pre-surgery guide
How to Prepare for a Hair Transplant
Learn how to prepare for a hair transplant with Dr Peter Thomas. This practical pre-surgery guide covers medication, minoxidil, alcohol, smoking, shaving, scalp care, food, exercise, travel and what to expect on the day of surgery. Follow a clear timeline from the weeks before your procedure through to the morning of your hair transplant.
start preparation
4 Weeks
Before Your Hair Transplant
Start Preparing Your Scalp
Dr Thomas recommends using ketoconazole shampoo (such as Nizoral) once a week for around four weeks before surgery. It is available to buy from pharmacies and most supermarkets.
If you have dandruff, itching or scalp irritation you may be advised to use it more often. Apply the shampoo to the scalp and leave it for around three to five minutes before rinsing thoroughly. The aim is simply to arrive for surgery with a healthy and settled scalp.
If you have persistent redness, soreness, scaling or irritation that hasn’t settled, let the clinic know before your procedure.
Try To Stop Smoking and Vaping
If you smoke or vape, try to stop well before your hair transplant. Ideally, Dr Thomas recommends stopping several weeks before surgery.
Nicotine causes blood vessels to narrow and can affect blood flow. For that reason, it can effect graft survival and ultimately your results. It can slow the repair and healing of the scalp tissue which may raise the risk of infection and poor scarring. The earlier you can stop, the better.
Smoking cannabis brings similar risks. Also, it can increase pain sensitivity due to reduced effect of local anaesthetic.
If you are unable to stop completely, let the surgical team know.
Review Your Medication
Make sure the surgical team knows about all medication you take. This includes prescribed medication, over-the-counter medicines, anticoagulants or blood thinners, vitamins, herbal remedies and treatments for hair loss.
Some medication may need to be adjusted before surgery so we will need time to review these and manage them safely.
Do not stop prescribed medication without first discussing it with your surgical team.
General Health and Blood Pressure
It’s recommended to check your blood pressure in the weeks before surgery. You can do this with a home blood pressure monitor, at some pharmacies or through your GP practice. A single raised reading does not necessarily mean there is a problem. However, if your blood pressure is repeatedly high let the surgical team know.
Also consider whether anything has changed with your health since your consultation. Please let the clinic know if you have developed a new medical condition, recent illness or injury, change in your medications, or a new scalp condition. This gives us an opportunity to review anything that could affect your surgery before the day itself.
adjustments
2 Weeks
Before Your Hair Transplant
Stop Minoxidil
Minoxidil widens blood vessels to increase blood circulation to the scalp. This extra blood flow can cause excessive bleeding during hair transplants. Minoxidil used as a topical solution can also cause some irritation to the skin and we want the scalp to be settled before the procedure.
Stop both oral and topical minoxidil two weeks before surgery. This also applies if you use a topical preparation containing both finasteride and minoxidil.
Oral finasteride can continue as usual.
If you are unsure which treatment you are using, check with the clinic before making any changes.
Avoid Hair Dye and Bleach
Do not dye or bleach your hair during the final two weeks before your hair transplant. If you regularly colour your hair, arrange this earlier.
Do Not Shave Your Head
Please do not shave your head before attending for surgery.
Dr Thomas needs to assess your existing hair before preparing the donor and recipient areas. This allows assessment of your natural hair direction, donor density and existing pattern of hair loss.
A normal haircut is fine beforehand. However, avoid having the hair cut extremely short. Discuss this with the team to make sure.
Safety planning
10 Days
Before Your Hair Transplant
Blood-Thinning Medication
Some medicines can increase bleeding during surgery. For example, aspirin is typically stopped 7-10 days before surgical procedures.
However, this must be assessed individually. Do not stop aspirin, apixaban or any other prescribed anticoagulant yourself. The timing should be discussed with the surgical team and where necessary the doctor responsible for prescribing it.
Other anticoagulants and antiplatelet medications may require different advice.
calm the scalp
7 Days
Before Your Hair Transplant
Avoid Alcohol
Do not drink alcohol for at least 7 days before your hair transplant.
Alcohol can increase bleeding during surgery and may also contribute to dehydration. Avoiding it for the week beforehand helps you arrive well hydrated and ready for the procedure.
Stopping NSAIDs
NSAIDs (Non-Steroidal Anti-Inflammatory Drugs) such as ibuprofen are typically stopped around seven days before surgery.
Whether you are buying them over-the-counter or you have them prescribed, discuss this with the surgical team before stopping medication you take regularly.
If you need pain relief during this period, ask which options are suitable for you or seek advoice from another medical provider.
Avoid Aggressive Scalp Treatments
During the final week avoid treatments that could irritate the scalp.
These include microneedling, scalp scrubs and exfoliating brushes, scratching or picking, and strong medicated scalp treatments that might cause redness and dryness.
Aim to keep the scalp calm and healthy before surgery. Reach out to the team if you are unsure.
almost ready
48 Hours
Before Your Hair Transplant
Keep Well Hydrated
Continue to drink normally and aim to stay well hydrated before your procedure.
Avoid Spicy Foods
Avoid spicy foods for 48 hours before surgery to help minimise bleeding risk.
final preparation
24 Hours
Before Your Hair Transplant
Avoid Caffeine
Do not have caffeine at least 1 day before your hair transplant. This includes coffee, energy drinks and other highly caffeinated drinks.
Again, this is important in order to help bleeding risk, blood pressure, and effectiveness of local anaesthetic.
Avoid Heavy Exercise
Avoid strenuous exercise during the 24 hours before surgery. This includes heavy gym sessions, running and other intense exercise.
Keeping things relatively calm helps avoid unnecessary increases in blood pressure before your procedure.
Arrange Your Journey Home
Make your transport arrangements before the day of surgery.
A mild sedative is used during the procedure. Therefore, you will not be able to drive yourself home afterwards. You can arrange for someone to collect you, use a taxi, or stay in local accommodation.
Prepare For The Morning
Wash your hair either the night before surgery or on the morning of your procedure. Wash it thoroughly and rinse well. Your scalp should be free from any products.
Try to get a normal night’s sleep. Hair transplant surgery can be a long day so arriving rested is helpful.
arrival
On The Day
Of Your Hair Transplant
Eat Breakfast and Avoid Caffeine
Have a light breakfast before coming to the clinic. Choose something familiar and avoid an unusually heavy meal. Lunch will be provided during the day.
Do not have caffeine on the morning of surgery. This includes coffee, energy drinks and other highly caffeinated drinks. Water is fine and you should arrive well hydrated.
Do Not Shave Your Head
Your hair and scalp should be clean. Do not apply styling products after washing.
Do not shave your head before arriving. Dr Thomas will assess your hair first and the necessary areas can then be prepared as part of the procedure.
Wear Suitable Clothing
Wear comfortable clothing and choose a top that buttons or zips at the front.
Avoid clothing that needs to be pulled tightly over your head. This is particularly important after surgery because we want to avoid disturbing the newly implanted grafts.
Medications
Guide
Medication Before A Hair Transplant
Medication is one of the most important parts of hair transplant preparation. Please tell the surgical team about everything you take before the procedure.
Below is a guide to some medications before your procedure. Please discuss all medicines and supplements with us as some may affect your surgery and recovery.
Do not stop any prescribed medication without first speaking to the clinician who prescribed it.
Minoxidil
Stop oral and topical minoxidil two weeks before surgery. If topical finasteride is combined with minoxidil stop the combination product as well.
Finasteride
Oral finasteride can continue as usual.
NSAIDs
NSAIDs such as ibuprofen are usually stopped around seven days before surgery.
Aspirin
Aspirin is typically stopped around 7-10 days beforehand where this has been medically agreed.
Other blood-thinning medicines
Other anticoagulants or antiplatelet medications require individual advice.
Quick
Reminders
What Should I Avoid Before A Hair Transplant?
Your individual medical circumstances may mean that some instructions are different. As a simple reminder, I advise my patients to avoid:
- Smoking and vaping: ideally stop several weeks before
- Minoxidil: stop two weeks before
- Hair dye or bleach: avoid within two weeks
- Shaving your head: do not shave before attending
- NSAIDs such as ibuprofen: typically stop 7 days before after discussion
- Aggressive scalp treatments: avoid during the final week
- Alcohol: avoid for 7 days
- Spicy food: avoid for 48 hours
- Heavy exercise: avoid for 24 hours
- Caffeine: avoid at least 1 day before surgery
- Hair styling products: do not use after your final hair wash
Frequently
Asked
Questions
Dr Peter Thomas
MBBS MRCGP FUE Hair Transplant Surgeon
UK-trained doctor and specialist FUE hair transplant surgeon with postgraduate qualifications including MRCGP and specialist training to CCT level. Bringing refined FUE hair restoration techniques and renowned for natural results.