When Hair Restoration Goes Wrong

Man Putting a Hand Over His Thinning Hair

Hair restoration techniques have come a long way, but that doesn’t mean things can’t go wrong if inexperienced technicians do the procedure.

With traditional hair transplant surgery, hair is harvested in strips from the back of the head and surgically implanted into other areas of the scalp where more hair is wanted. Newer, less invasive techniques, like follicular unit extraction (FUE), gently and painlessly extract individual hair follicles while leaving the scalp intact. The follicles are then carefully placed in areas where you want more hair coverage without the risk of scarring or need for scalpels and sutures.

Though all hair restoration procedures carry some risks, side effects range in severity and largely depend on the experience of the team conducting the transplant. Here are some of the side effects that can occur when a procedure goes wrong:


Traditional hair transplant techniques surgically remove healthy areas of the scalp and move them to areas where there is less hair growth. During strip harvesting, a large incision is made on the back of the patient’s head and a section of scalp is removed and used as a source of hair follicles, which are then implanted to a new location. The donor part of the scalp is then sutured back together, often leaving a long visible scar. Sometimes the hair over the scar area does not regrow or regrows in patches, leading to unnatural looking results.


If an unskilled technician or surgeon makes incisions that are too deep, makes too many incisions in one area or does not practice proper sterilization techniques, an infection can develop after hair transplant surgery. Most infections can be treated with antibiotics, but if left untreated, the infection can spread deep into the scalp and permanently damage the tissue.


Pitting, or “pit scarring,” can occur after hair restoration surgery and is most commonly a result of older transplant procedures, which used larger punch devices to harvest hair follicles. The hairs look as if they are growing out of a deep “pit” or divot, as you’d find on the surface of a golf ball. Pitting typically occurs when the follicular hair unit is placed too deep into the scalp and causes a concave imprint.

Subdermal Cysts

In some cases, cysts can appear after a hair transplant procedure. A hair follicle near the transplanted follicle is injured in some way and a cyst forms on the scalp. These fleshy nodules range in size and can often be treated with an injection of a corticosteroid or with minor surgery. Antibiotics can be prescribed to prevent infection.


An itchy scalp commonly occurs directly after hair transplant surgery as the scalp begins to heal. This can be especially irritating because even though the scalp itches, the patient is strongly discouraged from scratching because that can cause damage and bleeding to the scalp or even destroy the newly implanted hair follicles. Generally, the itching is a short-term problem and can be eased by rubbing vitamin E or shampoo gently over the scalp.


In rare cases, hair transplant surgery can cause the death of scalp tissue because of substandard surgical techniques or equipment. Necrosis can cause scarring and is one of the worst complications that can follow hair transplant surgery. It is typically caused by an inexperienced technician who “over packs” the receiving area with too many transplanted follicles. This can disrupt blood flow to parts of the scalp and lead to the death of tissue.


A common skin condition in which hair follicles become inflamed and resemble “pimples,” folliculitis is typically caused by a bacterial or fungal infection that can occur after hair transplant surgery. The infection can be itchy and spread, creating crusty sores. If not treated, folliculitis can lead to scarring and permanent hair loss in some cases.

Shock Hair Loss

In some rare cases, a patient’s natural hair can experience “shock loss” after hair restoration surgery, where some weak natural hair follicles do not grow back. This can occur in the donor or recipient area following surgery, though it is more common in the recipient area. Though this can sometimes result in permanent loss of natural hair, most hair follicles rebound and hair regains its original thickness over a period of time.

Avoiding Side Effects

All of these side effects are rare and most can be avoided by choosing a skilled, experienced hair restoration team. If you are considering a procedure to restore your hair, explore all of the options and carefully select an office with a credible technician on staff.

Do your homework and make sure the office you choose is the right fit for you. Ask to see before-and-after photos and read online patient testimonials. Don’t be afraid to ask questions — your team should be knowledgeable and thorough.

To learn more about follicular unit extraction restoration and other transplant options, contact our experienced team at Dallas NeoGraft today!