Cysts after FUE hair transplant are small bumps that form when a transplanted graft is embedded too deeply or when hair grows beneath the skin surface instead of emerging normally. They affect a small percentage of FUE patients and are almost always treatable with simple interventions.
This content is for informational purposes only and does not constitute medical advice. Contact your hair transplant surgeon if you develop cysts or any unexpected lumps after your procedure.
Why Cysts Form After FUE
FUE (Follicular Unit Extraction) involves placing individual follicular units into small recipient sites in the scalp. Graft survival rates are 90% to 95% at experienced clinics, but the precise depth and angle of each graft placement matters. Cysts develop for one of three main reasons.
Graft Placed Too Deep
When a graft is inserted deeper than the natural follicle depth, the growing hair may not have a clear path to the skin surface. Instead, it curls beneath the skin and forms a keratin-filled cyst (similar to an ingrown hair but deeper).
Buried Graft
If a graft becomes fully buried beneath the skin surface during healing, the follicle may still produce hair that has no exit point. The trapped hair and sebum accumulate, forming a visible bump.
Blocked Sebaceous Glands
The trauma of creating recipient sites can temporarily block or damage nearby sebaceous (oil) glands. Blocked glands fill with sebum and form small cysts that are not directly related to the graft itself but occur in the transplanted zone.
When Cysts Typically Appear
| Timeframe | Type of Cyst | Likely Cause |
|---|---|---|
| Weeks 2-6 | Small, superficial bumps | Ingrown hairs or minor folliculitis |
| Months 1-4 | Firm, deeper bumps | Buried grafts or deep placement |
| Months 3-6 | Persistent or recurring bumps | Blocked sebaceous glands |
Most cysts appear during the first 1 to 4 months after surgery, coinciding with the period when transplanted hairs begin their first growth cycle.
How to Identify a Post-FUE Cyst
Post-transplant cysts share common characteristics:
- Size: Typically 2 to 5 mm in diameter (pea-sized or smaller)
- Texture: Firm or slightly soft, often with a smooth surface
- Color: Skin-colored, slightly red, or with a white center if keratin-filled
- Location: Within the recipient (transplanted) area
- Pain: Usually painless unless infected; may be tender when pressed
Cysts are different from folliculitis (inflamed follicles), which presents as multiple small red bumps with visible pus at the hair exit point. If you see spreading redness, increasing pain, or pus, contact your surgeon to rule out infection.
Treatment Options
Wait and Observe
Many small cysts resolve on their own as the trapped hair eventually breaks through the surface. If a cyst is painless and not growing, your surgeon may recommend monitoring it for 2 to 4 weeks before intervening.
Warm Compresses
Apply a clean, warm compress to the cyst for 10 to 15 minutes, two to three times daily. The warmth increases local blood flow and can help the trapped hair or material reach the surface.
Gentle Expression by a Professional
Your surgeon or dermatologist can carefully express (drain) the cyst contents using a sterile needle or small incision. This is a quick in-office procedure that provides immediate relief. Do not attempt to squeeze or pop cysts yourself, as this risks infection and can damage the underlying graft.
Topical or Oral Antibiotics
If a cyst shows signs of infection (redness, warmth, pus), a short course of antibiotics may be prescribed. Topical clindamycin or oral cephalexin are common choices.
Incision and Drainage
For larger or persistent cysts that do not respond to conservative treatment, a minor incision and drainage (I&D) procedure may be needed. This is performed under local anesthesia in the clinic and typically does not affect the transplanted graft if done carefully.
Does a Cyst Mean the Graft Failed?
Not necessarily. In many cases, the graft and follicle are still viable beneath the cyst. Once the cyst is resolved and the hair can emerge normally, the graft continues its growth cycle. However, deeply buried grafts that form recurring cysts may eventually lose viability if the obstruction is not addressed.
Reducing Cyst Risk
While cysts cannot be completely prevented, these factors reduce the likelihood:
- Surgeon technique: Experienced surgeons place grafts at the correct depth and angle, minimizing burial risk
- Proper aftercare: Following your washing and moisturizing protocol prevents surface skin buildup that can trap emerging hairs
- Avoiding tight headwear: Compression against healing grafts can push them deeper into the scalp during the first 2 weeks
Monitoring Your Recovery
Track your recovery with regular photos from consistent angles. Any new bumps that appear in the transplanted area during the first 6 months should be shown to your surgeon at your follow-up visit.
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