Despite the very best surgical techniques, including follicular unit grafting, cysts do sometimes occur and most commonly they occur as the newly transplanted hairs begin to re-grow at three to four or more months. It is not uncommon in a procedure of 2,500 grafts for the patient to have five to eight tiny pimples which are easily treated with topical antibiotic cream and usually prescription strength ointment as well as, if necessary, antibiotic pills. Sometimes the application of heat can help in opening them up. Despite the very best techniques they cannot always be prevented and should be accepted as a possible side effect of the procedure and they do, as mentioned before, indicate early hair re-growth. When extensive cyst formation occurs, it can be due to poor technique including the improper placement of grafts too deep so that the skin of the hair graft is buried underneath the skin of the scalp resulting in cyst formations. This can be avoided by the grafts not being placed too deep and is the main reason why hair grafts are placed so that a small tuft of graft skin sits above the surface of the scalp.
Posted by Jeffrey S. Epstein, MD, FACS