Greg Williams, FRCS (Plast)

Hair transplantation is possible for some burn scars but the growth of transplanted hairs is often less successful than in uninjured skin. You should have a consultation with a doctor who has a wide experience transplanting in scar tissue. 

The skin has two layers - a thin epidermis and a thicker dermis. The thickness of the dermis varies hugely in the body with it being thickest on the back and thinnest in the eyelids. Only the glabrous skin of the palms and soles has no hair. Actually, the bulb of a hair usually sits below the dermis in the fat, or subcutaneous layer.

When implanting a hair, the depth of the incision should be made to match the length of the hair follicle but most hair transplant surgeons will leave the epidermis of the follicular unit graft sitting just proud of the skin surface. This is often more pronounced in FUE than in Linear Strip Excision/Strip FUT procedures.


Where the bulb of a transplanted hair actually sits is difficult to predict. What is critical is that the bulge portion of the follicle, where the majority of the stem cells are located, sits comfortably beneath the surface of the skin.

One of the most challenging aspects of being an ethical hair transplant surgeon is trying to predict the likely extent of future hair loss. This becomes more accurate the older the patient is. I recently saw a young patient whom I first saw 5 years ago and recommended medical therapy. At the time he was only thinning in the temples. He chose not to treat his hair loss with minoxidil/finasteride. Now he is obviously progressing towards an N7 pattern.  Filling in his temples at the time wound have been a big mistake.

Making diagnoses and treatment suggestions from photos is risky. If your hair is stable on  finasteride then, from the photos, you look  like you might be a good candidate for what you are asking for.

However, you should have a face to face consultation with a reputable hair transplant surgeon who will examine you and advise on a long term treatment plan. Often these are the doctors who are more expensive and not offering deals or discounts.

Some patients will see a marginal improvement in scalp laxity with regular up and down massaging of the occipito-parietal scalp which might allow a wider strip to be removed in a Strip Follicular Unit Transplantation (Strip FUT) hair transplant surgery procedure 

Folliculitis Decalvans is a very distressing chronic scalp infection that can be very difficult to control or get rid of.

Often, maintenance antibiotics are needed for prolonged periods of time.

I would not perform a hair transplant if there is any evidence of active disease or if the patient is on antibiotics.

If the disease has been non-active for 5 years then I would consider hair transplant surgery but the patient would need to accept the risk of this precipitating a recurrence of the infection.