I have a couple of scars on my head since 2004 and my hair hasn't grown back since then. What can I do? I had surgery in 2004 from having a brain aneurism.
What to Do About Hair Loss and Scars After Head Surgery?
Doctor Answers (5)
Follicular Unit Extraction to Treat Scars/Hair Loss
Follicular unit extraction is an excellent (and permanent) way to restore hair lost due to scarring. Transplanting hair into the scar would involve either some some grafts from the back of the head or an entire donor strip depending on how many grafts that will be needed. Hair transplants will grow in scar tissue thus providing excellent coverage.
Follicular Unit Extraction Repairs Scarring
Follicular unit extraction (FUE) is an excellent (and permanent) way to restore hair lost due to scarring. As an FUE hair transplant surgeon, I have restored hair loss cases that were due to severe scarring from prior surgeries with great success. You should look into FUE hair transplant as a serious option by doing the following:
- Research respected surgeons and clinics
- Take a free consultation with any whom you see fit
- Be sure they have the kind of experience you need; i.e.that they have operated on cases like yours with satisfactory results (video/photo documentation of prior patients is paramount)
Hair Loss in Scars on Head: To Transplant Hair or to Revise the Scar
As you see from my title, there really are two options available for you now that you know the hair won't come back.
Option 1: Transplanting hair into the scar would involve either some some punch grafts from the back of the head or an entire donor strip depending on how many grafts i will need. Whenever I transplant into a scar, I worry about blood supply in the area, i.e., whether the grafts will take. Surprisingly, some theories out there are that hairs that are transplanted into the scars will actually make the scar soften and heal because of the regenerative capacity of the transplanted hairs. The goal of transplantation is to visually break the linear appearance of the scar not necessarily to fill every square inch in. If you visually break the scar line, it is harder to detect (I have attached a video to demonstrate). Btw, you can check the blood supply by pricking the skin with a small needle. Bleeding indicates that the blood supply is most likely adequate. Also btw, you are not to do this but a qualified physician.
Option 2: Scar revision. Unlike traditional scar revision, it is not to zig or zag too much because you will have too much tension here. You can also kill more hair shafts if you undermine widely and try to take healthy tissue out. If the scar is under a lot of tension, this is not a good option. If the scalp feels loose and the scar is not too wide, then scar revision may be the option. It is the less expensive option since it is far easier to do a scar revision than to have my transplant team work on it.
Sometimes you need both options. Scar revision followed by hair transplant to make it as good as possible. In summary, if you have a tight scalp or a wide area of hair loss, then transplant would probably be the better choice. If you have a looser scalp and a narrower scar, scar revision would probably be better (as a first choice) with a back up plan for possible scar revision as needed. Hope that helps.
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What to do about hair loss and scars after head surgery?
Hair follicles live in one of two states ON when they grow and OFF, when they shed and are dormant. Follicles are extremely sensitive to male hormones (causing male pattern baldness) and to tension.
Sometimes we get temporary hair loss with scalp incision based on tension but this does not last 5 years. As far as what to do - first, I would find out if you lost hair more than a cm away from the incision as that would indicate a process OTHER than the surgery as being responsible (such as male pattern baldness). If that is not the case, depending on the quality of the incision, hair plugs may be placed in the scar and oriented in the direction of the local hair OR, if there is enough scalp laxity, the scar may be cut in beveled fashion to allow adjacent hair to grow through the new scar in the coming months masking it.
Peter A Aldea, MD, FACS
Hair loss can be temporary.
In many instances th hair loss following facial or scalp surgery, with the exception of the scars themselves, van be temporary and will typically last yp to 6 months. When an incision is placed in the scalp, occasionally the use of a zig zag incision so that when the hair is wet, it does not "part" and make the scar nore visible,
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.