Q: Why can donor hair become frizzy and dry once transplanted? — G.F., Stamford, C.T.

A: Frizzing and kinkiness is a temporary phenomenon that is part of the normal healing process after a follicular unit hair transplant. During the healing process, the new collagen that forms around the grafts can alter their growth. Over time, usually within a year, this collagen matures and the hair quality usually returns to normal. If grafts have been excessively traumatized or grafts larger than follicular units have been used, these changes are more likely to be permanent.

Dry hair is felt to be caused in part by trimming follicular units too closely and thus removing the sebaceous glands which normally provide an oily film to the surface of the hair and skin. With grafts smaller than follicular units (i.e. with closely trimmed micro-grafts) the risk is even greater.

To prevent this, in the dissection phase of the hair transplant, one should isolate intact follicular units from the donor tissue and trim away excess skin, but not trim the follicular units “to the quick.” Excess trimming, besides removing the sebaceous glands, also makes the grafts more subject to drying, warming and mechanical trauma (particularly during graft placing).