Hair Transplantation in Frontal Fibrosing Alopecia and Lichen Planopilaris: A Systematic Review

Laryngoscope. 2021 Jan;131(1):59-66. doi: 10.1002/lary.28551. Epub 2020 Feb 11.


Objective: Evolving hair transplantation (HT) techniques have offered new possibilities for hair restoration. However, the role of HT in patients with frontal fibrosing alopecia (FFA) and lichen planopilaris (LPP) remains unclear. This study aims to evaluate the outcomes and temporal relationship of HT in this population.

Methods: A literature search of three databases was conducted. We reviewed 1) literature reporting outcomes of patients with LPP or FFA who received HT, and 2) studies reporting the development of LPP or FFA resulting from HT.

Results: Thirteen articles included 42 patients that provided data for evaluation. Fifteen patients had previously been diagnosed with FFA or LPP, and the remaining 27 patients developed disease after undergoing HT. Seven patients with FFA and eight patients with LPP received HT, with a mean sustained disease remission of 2.69 years prior to HT. In total, two of seven (29%) patients with FFA and five of eight (75%) patients with LPP experienced positive HT results over a follow-up period of 8-72 months. Interestingly, 27 patients without evidence of previous disease developed FFA or LPP following HT after a median duration of 16 months.

Conclusions: HT for LPP and FFA is feasible but results may be less favorable compared to HT for other causes. Outcomes may be more favorable for LPP than FFA but this was not statistically significant and evidence is very limited. FFA and LPP can also develop following HT in patients without previous evidence of disease.

Level of evidence: NA Laryngoscope, 131:59-66, 2021.

Keywords: Hair transplantation; frontal fibrosing alopecia; lichen planopilaris; scarring alopecia.

Publication types

  • Systematic Review

MeSH terms

  • Alopecia / therapy*
  • Dermoscopy
  • Hair / transplantation*
  • Humans
  • Lichen Planus / therapy*
  • Scalp

Supplementary concepts

  • Lichen planus follicularis