Once the first 7 days of aftercare are done, losing a whole graft is uncommon. The first week is when grafts are most at risk, which is why rubbing, scratching and picking scabs are avoided until the first head wash on Day 7. Scabs lifting off at that wash are expected and are not lost grafts. Hair that falls from about Day 30 is normal shedding: the hair shaft falls while the root stays in the skin.
Why are the first 7 days the most important for your hair grafts?
In the first 7 days, the grafts are settling into the tiny openings in the recipient area and the skin is healing around them. The key rule of post operative care at Eugenix is simple: the grafts must not be rubbed, and no sideways pressure should be put on them.
During the first week:
- Do not rub, touch or fiddle with the transplanted area, and avoid scratching even when it itches.
- Do not bump your head on a car door, roof or wall, and take care when bending down or getting in and out of a car.
- Do not sleep face-down. After a crown transplant, sleep at the edge of the bed with a large neck pillow under the nape, so the crown does not press on the pillow.
- Wear open-button shirts, not t-shirts pulled over the head.
- Wear only the surgical cap provided by Eugenix when you go out.
- Spray saline on the recipient area every 30 minutes to 1 hour during the day, to stop it drying out and to keep scabs from sticking too firmly. No spraying is needed at night.
- Keep away from dust, and avoid sitting under a strong blast of air from an air conditioner.
When are grafts secure?
Grafts become more secure with each day of healing, as the skin heals around each follicular unit. This process is often called graft anchoring, and the first-week rules are built around it. A published study that tested how firmly grafts were held after surgery found that, in the first days, pulling on a stuck scab could take a graft out with it, and that by Day 9 the grafts were no longer at risk of being dislodged by pulling. The study also found that crusting lengthens the time grafts are at risk, which is one reason the saline spray matters.
At Eugenix, the routine follows the same logic. The first head wash is on Day 7, scabs come away over Days 7 to 8, and from Day 8 the first-week precautions, such as the surgical cap, are no longer needed. A review of hair transplant complications also reports graft dislodgement in the first 24 hours after surgery, which is why the first week is the period to protect.
Is losing scabs at the first head wash the same as losing grafts?
No. Scabs form over the grafts in the first days, and scab formation is at its maximum around Day 6. On Day 7, the first head wash softens and lifts them. Scabs coming off at the first head wash are expected and are not lost grafts.
The gentle washing method shown by the team is:
- Wet the hair gently with saline water.
- Apply a mild shampoo and foam it up slowly.
- Keep sprinkling saline water every few minutes and leave the lather on for about 20 minutes.
- Very gently use your fingertips on the transplanted area to loosen the scabs.
- Rinse with saline water or normal drinking water.
If all the scabs do not come off, repeat the wash the next day. Two to three washes in a row may be needed. Scab removal is gentle and gradual. Picking scabs off with your nails is the one thing to avoid, because a stuck scab can take a graft with it in the first days. Use lukewarm water only, never hot water. Our guide to washing your hair after a hair transplant has the full routine.
Why does transplanted hair fall out from Day 30?
This is shedding, and it is a normal part of recovery. For the first month, most transplanted hairs stay in place and even grow a little. Then, usually between Day 30 and Day 90, the transplanted hair shafts fall. This happens in every patient and is also called forced telogen effluvium of the transplanted hair. The follicles remain beneath the skin, rest in the resting phase for a while, and then start a new hair growth cycle.
New hair growth begins from Month 4, becomes clearly visible between Months 6 and 8, and full results take 10 to 12 months, or 12 to 15 months for the crown. During the shedding phase the area can look patchy or thinner than before surgery. This is temporary shedding, not actual graft loss, and hair regrowth follows. Our guide to shedding after a hair transplant explains the full timeline.
Shedding and shock loss are different
Shedding is the loss of the transplanted hairs, and it happens in everyone. Shock loss is the loss of some native hair, the hair you already had in or near the transplanted area, and it does not happen in every patient. Neither one means a graft has come out.
How can you tell normal healing from graft loss?
These are normal in the first weeks:
- Serum oozing on Days 1 to 2, a yellowish or pinkish fluid on the pillow.
- Itching from Day 3, as the skin heals.
- Mild swelling on the forehead on Days 3 to 4, which settles with gentle massage and keeping your head elevated.
- Scabs, which peak around Day 6 and clear with the first washes.
- Mild redness in the recipient area for about 4 to 8 weeks.
- Hair falling between Day 30 and Day 90.
Contact the Eugenix team if you notice:
- Bleeding that does not stop.
- Signs of infection, such as pus, spreading redness, severe swelling or fever.
- Severe pain that does not settle with your medicines.
- Any worry after a knock or a scratch to the transplanted area in the first week.
If you are not sure what you are seeing, send a clear photo to the team.
What can you do safely after Day 7?
After the first head wash, most of the first-week limits end. Follow the clinic’s instructions and your post operative instructions for each step:
- Heavy exercise, gym and yoga: after 7 days, once the first head wash is done. Sweating does not harm the grafts.
- Sauna and steam bath: after 7 days.
- Swimming: after 10 days.
- Hair mousse: after 7 days, on the length of the hair.
- Hair fibres: after 10 to 15 days.
- Trimming the scalp hair: after 15 days, with a trimmer, not a razor.
- Hair gel, serum and hair colour: after 30 days.
- Sun exposure: avoid direct sun on the transplanted area for the first week, then minimise long periods in strong sun.
- Smoking and alcohol: avoid for 7 days after surgery.
When should you message the E-Care team?
Message the Eugenix E-Care team whenever something does not look right. The team is available on WhatsApp, call and email from 9 am to 9 pm, all 7 days. The operating doctor holds a video consultation with you on Day 8, after your first head wash, and the team asks for photos on Day 13, Day 21 and Day 30, and then every month, so your recovery timeline is tracked from the start.
Frequently asked questions
Can grafts fall out after 7 days?
Once the first 7 days of aftercare are done, losing a whole graft is uncommon. The first week is when grafts are most at risk, which is why touching, rubbing and picking scabs are avoided until the first head wash on Day 7. Scabs lifting off at that wash are expected. Hair that falls from about Day 30 is normal shedding, and the root stays in the skin.
How do I know if I lost a graft or just shed a hair?
Shed hairs and scabs are the usual reasons patients think they have lost a graft. Scabs come away at the first washes on Days 7 to 8, and transplanted hairs shed between Day 30 and Day 90 while the roots stay in the skin. A lost graft is uncommon after the first week. If you are unsure, send a clear photo to the Eugenix E-Care team so the doctor can check.
Can I touch my grafts after 7 days?
From Day 7, you can touch the transplanted area as gently as washing needs, using clean fingertips to loosen the scabs. Avoid scratching, rubbing hard or picking at any scab that has not come off yet, and repeat the gentle wash the next day instead. From Day 8, the first-week precautions such as the surgical cap are no longer needed, and the grafts become more secure each day.
Can I dislodge hair grafts after 10 days?
By 10 days, the first head washes are done, the scabs have usually cleared and the grafts have settled into the skin, so normal gentle care does not dislodge them. Gym, sauna and swimming are allowed by this stage. Keep using lukewarm water and a mild shampoo, avoid harsh rubbing, and contact the E-Care team if you knock your head hard and notice bleeding or pain.
Is it normal for transplanted hair to fall out a month after surgery?
Yes. This is shedding, and it happens in every patient, usually between Day 30 and Day 90 after surgery. The hair shaft falls, but the follicle stays beneath the skin, rests and then starts a new growth cycle. New hair growth begins from Month 4, becomes clearly visible between Months 6 and 8, and full results take 10 to 12 months.
Can I wear a cap after the first week?
In the first 7 days, wear only the surgical cap provided by Eugenix when you go out. After Day 8, the first-week cap precautions are no longer needed. From then on, a cap can be worn as usual. If you have any doubt about a particular helmet or tight headwear, ask the E-Care team at your Day 8 video consultation.
Will sweating or exercise after Day 7 harm my grafts?
No. Sweating on the scalp from exercise or hot weather does not damage the implanted grafts and does not affect healing of the donor area. Heavy exercise, gym and yoga can be resumed after 7 days, once the first head wash is done. Contact sports can also be resumed after 7 days. Leave hot yoga until all the scabs have come off.
Eugenix Hair Sciences has worked only in hair restoration since 2009, with centres in Gurugram, Mumbai, Hyderabad, Bhubaneswar and Bengaluru. It was founded by Dermatologists, alumni of AIIMS, New Delhi, and Fellows of ISHRS.
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Medically reviewed by Dr. Arika Bansal, Co-Founder, Eugenix Hair Sciences; MBBS, MD Dermatology, Fellow of ISHRS; Reg. No. HN-34095 (Haryana Medical Council).
Dr. Arika Bansal
Dr. Arika Bansal, Co-Founder, Eugenix Hair Sciences. MBBS (Gold Medallist, Lady Hardinge Medical College), MD Dermatology, alumni of AIIMS, New Delhi. Fellow of ISHRS. Reg. No. HN-34095 (Haryana Medical Council).
