Patchy acute effluvium in and around the donor area following FUE hair transplant and its predilection for two-day session and high graft extraction cases

: With the advancements in Follicular unit extraction (FUE) technique of hair transplant (HT) advanced grades of baldness are taken up nowadays requiring higher donor grafts and surgery often extends to the second day. This has brought into light some lesser known complications of hair transplant like acute donor site effluvium (ADE).Data on ADE is scanty; more research is needed on associated clinico-etiological factors and presentations of the condition. of our study was to study various clinico-epidemiological factors in patients of acute donor effluvium and to assess the relationship of number of grafts extracted with severity of ADE. : It was a centre based retrospective cross sectional study in which 30 patients of ADE were enrolled. Clinical and photographic record of all patients of ADE presenting in the last 3 years was screened. Age, gender, co-morbidities, personal habits, grade of androgenetic alopecia, total graft extraction, severity of hair loss and duration of surgery was compiled along with photographs and follow up notes. Mean age of patients was 33.9±5.4 years. All patients were male. Out of 30 patients 5(16.6%) were smokers and 7(23.3%) alcoholic. In 22(73.3%) of the cases of ADE the HT lasted for more than a day. The maximum duration of surgery in all cases didn’t exceed 2 days. Out of 30 cases of ADE, total grafts extracted exceeded 4000 in 28(93.3%) of cases; only 2(6.7%) of the cases had a graft extraction of <4000. There was a significant and direct correlation between the severity of ADE hair loss (using SALT score) and the number of total scalp grafts extracted (r=0.657, p=0.024). ADE was seen more with advanced baldness requiring high scalp graft extraction of >4000 grafts and when surgery extended to second day. Hair loss in ADE correlated directly with the number of scalp grafts harvested.