Hair Transplant for Patients with Scarring Alopecia?

There are a variety of scarring alopecias, some that are in fact very appropriately treated with hair transplants. Discoid Lupus can often be successfully treated with a hair transplant.

In order for a hair transplant to be successful for scarring alopecia, the disease needs to be inactive and there must be adequate donor hair. I have good results putting hair into scar tissue as long as the primary disease is stable.

With what appears to be an active auto-immune disease process, hair transplants might be rejected. One should wait for 2-3 years of inactivity before trying transplants or excision of bald areas.

Your best choice for scarring alopecia is excision of the scar with or without a tissue expander, or a scalp flap to reconstruct the area where the scar was removed. For large areas we use the Fleming-Mayer Flap, but this is not usually needed for small areas. Also, excision is much cheaper than transplants.

Hair Transplants do work for scarring alopecia and I have had great success with this. This is a somewhat controversial topic in the hair transplant literature. It has been suggested that more studies be done on patients with Lupus and other autoimmune disorders due to poor results that have been observed. The best that we can say is that follicular unit hair transplantation has very little risk and does work for many patients with scarring alopecia.

Hair grafts do not generally do well in scarred recipient beds. Successful take of transplanted hair grafts is possible but it truly depends on the extent and depth of the scars.