Hair Transplant for Patients with Scarring Alopecia?

Hair Transplants do work for scarring alopecia and I have had great success with this. This is a somewhat controversial topic in the hair transplant literature. It has been suggested that more studies be done on patients with Lupus and other autoimmune disorders due to poor results that have been observed. The best that we can say is that follicular unit hair transplantation has very little risk and does work for many patients with scarring alopecia.

Hair transplant is not generally recommended for scarring type of alopecia. Some doctors depending on history and exam may consider a small "test" transplant to see if the surgery may work.  This does not guarantee success but it may help make a decision with the risks in mind.  SMP may also be an option for those who cannot have a hair transplant surgery.

It depends on the cause of the scarring. If it is an active disease, a hair transplant is not advised since the hair would be lost. Sometimes an active disease can become inactive or burnt out. If a disease has remained dormant for a number of years, this can be the case. In that case, test implants are first done to test viability before a full-blown surgery is committed.

There are a variety of scarring alopecias, some that are in fact very appropriately treated with hair transplants. Discoid Lupus can often be successfully treated with a hair transplant.

Your best choice for scarring alopecia is excision of the scar with or without a tissue expander, or a scalp flap to reconstruct the area where the scar was removed. For large areas we use the Fleming-Mayer Flap, but this is not usually needed for small areas. Also, excision is much cheaper than transplants.