A Systematic Review of Follicular Unit Graft Survival Rates After Hair Transplantation in Primary Cicatricial Alopecia

Abstract

Background: Primary cicatricial alopecia (PCA) refers to a clinically diverse group of inflammatory hair loss disorders characterized by the irreversible destruction and scarring of hair follicles. Hair transplantation (follicular unit extraction [FUE] or strip harvesting follicular unit transplantation [FUT]) has been proposed as a treatment for inactive PCA.

Objective: This study aims to evaluate the efficacy and safety of HT for the management of PCA.

Methods: A systematic review was conducted to identify studies assessing treatment of PCA in adults (≥18 years) with FUE or FUT. The primary outcome measure was follicular unit (FU) graft survival rate. Secondary outcomes included postoperative complications and patient satisfaction.

Results: Eight observational studies with a total of 123 patients met the inclusion criteria. Overall, the weighted FU graft survival rate after HT was 82.7% at 7 to 12 months, 73.3% at 13 to 24 months, 58.4% at 25 to 36 months, 55.4% at 37 to 48 months and 39.6% at 49 to 72 months. Four patients developed reactivation of their disease after HT.

Conclusion: The FU graft survival rate after FUE or FUT for the management of inactive PCA peaks at 1 year and diminishes over time.