Oleg Antonov, MD (in memoriam)

Sometimes prominent post op skin scarring appears to be keloid when it could also be hypertrophic scarring. If it is a true keloid scar  then I would be more cautious to perform any cosmetic procedure on visually open areas. If we are dealing with hypertrophic scar, I would recommend performing a "spot test" on area of interest. Some doctors will inject steroids as a prevention of post op significant scarring. If the post op skin changes are prominent, then treatment with steroids or a combination of silicone with steroids would appropriate care. And to answer your question, sometimes I do follicle grafting into the scar tissue to camouflage aesthetic damage. A knowledgeable surgeon will not give a 100% guarantee that a hair transplant will be successful in favorable conditions but will apply his best skills to achieve that.

If the folliculitis is inactive and we are dealing with the scar tissue only, then we have options. Most common procedure in this situation will be steroid injections into the scars. Success depends on the amount of time that has passed since the problem began. The sooner the treatment is implemented the better chance of it's effectiveness. Surgical excision might be another option which typically is performed in a few steps. In some cases we have to use skin flaps which when healed can be grafted with follicles or camouflaged with micropigmentation. Very promising results we expect from the application of topical siliconic acid.  

Everyone hears about topical solutions i.e. Rogaine/Minoxidil, Finasteride, Dutasteride and rumors about results. It is no secret that the efficiency of Minoxidil-Rogaine does not get any higher than 10-15% at best. Minoxidil was originally used as medicine for hypertension with its action on dilatation of small blood vessels. Therefore it's mechanism to treat baldness is to improve blood flow to the scalp. Other more powerful agents like Finasteride or Dutasteride have a different mechanism of action - they block powerful destruction to the follicles by DHT/Testosterone which is a major problem with androgenic alopecia. Considering the fact that the positive effect in using Minoxidil is not very high, we should not expect spectacular results. Good news is that it is a harmless medicine which will not damage the transplanted hairs.      

Hyperpigmentation even in good hands, performing 3D microblading  may create illusion "as something growing on your scalp" It is a very weak stimulant for dormant follicles. You may have better luck using a dermaroller or laser treatments. Chemical peels are acids that may kill follicles and this never has been consider as treatment for hair loss. As to PRP, if you would like to have straight answer there are two choices, 1. scalp biopsy for dormant follicles. 2. you may try three or four treatments with PRP and if you notice that hair loss has been significantly diminished and see new hairs growing you should continue with PRP. I would like to mention protocols which are not a standard in different clinics using their own protocols. I perform three treatments at six week intervals followed by 6 months at 3 month intervals, then every six months to maintain.

Currently in U.S.A. any treatment using stem cells should be considered as experimental because it is not considered as a standard of care. Despite the fact that some researchers achieved very impressive results even with restoration of different body parts. Gary Steinberg chief of neurosurgery at Stamford University School of Medicine was able to restore stroke victim with arm and leg paralysis, impaired speech to normal; life style and motherhood. Of course stem cells participate in any restoration of damaged tissue in a natural way but at this time specific organ restoration still under research. Having PRP Treatments patients should expect results of growth factors  from platelets to sick or dormant follicles only.