Short answer
Usually not much during the procedure itself, because the scalp is numbed with local anaesthetic, often with sedation, and you stay awake. Afterwards, a tight, achy or swollen scalp for a few days is common. How uncomfortable recovery feels depends mainly on the harvesting method: the stitched wound from strip surgery (FUT) tends to cause more discomfort in the first week than the small punch sites of FUE.
Key points
- Hair transplants are usually done under local anaesthetic, sometimes with a mild sedative.
- A session commonly lasts four to eight hours, which can itself be tiring.
- A tight, achy, swollen scalp for a few days afterwards is a common side effect.
- Strip (FUT) closure can cause pain or discomfort in the first week.
- Advertising that calls hair transplant “pain free” is considered misleading by the specialist society.
What it feels like during the procedure
The NHS describes hair transplants as usually carried out under local anaesthetic and sedation, so you stay awake but should not feel pain during the operation.1 The American Academy of Dermatology (AAD) says patients need only anaesthesia that numbs the scalp; most stay awake, and some also take a mild sedative.2
Numbing is done before any graft is taken. The International Society of Hair Restoration Surgery (ISHRS) describes the patient being given anaesthesia to numb the scalp in preparation for the procedure.3 Ask how the numbing will be given and how it will be topped up if the session runs long.
Duration matters for comfort. The AAD notes that a transplant typically takes four to eight hours, and a large session may need a return visit the next day.2 A long session can be tiring even when the scalp is numb, so it is worth asking beforehand about breaks.
What recovery feels like
According to the NHS, common side effects include temporary scabbing where hair was transplanted and a scalp that feels tight, achy and swollen for a few days. It suggests one to two weeks off work may be needed.1 The ISHRS notes that small scabs usually remain until they are gently removed one to two weeks later, though surgeons’ aftercare routines differ.3
The discomfort that does occur is usually managed with the pain relief and aftercare instructions given by the surgical team. Ask before the procedure what pain relief you will be given, and which over-the-counter medicines to avoid.
Does FUT hurt more than FUE?
Generally, recovery from FUT is more uncomfortable at the donor site. In FUT (follicular unit transplantation, or strip surgery), a strip of skin is removed from the back of the head and the wound is stitched closed. ISHRS clinical practice guidelines for FUT state that wound closure may cause some pain or discomfort in the first week after surgery, and that numbness or altered sensation above the incision is possible but rare.4
In FUE (follicular unit excision), individual grafts are removed with tiny punches. The ISHRS says FUE can be less uncomfortable than FUT in many cases and offers a faster recovery, while noting that it is not scarless.3
| Aspect | FUT (strip) | FUE (individual grafts) |
|---|---|---|
| During surgery | Local anaesthetic, often with sedation | Local anaesthetic, often with sedation |
| Donor area afterwards | Stitched wound; discomfort mainly in the first week | Many small punch sites; often less uncomfortable |
| Altered sensation | Numbness above the incision possible but rare | Not specifically described in the sources used here |
| Both methods | Tight, achy, swollen scalp for a few days; scabs at the transplanted area | |
The comparison above rests on professional guidance and clinical experience rather than large head-to-head trials of pain, so the evidence for exact differences in discomfort is Limited. For the wider differences between the two methods, see FUE vs FUT.
Be wary of pain-free promises
The ISHRS lists “pain free”, “no incision”, “no cutting” and “scarless surgery” among misleading terms in hair restoration marketing.5 A hair transplant is surgery, and an honest description includes some discomfort and a recovery period. Exaggerated comfort claims are a reason to look more closely at other claims from the same provider.
When to seek medical advice
The NHS lists bleeding, infection and an allergic reaction to the anaesthetic as recognised risks of hair transplant surgery.1 If pain is getting worse rather than settling, bleeding does not stop, or you think the scalp may be infected, contact the treating team or a local doctor promptly.
Common questions
Will I be asleep?
Usually not. Most patients stay awake with a numbed scalp, and some receive a mild sedative.2
How long does the soreness last?
Typically a few days for the tight, achy, swollen feeling, according to the NHS.1 After FUT, donor-site discomfort is mainly in the first week.4
When can I go back to work?
The NHS suggests one to two weeks off work may be needed, partly because of visible scabbing.1 Physically demanding work may need longer; ask your surgeon.
Does the donor area hurt more than the top?
After FUT it often does, because of the stitched wound.4 After FUE, the donor area has many small punch sites that tend to be less uncomfortable.3
Bottom line
With good local anaesthesia, the operation itself is usually tolerable; the long session and the first days of recovery are where discomfort is more likely. Expect more donor-site soreness after strip surgery than after FUE, and treat any promise of a pain-free experience with caution.
Related reading
- Hair transplant guide
- FUE vs FUT: What Is the Difference?
- When Will Hair Transplant Results Show?
- What Is Shock Loss After a Hair Transplant?
Sources
- NHS. Hair transplant. NHS website; page last reviewed 2023. https://www.nhs.uk/conditions/cosmetic-procedures/hair-transplant/ Accessed 5 November 2026.
- American Academy of Dermatology. Hair loss: hair transplant. AAD; undated. https://www.aad.org/public/diseases/hair-loss/treatment/transplant Accessed 5 November 2026.
- International Society of Hair Restoration Surgery (ISHRS). FUE: what is it? ISHRS; 2024. https://ishrs.org/fue-what-is-it/ Accessed 5 November 2026.
- Cooley JE, Finner A, Gambino V, Radwanski H, Unger R; ISHRS FUT Guidelines Task Force. Clinical practice guidelines for follicular unit transplantation (FUT). Hair Transplant Forum International; 2024;34(6):197, 202-204. https://ishrs.org/wp-content/uploads/2025/02/fut-task-force-nov-1-2024.pdf Accessed 5 November 2026.
- International Society of Hair Restoration Surgery (ISHRS). Red flags: misleading and inappropriate messaging. ISHRS; revised 2026. https://ishrs.org/red-flags-misleading-inappropriate-messaging/ Accessed 5 November 2026.
Article history
- — First published.