Hair Transplant Procedures

DHI Direct Hair Implantation: Post-Op Medications Guide

February 23, 20266 min read1,200 words

After a DHI procedure, patients receive a medication protocol that typically includes antibiotics for 5-7 days, anti-inflammatory drugs for 3-5 days, and pain relievers for the first 2-3 days. Patients already taking finasteride can usually continue without interruption, while minoxidil should be paused for 10-14 days to allow graft sites to heal.

This article is for informational purposes only and does not constitute medical advice.

Prescribed Medications After DHI

Your surgeon will provide a specific medication schedule before you leave the clinic. While protocols vary between providers, most DHI post-op medication plans include the same core categories.

Antibiotics

Antibiotics are prescribed to prevent infection at both the donor and recipient sites. The scalp has excellent blood supply, making post-transplant infections rare (under 1% of cases), but prophylactic antibiotics remain standard practice.

MedicationTypical DosageDurationPurpose
Cephalexin (Keflex)500mg twice daily5-7 daysBroad-spectrum infection prevention
Amoxicillin/Clavulanate875/125mg twice daily5-7 daysAlternative for penicillin-tolerant patients
Azithromycin (Z-pack)500mg day 1, 250mg days 2-55 daysAlternative for penicillin-allergic patients

Complete the full course of antibiotics even if the scalp looks and feels fine. Stopping early increases the risk of resistant bacterial infection.

Signs of infection that warrant contacting your surgeon include:

  • Increasing redness or warmth after day 3
  • Pus or yellowish discharge from extraction or implantation sites
  • Fever above 38 degrees Celsius (100.4 degrees Fahrenheit)
  • Unusual odor from the donor or recipient area

Anti-Inflammatory Medications

Swelling after DHI typically peaks on days 2-4 and can migrate from the forehead down to the eyelids and bridge of the nose. Anti-inflammatory medications reduce this swelling and its associated discomfort.

Common anti-inflammatory protocols include:

  • Methylprednisolone (Medrol Dose Pack): A tapered steroid course over 6 days that starts with a higher dose and gradually decreases. This is the most effective option for preventing significant swelling.
  • Dexamethasone: Some clinics administer a single injection of dexamethasone during the procedure to preemptively reduce inflammation.
  • Ibuprofen (Advil/Motrin): 400-600mg every 6-8 hours for 3-5 days. Note that some surgeons avoid ibuprofen in the first 24-48 hours because it has mild blood-thinning properties.

Pain Medication

Post-DHI pain is generally mild enough to manage with over-the-counter options:

  • Acetaminophen (Tylenol): 500-1000mg every 6 hours as needed. This is the first-line recommendation because it does not affect blood clotting.
  • Prescription analgesics: Hydrocodone/acetaminophen or tramadol may be prescribed for patients with lower pain tolerance or larger sessions (3,000+ grafts). These are typically needed only for the first 1-2 days.
  • Avoid aspirin: Aspirin thins the blood and can increase post-operative bleeding. Do not take aspirin for at least 2 weeks after DHI unless directed by your physician for another medical condition.

Antacids and Stomach Protection

When anti-inflammatory medications and antibiotics are taken together, they can irritate the stomach lining. Many surgeons include an antacid or proton pump inhibitor in the post-op medication kit:

  • Omeprazole (Prilosec): 20mg once daily for the duration of antibiotic and anti-inflammatory use
  • Pantoprazole (Protonix): 40mg once daily as an alternative

Take these medications with food to further reduce stomach irritation.

Hair Loss Medications: Finasteride and Dutasteride

If you are taking finasteride or dutasteride for hair loss management, the timing of these medications around your DHI procedure matters for both graft health and long-term hair retention.

Finasteride During DHI Recovery

Finasteride (1mg daily for hair loss) does not interfere with graft healing or survival. Most surgeons recommend one of two approaches:

Continue without interruption: This is the most common recommendation. Finasteride works by reducing DHT levels in the scalp, and maintaining those reduced levels during recovery helps protect existing native hairs from shock loss. There is no pharmacological reason to stop finasteride for DHI.

Brief pause and restart: Some surgeons ask patients to stop finasteride 2-3 days before the procedure and restart 1-3 days after. The reasoning is typically related to reducing any theoretical bleeding risk, though finasteride has minimal effects on blood clotting.

Dutasteride Considerations

Dutasteride (0.5mg daily) follows the same guidelines as finasteride. Its longer half-life (5 weeks vs. 6-8 hours for finasteride) means that even if stopped briefly, blood levels remain therapeutic. Continue dutasteride through the DHI process unless your surgeon specifically requests otherwise.

Starting Finasteride for the First Time After DHI

For patients not already on finasteride, many surgeons recommend starting it within the first month after DHI. The rationale:

  • Protects existing native hair from ongoing androgenetic alopecia
  • May reduce shock loss severity by stabilizing vulnerable follicles
  • Supports long-term results by preventing further loss around the transplanted area
  • DHI addresses existing loss; finasteride addresses future loss

Discuss the benefits and potential side effects of finasteride with your surgeon or dermatologist before starting.

Minoxidil Restart Timeline

Minoxidil (topical or oral) requires more careful timing around DHI because the topical form is applied directly to the scalp, where it could interfere with graft site healing.

Topical Minoxidil

TimeframeGuideline
Day of procedureDo not apply
Days 1-10Do not apply to transplanted areas
Days 10-14Restart if graft sites have closed (confirm with surgeon)
Week 3-4Most patients can fully resume
OngoingContinue daily application as part of maintenance

When restarting minoxidil, use gentle application technique. Do not rub or massage it into the transplanted area for the first month. Use a dropper to apply the solution and let it absorb naturally.

Oral Minoxidil

Low-dose oral minoxidil (1.25-5mg daily) does not require the same pause as topical because it works systemically rather than through direct scalp contact. Most surgeons allow oral minoxidil to continue uninterrupted through the DHI process, similar to finasteride. However, confirm this with your prescribing physician.

Supplements and Over-the-Counter Products

Beyond prescription medications, some clinics recommend supplements during the recovery period.

  • Biotin (5,000-10,000mcg daily): Supports keratin production and hair growth. Evidence is limited but the supplement is safe for most people.
  • Vitamin D (2,000-4,000 IU daily): Low vitamin D levels are associated with hair loss. If your levels are below optimal range, supplementation may support hair health.
  • Zinc (25-50mg daily): Plays a role in tissue repair and immune function. Do not exceed recommended doses as excess zinc can cause copper deficiency.
  • Iron (if deficient): Only supplement iron if blood tests confirm a deficiency. Unnecessary iron supplementation can cause side effects.

Products to Avoid After DHI

  • Alcohol: Avoid for at least 5-7 days post-procedure. Alcohol thins the blood and impairs healing.
  • Blood-thinning supplements: Fish oil, vitamin E (high dose), ginkgo biloba, and garlic supplements can increase bleeding risk.
  • Topical hair products: Avoid gels, sprays, wax, and other styling products on the transplanted area for at least 2-3 weeks.
  • Herbal scalp treatments: Tea tree oil, peppermint oil, and other topical herbal products can irritate healing graft sites.

Your Medication Schedule Summary

A typical post-DHI medication schedule looks like this:

TimeAntibioticsAnti-InflammatoryPainFinasterideMinoxidil
Day 1StartStart Medrol packAs neededContinuePause
Days 2-5ContinueContinueAs neededContinuePause
Days 5-7Finish courseFinish courseRarely neededContinuePause
Days 10-14CompleteCompleteNoneContinueRestart (with surgeon approval)
Week 3+NoneNoneNoneContinueResume normal application

Follow your surgeon's specific instructions over any general guidelines. Your medical history, allergies, and the size of your session may require modifications to this standard protocol.

For a full recovery timeline including activity restrictions and healing milestones, see the DHI recovery timeline. To understand what results to expect month by month, read our DHI results guide.

Have questions about your specific medication needs after DHI? Get a free AI hair analysis at myhairline.ai/analyze to start your personalized assessment and connect with procedure planning resources.

FAQ

What medications do you take after DHI?

After DHI, patients typically take antibiotics for 5-7 days to prevent infection, anti-inflammatory medication (such as methylprednisolone or ibuprofen) for 3-5 days to control swelling, and pain medication (acetaminophen or prescribed analgesics) as needed for the first 2-3 days. Many surgeons also prescribe a short course of antacids to protect the stomach from anti-inflammatory side effects.

When can you restart finasteride after DHI?

Most surgeons recommend continuing finasteride without interruption through the DHI procedure. If you stopped finasteride before the procedure, you can typically restart within 1-3 days post-surgery unless your surgeon advises otherwise. Finasteride does not interfere with graft healing and helps protect existing native hair from continued loss during the recovery period.

When can you restart minoxidil after DHI?

Minoxidil should not be applied to the transplanted area for 10 to 14 days after DHI to allow the graft sites to close and begin healing. Some surgeons recommend waiting up to 3-4 weeks before resuming. You can continue applying minoxidil to non-transplanted areas of the scalp immediately, but avoid letting it drip or spread into the recipient zone during the restricted period.

Frequently Asked Questions

After DHI, patients typically take antibiotics for 5-7 days to prevent infection, anti-inflammatory medication (such as methylprednisolone or ibuprofen) for 3-5 days to control swelling, and pain medication (acetaminophen or prescribed analgesics) as needed for the first 2-3 days. Many surgeons also prescribe a short course of antacids to protect the stomach from anti-inflammatory side effects.

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