Do I have scarring alopecia? If so, can I get a hair transplant? (Photo)

It appears you might have traction hair loss from your hairstyles but it is also possible you have FFA (frontal fibrosing alopecia). In order to tell, you would need a scalp biopsy. FFA is a scarring alopecia and transplant should not be performed. However, traction hair loss can be treated with a hair transplant.

Looking at the picture, it looks more like traction alopecia, a trichoscopic examination would actually provide a clearer result for diagnosing this type of condition.

If you have been tying your hair back this way for a long time, traction related hair loss can eventually damage the follicles and progress to scarring alopecia.

A diagnosis via trichoscopy is needed first; however, if it is scarring alopecia, a hair transplant should not be performed immediately, as the transplanted grafts could also fall out.

A photograph alone cannot reliably confirm scarring alopecia, but certain features raise concern: smooth, shiny scalp skin; loss of visible follicular openings; redness, scale, pustules, or pigment change; and symptoms such as itching, burning, pain, or tenderness. Scarring alopecia means inflammation has destroyed the hair follicles and replaced them with scar tissue, so hair will not regrow from the affected follicles.

The next step is a focused scalp examination with dermoscopy and, when the diagnosis is uncertain or there are signs of activity, a scalp biopsy from the active edge of the involved area. It is important to identify the specific cause, such as lichen planopilaris, frontal fibrosing alopecia, central centrifugal cicatricial alopecia, lupus, traction, or prior injury, because treatment is aimed first at stopping any ongoing inflammation.

A hair transplant can be an option in selected cases, but only after the disease has been inactive and stable for a prolonged period—commonly at least one to two years. Transplanting into active scarring alopecia can trigger further inflammation, lead to poor graft survival, and worsen hair loss. Scar tissue also has reduced blood supply, so graft density and results can be less predictable than in non-scarring hair loss.

If the area is truly inactive and the donor hair is adequate, a small test session may help determine likely graft survival before a larger transplant.

— Dr. Anna Chacon

Yes, if you have traction alopecia, you can definitely be a candidate for a hair transplant, as long as the damage has stabilized and there’s no ongoing pulling or tension on your hair. Traction alopecia occurs when hair is lost due to repeated stress from tight hairstyles or mechanical pulling. The good news is that since this type of alopecia doesn’t involve inflammation or autoimmune conditions like scarring alopecia, hair transplants can be a great solution.
During a hair transplant, healthy hair follicles from the back or sides of your scalp are transplanted to the areas affected by traction alopecia, such as your edges or hairline. The success of the procedure will largely depend on the quality of your donor area and whether the traction-causing habits have been corrected.

Hello, thank you for your question. To determine whether you have scarring alopecia we would need to know more information regarding your hair loss, and it may be strongly recommended that you get a scalp biopsy done. Based on the results it can then be determined whether or not you are a surgical candidate. Generally, if a patient at my practice is diagnosed with scarring alopecia I do not recommend surgery due to numerous factors. In patients with scarring alopecia a hair transplant has a very high chance of worsening the condition, it is also possible that the transplant may be unsuccessful. If you are in fact diagnosed with scarring alopecia I recommend you seek out a doctor who specializes in hair and hair loss to help manage the condition and discuss your treatment options.

Hope this was helpful. If you have any further questions feel free to reach out at (949) 374-2563 or email info@modenahair.com

Without a detailed hair loss history, medical history and hair/scalp examination it is impossible to correctly diagnose you. The picture suggests that you may have Traction Alopecia, which is common and it is a transplantable condition. However, if you do have Scarring Alopecia (a scalp/hair condition that destroys the follicles and causes scarring in the affected areas), transplants are not the first choice. Transplants may be done, but the general consensus is that the scarring alopecia needs to be inactive for at least 2 years before a hair transplant is attempted. If a hair transplant is performed in an area of scarring alopecia, it is important that you understand that the transplant itself can reactivate the condition and it can also affect the transplanted hairs.

Hello fcaldwell,
From the photo, it does not look like you are having a scarring alopecia. My first diagnosis would be traction alopecia which probably caused by the dreadlock hairstyle you are having in the photo. However, in order to get the correct diagnosis, I highly recommend you to see a dermatologist. Fortunately, traction alopecia can be corrected by hair transplant surgery. It is advised that you should stop wearing the dreadlock or the alopecia will get worse.

I think so ,
you may have a hair loss called as frontal fibrosing alopecia that is an autoimmune cicatririal alopecias. In that case, body immune system attacks to your hair follicules with an unknown reason to destroy hair follicules ending with a permanent hair loss. So you may need to have a full exam with an hair surgeon, dermatologist and skin biopsy to find out reason for hair loss.

Hello and thank you for your question. It's very difficult to diagnose accurately by looking at a photo. You need to start with your doctor and have a thorough exam to determine what is going on. I wish you the best of luck.

Dr, T

More likely than not, this is traction alopecia. A fringe sign is present in the photo which makes traction alopecia likely. Now keep in mind that the proper way to diagnose hair loss is by listening to a person’s entire story and examining the scalp up close. There’s no better way than this. There are mimickers that can look 100 % like this includes alopecia areata so be sure to see a good doctor. I don’t suspect alopecia areata but rather traction alopecia.

Some forms of traction alopecia are scarring but that does not affect the answer to the question “can I have a transplant?” all that much. A transplant is possible for many people provided the traction forces have stopped. If the cause of the traction is still ongoing (still using hairstyles that caused traction in the first place) the a transplant should not be done. For anyone with traction, a good scalp examination should be done in other areas to exclude other conditions that night be a contraindication to surgery. All in all, be sure to see an expert.