Hair Transplantation in Scarred Areas
Hair loss in scarred areas represents a unique and demanding aesthetic problem.
Unlike other forms of hair loss, in this case the skin has suffered permanent damage, with hair follicles being replaced by scar tissue.
The advancement of modern microsurgical hair transplantation techniques, along with complementary regenerative treatments, now makes it possible to achieve partial or even complete restoration of hair growth, even in challenging cases.
Hair loss in scarred areas represents a unique and demanding aesthetic problem.
Unlike other forms of hair loss, in this case the skin has suffered permanent damage, with hair follicles being replaced by scar tissue.
The advancement of modern microsurgical hair transplantation techniques, along with complementary regenerative treatments, now makes it possible to achieve partial or even complete restoration of hair growth, even in challenging cases.
Causes of hair loss
Hair loss caused by scarring is not related to the natural shedding of hair, but to permanent damage to the hair follicles due to destruction of the skin tissue.
Hair growth cannot regenerate naturally in these areas, as scar tissue lacks the structures and blood supply required for normal hair development.
The main causes include:
- Scarring Alopecia
This is an inflammatory dermatological condition that permanently destroys the hair follicles and replaces them with fibrous tissue.
Indicative forms include lichen planopilaris, discoid lupus erythematosus, etc. - Traumatic causes, such as thermal or chemical burns, road accidents.
- Surgical procedures or aesthetic interventions, such as craniotomies, facelifts, and even hair transplantation using the FUT (strip) method.
Early diagnosis and timely treatment of the underlying causes are critical for preventing the progressive loss of hair growth.
Is hair restoration possible?
Restoration in scarred areas is achievable, but it depends on the following factors:
- Stability of the condition
An inactive scar (without inflammation or progression) is required. In active scarring alopecia, medical stabilization must precede any intervention.
- Quality of the tissue
Adequate vascularization and scar thickness are necessary. Additionally, the skin should have good elasticity and show no signs of infection.
- Clinical evaluation
During evaluation, trichoscopy, palpation of the scar, and biopsy (if active disease is suspected) are performed.
Is hair restoration possible?
Restoration in scarred areas is achievable, but it depends on the following factors:
- Stability of the condition
An inactive scar (without inflammation or progression) is required. In active scarring alopecia, medical stabilization must precede any intervention.
- Quality of the tissue
Adequate vascularization and scar thickness are necessary. Additionally, the skin should have good elasticity and show no signs of infection.
- Clinical evaluation
During evaluation, trichoscopy, palpation of the scar, and biopsy (if active disease is suspected) are performed.
About implantation in scarred areas
Advantages
- Aesthetic restoration: Covers visible scars on the scalp, face, eyebrows, or beard, restoring hair growth.
- Permanent result: The transplanted hair follicles are durable and remain for a lifetime.
- Confidence: Covering a scar with natural hair growth can have a strong positive impact on the patient’s psychology and social image.
Restrictions
- Reduced blood supply: Scar tissue has a smaller vascular network, which may affect graft survival.
- Limited density: The implantation density is usually lower than that of normal skin to avoid overloading the tissue.
- Need for repetition: Some cases may require a second session for optimal coverage.
Unsuitable cases
In cases of active inflammation or an unstable scar, transplantation is contraindicated until the condition stabilizes.
The proper selection of candidates and the realistic determination of goals are crucial for the success of the procedure.
Diagnosis
The success of hair restoration in scarred areas does not depend solely on the transplantation technique, but begins with proper diagnosis and the individualized design of the treatment.
Each case is unique. The texture of the scar, the level of vascularization, the history of the injury, and the possible presence of an underlying condition determine whether, when, and by which method restoration can be performed.
The evaluation includes:
- Clinical examination of the scar (thickness, elasticity, extent)
- Trichoscopy, to assess microcirculation and the condition of the skin
- Skin biopsy, when active inflammatory activity is suspected (e.g., scarring alopecia)
- Recording of medical history and any coexisting conditions
Planning
The design of implantation in scarred areas is personalized based on:
- The type and extent of the scar
- The availability of the donor area
- The patient’s realistic expectations
- The possibility of applying supportive therapies
Scientifically documented diagnosis, combined with careful and realistic planning, forms the foundation for a stable, natural, and long-lasting result.
Restoration methods
Hair restoration in scarred areas—whether due to trauma or scarring alopecia—is now achievable thanks to advancements in modern transplantation techniques and supportive therapies that enhance follicle viability.
Transplantation
The primary method used is FUE hair transplantation, which allows for the precise placement of individual follicles even on scarred surfaces.
The procedure is adapted to the specific characteristics of the tissue.
Fine instruments are used, and both the depth and angle of implantation are carefully adjusted to ensure graft stability and the natural appearance of the final result.
In stable, well-healed scars—where no active inflammation is present—transplantation can offer satisfactory success rates.
Supportive therapies
To optimize the outcome, the procedure may be preceded or accompanied by specialized treatments such as:
- PRP (Platelet-Rich Plasma): enhances microcirculation and healing.
- Microneedling or fractional laser: improve tissue structure and vascularization.
- Medication (topical or systemic): used in cases with a history of inflammation to ensure stabilization.
Expected results
Recovery after transplantation on scar tissue is mild, without significant discomfort or prolonged healing time.
After the third month, the first signs of new hair growth usually begin to appear, as the grafts gradually enter the growth (anagen) phase.
Between the 9th and 12th month, hair growth continues to improve progressively month by month, with the density and naturalness of the result becoming stabilized.
In many cases, the full integration of the grafts into the scar offers impressive aesthetic outcomes, with natural texture, proper hair direction, and satisfactory density.
Depending on the size of the area or the characteristics of the tissue, a second session may be recommended to enhance density or extend coverage, ensuring an even more complete result.
The correct selection of technique, combined with individualized evaluation and planning, plays a decisive role in the success of the restoration.
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