Can hair transplant for hairline restoration be done if there are still active (but damaged) hair follicles? (photo)

First of all, I’m really sorry you’re going through this. IPL (intense pulsed light) isn’t meant for the hairline, and it sounds like you’ve been incredibly patient trying to recover what was lost.Now to the point:
Yes, hair transplantation in such an area is quite possible, even if there is ‘live but weak’ hair left there. The main thing is to assess whether this hair will actually recover or whether it has already been permanently miniaturised. In practice, if nearly a year has passed and the hair is still thin, light and ‘fluffy’, then most likely it will not return to its previous appearance. And discontinuing minoxidil will cause these fluffy hairs to regress.
The good news is that such areas can be covered with a transplant, especially if they spoil the symmetry or stand out visually. Thin vellus hair will not interfere with the engraftment of new grafts; on the contrary, it is often simply ‘rubbed out’ by the new volume.
So if you have been treating for a year and there are no results, it may be time to consider transplantation as a real option. If you want, you can evaluate the photos and understand how realistic it is to fix this and how many grafts may be needed. You are definitely not alone, and such cases can be resolved.

It sounds like your hair is showing some response to treatment, which is a positive sign. Intense Pulsed Light (IPL) can sometimes cause temporary shock to hair follicles, leading to delayed regrowth, but in some cases, it may also cause permanent damage. If you are seeing thin, fluffy regrowth, it’s possible that the follicles are still recovering.

Typically, with treatments like minoxidil and Latisse, the full effects can take up to a year or more to stabilize. However, if the regrown hair remains significantly finer and lighter than your original hairline and does not continue improving, it may indicate that the follicles have been weakened or are no longer producing terminal hair.

A hair transplant can still be an option, even if there are active follicles in the area. The key would be determining whether those follicles will continue to improve or if they have reached their maximum recovery. A thorough evaluation would help assess the status of the hair and whether a transplant is appropriate to restore density and natural appearance.

Hair transplant procedures can often be performed in areas where there are still active, though damaged, hair follicles. If you've been using treatments like minoxidil and Latisse and have seen some regrowth, it indicates that the follicles are still active, although they may not be functioning optimally.

Transplanting hair into these areas can help achieve a fuller, more natural-looking hairline. However, it's typically advised to wait and see the full effects of topical treatments, as these can sometimes stimulate further regrowth and thickening over time.

Your dermatologist is right in suggesting patience with topicals, as hair regrowth can take time. It can often take 6 to 12 months to see the full results of such treatments. If, after this period, you are not satisfied with the density or appearance, a hair transplant could be considered. Consulting with a hair restoration specialist will provide more personalized guidance based on the condition of your scalp and hair.

Best wishes as you continue your hair restoration journey.