the doctor takes small punches of skin to remove individual hair follicles from the donor area, which they then relocate to the new area.

There is a risk of infection with FUT but almost no risk of infection with FUE. With FUE, other complications can arise, including keloid or hypertrophic scars, epithelial cysts, and overharvesting (removing too much hair from the donor site). Overharvesting can lead to permanent damage in the donor area, including hair loss.

The scalp has a high rate of blood flow, which combats infection and promotes healing.

However, complications can occur. If they do, treatments may include:

  • antibiotics
  • exfoliation with warm compresses
  • shampooing twice daily

Following aftercare instructions is key to avoiding any type of infection.

According to 2014 research, infections in the scalp are very rare because the scalp has strong blood flow. This promotes good healing. Infections are generally the result of difficulty following hygiene recommendations, the formation of crusting, or preexisting medical risk factors.

To help prevent infection, a person should:

  • wash the hair and scalp according to the surgeon’s instructions
  • take medications exactly as their doctor prescribes
  • attend all appointments

The healing time for a hair transplant will depend on the complexity of the procedure.

Bandages will usually come off within 1 day. Hair washing may be allowable within 2 days. Stitches may remain in for 1 week to 10 days.

Hair transplant recipients should avoid vigorous exercise and activity for at least three weeks. This is because these types of movements may increase blood flow to the scalp and cause potential bleeding.

Checkups with a doctor may be scheduled for the first several weeks after surgery to monitor progress.

Surgical teams can remove and replace hair transplants that have created results the person is unhappy with. Examples may include an unnatural hairline or infection. The surgeon will do the procedure using FUE.

In these cases, surgeons re-implant new grafts of donor follicles into the areas the person would like coverage.

Any medical procedure can cause side effects. A few that people should consider include:

  • adverse reaction to anesthesia
  • bleeding
  • tachycardia
  • fainting
  • pain
  • postoperative pain
  • itching
  • swelling
  • dissatisfaction with results
  • prescription drug reaction

In the case of the transplant area, complications can include:

  • a hairline the person is unhappy with
  • unnatural appearance
  • edema
  • necrosis (tissue death)
  • folliculitis
  • cysts

FUT side effects

There are a few considerations concerning the donor site for a FUT procedure. These include:

  • bleeding
  • folliculitis
  • infection
  • necrosis
  • numbness
  • persistent pain
  • postoperative pain
  • suture extrusion (stitches forced out by the body)
  • keloid scarring
  • donor hair effluvium (hair loss)
  • hiccups

FUE side effects

After FUE, there are a few considerations with regard to the donor site. These include:

  • donor site depletion
  • hypopigmentation or pinpoint scarring
  • acute effluvium
  • buried grafts (where the punch pushes the graft too far into the skin)
  • higher transection rate (where follicles are cut or damaged during removal)
  • keloid scarring
  • epithelial cysts
  • necrosis
  • overharvesting
  • numbness and persistent pain
  • harvesting grafts outside a “safe zone” (usually in between the upper and lower ridges of bone at the back of the skull)

Most hair transplant procedures are done successfully without any problems.

Less than 1% of people who have a hair transplant experience infection.

Anyone experiencing unusual or uncomfortable pain, foul-smelling discharge from the wounds, or scabs should contact their surgical team.

Hair transplantation is a procedure that takes strips of the scalp or individual hair follicles and transplants them to areas where a person would like more hair. It is also known as hair plugs.

Though the risk is very low, hair plugs can become infected. In this case, they may become discolored, swollen, smell, or have discharge.

Hair transplant aftercare may include frequently washing the hair and scalp, avoiding alcohol, smoking, and sunlight, sleeping with the head elevated, and other measures. It is important to follow all aftercare recommendations to avoid complications, including infection.

In the case of a suspected infection, a person should follow up with a doctor immediately for treatment. This treatment will likely include antibiotics or topical washes.