One of the first questions patients ask during their initial surgical hair restoration consultation is whether a hair transplant hurts [1]. It’s a valid concern with any surgery, and knowing what to expect can help you prepare for the procedure. Fortunately, most patients only experience minimal, temporary hair transplant pain. The surgery is performed with potent local anaesthesia, and surgeons are trained in providing effective pain management for a comfortable and positive experience [1][2].
If concern about hair transplant pain is holding you back from getting the surgery you need, we have good news. Between local anaesthesia, conscious sedation and surgeons’ specific pain management techniques, most patients report little to no pain during their procedure. This article draws on the insight and practice of a top-tier surgeon to tell you how much you can expect your hair transplant to hurt and the steps taken to provide you with the best experience possible.
Key takeaways
Dr. Patel’s extensive experience encompasses a broad range of procedures, including hair transplantation for male pattern baldness (androgenetic alopecia), female hair transplantation, beard transplantation, and eyebrow transplantation. Since 2009, he has successfully performed over 4,000 procedures.
It’s normal to fear pain when having surgery, especially when the procedure involves repeatedly puncturing your scalp. However, you will be relieved to know that while it may sound scary, patients experience little pain during their transplant. And almost all of it occurs (briefly) during local anaesthetic injection and in the first 1-3 days of recovery [1] [2].
Surgeons have a variety of tools and techniques they can use to keep their patients comfortable during the procedure. And while pain can be a subjective experience, even anxious patients often find the level of discomfort to be far lower than they expected. The Wimpole Clinic’s experienced surgeon, Dr. Patel, illustrates this by sharing one of his many pain management success stories:
“I treated a young patient who was extremely anxious about the pain associated with a hair transplant. He had a pronounced needle phobia and a low pain threshold due to previous negative medical experiences. Understanding his concerns, I took extra time to thoroughly discuss anaesthesia options and decided to use a combination of local anaesthesia with mild intramuscular sedation to help him remain relaxed throughout the procedure. Additionally, while administering the anaesthesia, I applied cold ice packs to the injection sites and performed gentle tapping on the area to minimise his sensation of the needles.
During the surgery, he remained calm and comfortable, frequently expressing surprise at how little discomfort he felt compared to his prior experiences. After the procedure, his pain was minimal and easily managed with over-the-counter pain medication.
What stood out most was his profound gratitude and relief. He had anticipated a painful and difficult experience, but instead had a smooth and comfortable procedure. He was so pleased with the outcome that he wrote a detailed positive review highlighting his pain-free experience. This case continually reinforces the importance of customising pain management to each patient’s unique needs to achieve the best possible outcomes and satisfaction.”
Here is a step-by-step breakdown of any discomfort you may experience in the process of getting surgical hair restoration.
Paradoxically, the most painful moment in a hair transplant procedure takes place as you are injected with a local anaesthetic meant to prevent you from feeling pain during surgery. Your surgeon uses a fine-needle syringe to insert the medication in multiple areas of your scalp [2][3]. The pricking sensation can feel a bit intense for some people, but it dissipates in just a few seconds. The sensation can be likened to getting local anaesthesia injected by your dentist for more complex tooth repair. Here is how Dr Patel describes and manages it:
“The most discomfort is usually felt at the beginning, when the local anaesthetic is injected into the scalp. On a pain scale from 0 to 10—where 0 means no pain and 10 is the worst imaginable—this stage often scores between 3 and 6. The sensation is often described as sharp or stinging, but it fades quickly as the anaesthetic takes effect. To reduce this discomfort, I usually use finger tapping as a distraction technique during the injections.”
Surgeons are aware of patient discomfort during anaesthesia and use special techniques to reduce pain levels. In some cases, upon patient request, a numbing cream can be applied before the injections to take the edge off.
Most patients feel virtually no pain as the surgeon harvests their grafts from their donor area and inserts them into the specially-crafted slits on their transplant area. That is because the anaesthetic is very effective and prevents any painful sensation. So while they may experience some sensations in response to the surgeon’s actions, they should not cause distress. Dr. Patel confirms this part of the process should be largely painless:
“Once the scalp is numb, the actual transplant process—whether it’s follicular unit extraction (FUE) or follicular unit transplantation (FUT)—is generally not painful. Most patients report feeling little to no pain during the surgery itself, with pain scores close to zero. They might notice some pressure, tugging, or general awareness of what’s happening, but it’s not typically described as painful.”
You don’t need to take our word for it that most of our patients only feel mild and transient pain during their hair restoration surgery. Our reviews speak for themselves, as satisfied clients recount a positive and almost pain-free hair transplant experience at the award-winning Wimpole Clinic:
You can find more of our patient reviews on our Trustpilot page, where we have a 4.9 Trustscore rating, provided by thousands of patients.
Ensuring that your procedure is as comfortable and pain-free as possible is one of hair transplant surgeons’ top priorities. To this end, experts in the field have developed a set of pain management procedures, techniques and practices meant to reduce discomfort and calm your nerves [1][2][4].
You will be awake and aware during the entirety of your hair transplant surgery, as it is performed under local anaesthesia. This means that a numbing substance (such as Lidocaine, Bupivacaine, or Prilocaine) will be injected into your scalp, within and around the areas that are operated on. If the hair transplant is high-volume, the surgeon can decide to perform a nerve block, injecting the local anaesthetic next to major nerves on the scalp, for increased comfort and longer-lasting effects [2].
Some surgeons use tumescent anaesthesia, which is a combination of a numbing agent and a vasoconstrictor (a substance that makes the small blood vessels in your scalp shrink, reducing bleeding, such as epinephrine)[2]. This type of anaesthesia causes temporary swelling at the injection area, which helps the surgeon harvest the grafts more easily and with fewer risks.
Local anaesthetics are generally very safe, with mostly minor side effects (e.g. pain during injection, short-term dizziness or blurry vision, headaches, muscle twitching) [5]. However, if you have never had one before, it is best to do an allergy test before the surgery. Rarely, some patients can experience severe allergic reactions to the numbing agent itself or some of the additives it often contains.
Feeling nervous about a surgical intervention is natural. However, some patients experience a higher degree of anxiety. This can cause physical and psychological unwellness and affect pain perception. In these cases, surgeons normally offer a sedative to help you relax.
Anti-anxiety medications such as diazepam or midazolam can have a calming and soothing effect. They are usually offered to you as oral tablets, but sometimes they can be injected into your arm for a faster and deeper sedation [2].
Aside from medication, surgeons also have pain management techniques they can apply to make your experience as comfortable as possible. These may include [2][1][4]:
In his practice, Dr. Patel uses a tried and tested pain management protocol, in conformity with international guidelines and best practices, for an optimal experience:
“In my hair transplant procedures, I primarily use local anaesthesia to numb both the donor and recipient areas. I typically use lidocaine with epinephrine, which helps control bleeding and prolongs the numbing effect. This allows my patients to stay awake and comfortable throughout the procedure.
For patients who are particularly anxious or have a lower tolerance for pain, I also offer oral or Intramuscular sedation. I usually use medications like diazepam or midazolam to help them stay relaxed but conscious during the surgery.
Rarely, in some cases, I incorporate nerve blocks to further reduce discomfort, especially for patients undergoing longer sessions or those who are more sensitive. By targeting specific nerves—like the supraorbital or occipital—I can make the experience more comfortable.”
Here is what you can expect in terms of pain during your hair transplant recovery period, what to do to stay comfortable and how to tell if something is wrong.
The first days of your hair transplant healing period may hold some level of pain and discomfort. However, it is usually mild and easy to control with over-the-counter painkillers. It should reach peak intensity on the first day post-op and then quickly start to subside. Most FUE patients barely experience any pain during recovery [6], while FUT patients may start feeling some 1-2 hours after surgery and have some lingering discomfort up to the 3rd day postop. Dr Patel breaks down the pain scores you may expect after your procedure:
“After the procedure, during the early healing phase (usually the first one to three days), pain levels depend on the type of technique used. Patients who have had FUE often report only mild discomfort, typically rating it between 0 and 2. Those who undergo FUT may feel more soreness or tightness in the donor area due to the presence of stitches, with pain scores ranging from 1 to 4. In both cases, the discomfort is usually easy to manage with common pain relievers like paracetamol or ibuprofen.”
Several things can help you reduce pain during your hair transplant recovery. Most surgeons recommend taking paracetamol, ibuprofen, or a similar over-the-counter pain medication every 4 hours after your procedure, to keep pain away [1].
Staying off your feet, relaxing, and keeping your mind off your scalp with enjoyable sedentary activities can also help keep you comfortable. You can take this time to catch up on your reading, have extended phone calls with your loved ones or do that movie marathon you’ve always fancied.
Finally, some surgeons believe that low-level laser therapy can help reduce pain and speed up wound healing [2]. However, make sure any device you use makes no direct contact with your transplanted grafts. For example, laser hair growth caps can be a convenient and effective device to get red light therapy for hair growth at home. But they should only be used when it becomes safe to wear a hat after your hair transplant (about 10 days post-op). By that time, any pain you may have experienced will be long gone anyway.
Some mild pain, redness, swelling and itching in the first days post-procedure are normal hair transplant side effects. However, intense pain that doesn’t subside or worsens after the first day of recovery can be a sign of a developing hair transplant infection. This is especially true when it is accompanied by symptoms such as [7]:
Should you experience any of these symptoms during your recovery, do not hesitate to let your doctor know. Our surgeons at the Wimpole Clinic are happy to set a patient’s mind at ease that their recovery is going well, rather than risk them coming in too late after their hair transplant has already gone wrong. Even a small untreated infection can endanger your sensitive grafts, and there is no need to take such chances.
Follicular unit extraction (FUE) and follicular unit transplantation (FUT) are the two major types of surgical hair restoration available today. The main difference between FUE and FUT consists in how the hair grafts are harvested [2].
FUT involves removing an entire strip of skin from your donor area and cutting it up into hair grafts under a microscope. The wound on the donor site needs to be sutured so it can heal properly, leaving a very fine scar. FUE, on the other hand, is performed by manually harvesting each graft individually from the donor area. This can take significantly longer, but only leaves small puncture wounds which require no sutures and heal faster.
In terms of the surgery itself, both FUE and FUT are largely pain-free once the local anaesthesia has been administered. However, FUT can lead to a slightly longer and more painful recovery, due to the larger wound and the presence of the sutures [6]. Dr. Patel clearly explains this difference:
“After surgery, FUE generally causes less pain during recovery. Because it doesn’t involve stitches or a large incision, the small extraction sites heal faster and with less soreness. FUT, on the other hand, tends to cause more postoperative discomfort, especially around the donor area, due to the linear scar and sutures. Some patients may also experience discomfort when turning or moving their head during the first several days.
Regarding healing time, patients who undergo FUE usually recover quicker and more comfortably, often returning to their regular activities sooner. FUT typically requires a longer healing period because of the incision and stitches.
Overall, although both methods are well-managed with anaesthesia, FUE is typically linked to less pain and a faster recovery, making it a more comfortable choice for many patients.”
The level of discomfort you are going to feel during your hair transplant can be difficult to estimate ahead of time. That is because pain is a highly subjective experience, determined by many personal factors. Dr. Patel provides a detailed explanation of how your specific characteristics can influence the way you experience hair transplant pain:
Younger patients, particularly those in their twenties or thirties, may have a more sensitive nervous system and sometimes report slightly higher levels of discomfort during anaesthesia or the early recovery phase. In contrast, older patients often have a reduced sensitivity to pain, although they may experience slower healing.
Women generally have a greater sensitivity to pain due to hormonal and neurological differences and may be more expressive when describing discomfort. Men, on the other hand, might underreport pain or tolerate it differently, although individual variation is significant in both genders.
The pain levels experienced during a hair restoration surgery are comparable to those experienced during other, minimally invasive hair growth therapies. For example, platelet-rich plasma (PRP) hair treatments are also performed under local anaesthesia. And some patients still report mild pain during the injections as a PRP side effect which sometimes persists between 4 hours and 2 days post-procedure [8][9].
However, hair restoration surgery has significantly superior hair growth results compared to PRP. Moreover, a hair transplant is permanent, and most patients are satisfied with their results after a single procedure [10]. PRP treatments, on the other hand, involve 3 monthly sessions for the first 3 months and then refresher sessions every 3 months for the first year.
There are also non-invasive hair growth therapies (e.g. red light therapy for hair) or medications (e.g. Minoxidil, or Finasteride). They involve no pain or needles. However, most patients usually get a hair transplant after exhausting these options. Therapies and medications can work well in the early stages of androgenetic alopecia. But once your hair loss has advanced, they may become insufficient or ineffective.
If you are still concerned about hair transplant pain, book a free hair transplant consultation with one of our experienced and empathic surgeons. They will work with you to create a personalised pain and anxiety management plan which will help set your mind at ease.
At the Wimpole Clinic, we have a 50-year legacy of unwavering dedication to providing our patients with the safest, most comfortable surgical hair restoration experiences. And our ability to deliver almost 100% hair transplant success rates with minimal discomfort is part of the reason we have been voted Hair Transplant Clinic of the Year from 2021 to 2024. See our results for yourself in our before-and-after hair transplant gallery.
Find out even more about hair transplant pain and its management by perusing the responses to these frequently asked questions:
There are different types of local anaesthetics, so if you are allergic to one or more of them, your surgeon may be able to find a safe replacement. Should you be allergic to all local formulas, general anaesthesia is your only option, as hair transplants cannot be performed without anaesthesia.
While some clinics offer the option of general anaesthesia for really anxious patients, most surgeons do not recommend it without a medical reason. General anaesthesia carries a much higher risk of complications than the local options and can, in very rare cases, even be fatal. So it is normally used when medically necessary, such as the rare instances of allergies to all local anaesthetics.
Hair transplants can be successfully and almost painlessly performed with local anaesthetic. And if your anxiety is very high, your surgeon will offer sedatives to help you calm your nerves.
The only difference in pain levels between a classic and a needle-free hair transplant lies with the anaesthetic administration. Needle-free anaesthesia involves using a jet injector to push the numbing medication through your scalp at high speeds. This can also cause some mild discomfort. However, one study revealed that only 17,6% of patients who get needle-free anaesthesia report feeling pain during the injection [11]. But more research is needed to confirm that jet injectors are really pain-free.
Moreover, if your needle anxiety is very high, that can impact your pain tolerance, making the injection process feel more painful. In this case, you may benefit from the complete removal of needles from your procedure to ensure your psychological comfort.
The most painful part of having a hair transplant is when the local anaesthetic is injected. After that, the scalp is numb, and all you normally experience is some tugging or pressure. There is minimal to no pain during the surgery itself. This means that having 2 separate sessions would mean double the anaesthetic injections and twice the recovery time. This means that if the only reason you are considering splitting your hair transplant into two sessions is pain reduction, you are better off having one longer surgery.
However, sitting still for hours can be uncomfortable and make you stiff and sore, especially if you have muscular or skeletal health problems. So be sure to let your surgeon know if this is the case, and take regular breaks to adjust your position.
Wimpole Clinic Services:
Hair Transplants, Beard Transplants & Eyebrow Transplants.
Talk to a specialist
Dr Meena Zareie (GMC number 7722917) is the first female member of Wimpole Clinic’s Hair Transplant Surgeons team.
Dr Meena started her journey in the hair transplant industry 8 years ago, where she worked closely with leading surgeons to hone her skills, having conducted more than 1,000 FUE hair transplants.
Starting as a technician and nurse while working simultaneously for the NHS, she decided to take her passion for helping patients with hair loss further.
Her qualifications include an MD doctorate from the prestigious Medical University of Warsaw, and a Master’s degree in Drug Toxicology with the institute of cancer therapeutics. She has previously completed a bachelor’s in Biomedical Science, and is qualified in minor aesthetic and dermatological procedures for the face and body. She is a member of the British Medical Association and is a registered doctor on the General Medical Council.
Her passion for perfection and attention to detail is what drew Dr Meena to the aesthetic industry. She has completed additional FUE Hair transplant training with renowned hair transplant doctors in Georgia and Iran, and has developed a fine motor skills which serve to produce outstanding results, as each procedure is carried out with ultimate care and meticulous attention to the detail. Dr Meena’s care for her patients and work shows in her results is a real credit to the hair transplant industry.
