Necrosis is the death of skin tissue. In terms of hair restoration, this typically means the death of the scalp tissue in particular. There is no area of the scalp that is more susceptible to tissue death than any other area of the scalp. There is no regular size of the area affected by tissue death. The area in general can be the size of a small coin or smaller or it can involve half of the entire recipient scalp.
Necrosis of the scalp usually occurs due to one of two reasons:
After hair transplant surgery, the recipient’s scalp will be reddish or pinkish in hue. This is normal. Necrosis, on the other hand, will start out as a dark bruise. This bruise is actually blood pooling under the skin and clotting, which prevents new blood from reaching the tissue. Eventually, the tissue will die from a lack of oxygen and become infectious.
The following characteristics increase the likelihood of developing death of scalp tissue:
Epinephrine is routinely administered during a hair transplant to restrict or reduce blood flow to the scalp and minimize bleeding. An exceptionally high dose of epinephrine may starve the tissue of oxygen long enough to cause tissue death. New science, however, suggests that epinephrine has absolutely no link to tissue death. A 2006 study closely examines accidental high-epinephrine injections into the finger during hand surgeries. Of all 59 reported cases where too much epinephrine was used, not one instance resulted in tissue necrosis. For this reason, the connection between high levels of epinephrine and tissue necrosis remains unclear, and in need of further study.
The best way to prevent scalp necrosis is by selecting a highly trained doctor to perform your hair transplant. Be sure to ascertain the credentials of any potential candidates, and conduct at least one preliminary interview before making a final selection. Your likelihood of developing scalp necrosis is very low as long as you select a highly competent medical practitioner to perform your procedure. Be sure to ask how many hair transplants the doctor has performed in the past, and request to speak with one of their previous patients, if available.