Hair Transplantation

Book
In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan.
.

Excerpt

Hair loss is a common concern, affecting approximately 67% of males and 24% of females. Several non-surgical treatments, including minoxidil, finasteride, dutasteride, low-level laser light therapy, platelet-rich plasma, adenosine, and ketoconazole, can slow hair loss and stimulate new hair growth. Hair transplantation, through follicular-unit grafting, is the preferred surgical method for individuals with specific forms of alopecia seeking hair restoration. This procedure assists them in attaining a more natural and voluminous hair appearance.

The most frequent cause of hair loss is androgenic alopecia (AGA), now commonly known as male pattern hair loss (MPHL) and female pattern hair loss (FPHL). Individuals with androgenic alopecia experience the miniaturization of hair follicles in susceptible areas of the scalp. Ideal candidates for hair transplantation are those with stable androgenetic alopecia with a sufficient hair reservoir for transplantation.

Diagnosing androgenic alopecia is typically straightforward and relies on recognizing the characteristic patterns of hair loss, the miniaturization and depigmentation of hair, and the absence of clinical inflammation. If these features are absent, further evaluation may be necessary. The Norwood classification system best illustrates male pattern hair loss, while women use the Ludwig classification. Androgenic alopecia in women typically spares the hairline but presents with more diffuse thinning throughout the top and upper sides of the head.

During the hair transplantation procedure, healthcare professionals transfer androgen-resistant hair follicular units from the occipital region to the areas affected by alopecia. Two primary methods for harvesting donor's hair exist: hair follicular unit strip surgery (FUSS) and follicular unit extraction (FUE). Follicular unit extraction is preferred for younger men and those who prefer shorter hairstyles because it avoids creating a linear donor site scar. Since occipital hairs are resistant to androgens, the transplanted hairs retain the characteristics of the donor hair, maintaining their larger caliber as they grow.

Publication types

  • Study Guide