Hair Transplantation in Scars - Is it Possible?

New hair follicles transplanted into a scar.

Hair Transplantation in Scars

A small number of men and women have scars in the scalp. This can be scars from an previous accident, scars from a previous surgery in the scalp, scars from a previous hair transplant surgery or scars from a scarring hair loss problem. Regardless of the cause of scars, patients visiting the office want to know:

Is it possible to transplant hairs into a scar to improve the appearance of the scar?

In many cases, the answer is "yes" and certainly we've transplanted a wide variety of scarring issues.  But the decision as to whether someone is a good candidate for repairing a scar with a hair transplant depends on a number of factors:

1.  Thickness of the scar. Sometimes scars can be very thick and this compromises the ability of hairs to grow in the scar. A number of techniques can be used to improve a thick scar and make it more receptive to receiving new hair follicles. This includes thinning the scar slightly with steroid injections and debulking the scar by removing bits of the scar before putting in new hair follicles. 

2. Thinness of the scar. As surprising as it sounds, some scars are too thin to be successfully transplanted. The medical term for such thinning is 'atrophy.'  Some scars are too atrophic to receive new hair follicles. When we do decide to proceed and transplant atrophic scars, we use a number of techniques to improve the growth and 'uptake' of transplanted hairs but some severely atrophic scars are challenging to transplant. 

3. Blood supply to the scar. Before a transplant is performed in a scar, I usually test the blood supply. Sometimes a scarring process in the scar can reduce the blood supply to area and in turn reduce the chances of having successful uptake of hair follicles. Certain techniques, such as pre-operative and post-operative use of minoxidil to improve blood flow into a scarred area may be beneficial and is something we often recommend.

In general, our experience has been that transplanting scars can be very successful and patients are really happy to have their scars less noticeable.  It does require experience and a certain degree of art to best camouflage scars with a hair transplants.  We frequently perform smaller sessions (fewer grafts), space the grafts out a bit further and wait longer between sessions if another session is required.  A few other modifications are done during the actual procedures as well. All of these considerations are important and help improve the likelihood that individuals with a scar will achieve outstanding results.