Risk Factors and Hazards of Recipient-Area Perifollicular Erythema After Hair Transplantation: A Multicenter Retrospective Cohort Study

Background

Recipient-area perifollicular erythema (RPE) may delay graft growth after hair transplantation. However, there is currently a lack of observational clinical studies of RPE.

Objective

To study the clinical features and risk factors associated with RPE while analyzing its correlation with graft growth.

Methods

We conducted a multicenter retrospective cohort study between June 2020 and January 2023.

Results

A total of 1090 participants were included, 178 (16.33%) showed mild RPE, 56 (5.14%) showed moderate RPE, and 10 (0.92%) showed severe RPE. Patients with RPE had severe hair shaft shedding (P < 0.001) and a lower survival rate (P < 0.001) of grafts. Logistic regression analysis showed that folliculitis is a significant risk factor for mild RPE (OR 6.061, 95% CI 3.343–10.991, P < 0.001) and moderate RPE (OR 3.397, 95% CI 1.299–8.882, P = 0.013). Besides, untimely first postoperative hair washing was associated with the development of moderate RPE (OR 0.724, 95% CI 0.553–0.947, P = 0.018) and severe RPE (OR 1.553, 95% CI 1.156–2.086, P = 0.003).

Conclusion

RPE is a postoperative complication closely related to high hair shaft shedding proportion and low graft survival rate. Both postoperative folliculitis and untimely first postoperative hair washing may induce the occurrence of RPE.

Level of Evidence III

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