I'm a healthy 47-year-old African American woman but I'm dealing with a mild to moderate case of cicatricial alopecia--similar to male pattern baldness. Could I be a good candidate for a hair transplant or would another method be more advisable?
Hair Transplant for Female African American Alopecia Patient?
Doctor Answers 9
Hair Transplant for Alopecia Patient
If the cicatricial alopecia is burned out and stabilized. I have successfully put grafts in scar tissue. The key is whether or not your cause of hair loss is inactive.
Hair Transplant for Alopecia
With cicatricial alopecia, the hair loss is generally considered to be stable, therefore a hair transplant procedure can be an effective treatment. These are challenging procedures, but they can effectively restore density to the scalp even in areas of scarring.
You need an exam and possibly a small "test" transplant to make sure you would be a candidate.
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But timing is everything here. If you/we're confident that your scalp isn't actively inflamed or irritated then you would be good to go with the grafting. However, if there is any question, then you'll need to wait. One year from the last episodes of inflammation is a safe approximate time for things to cool off, but if there is any question, you could get a scalp biopsy, or what I prefer is to transplant a few hairs and see how they grow.
Dr John Frank, MD
Hair transplant in cicatricial alopecia
Hair transplantation in cicatricial alopecia is possible. ISHRS (International Soc of Hair Restoration Surgery) has now created a database in those with cicatricial alopecia who get hair transplants. I have done numbers of them. The important thing is to first get a slap biopsy to determine whether the inflammation has calmed down. If the condition is inactive (no inflammation), then we would do hair transplants. If the condition is active, I would wait because it is the inflammation that destroys the grafts.
Transplants can be done in cicatricial alopecia, but the growth of the grafts may not be ideal because of comprmised circulation. We prefer transpostion flaps which allow us to to remove the alopecia and replace this with normal scalp.
I have had tremendous success with transplanting African American females who have scarring hair loss due to traction loss, i.e., pulling the hairs so tight while straightening them, that you lose the hair. If that is your situation, then a hair transplant by someone who is skilled at helping African American women with this condition is a great idea.
However, if you have some of the unusual types of scarring alopecias that are active like central centrifugal alopecia, formerly known as "hot-comb" alopecia, that affects principally the back (crown) and midscalp portion of African Americans, then you are not necessarily a good candidate for hair restoration at this time until the disease process has burned out. Conservative physicians say a minimum of 2 years but it could still reactivate so there is always a risk. Plus, this type of scarring alopecia can truly injure the deeper tissues making transplantation results possibly spotty, making this distinction is critical.
There are 2 methods to repair this.
We have been doing hair transplants and flaps for 30 years. We think that hair transplants don't grow as well in cicatricial alopecia. Flaps on the other hand totally replace the scarred scalp with natural density, healthy scalp. Furthermore, you don't have to wait for hair to grow since with flaps the hair never falls out and only reuires one procedure.
Hair transplantation is a good option for alopecia
Hair transplantation can be a reasonable option for cicatricial alopecia. The first order of business would be to visit a physician with hair transplantation experience. Your general health and the area of alopecia must be evaluated to make sure if the area is robust enough to all for transplantation especially in an are of cicatricial alopecia. Additionally, examination of the donor area is performed to access the quality of the potential donor hair. If that criteria is met most patients would be good candidates for hair transplant.