Hair Transplants and Scar Tissue

I have some questions about hair transplant in skin with extensive scarring. I’ve tried looking for information on this online, but the vast majority of the information available is on transplantation into normal skin, and any information on scarring is generally limited to scarring as a result of the procedure itself. This seemed like a good place to ask.

A friend of mine was in a fire about 11 years ago and has had extensive skin grafts and reconstructive surgery. One of these procedures was an attempt to stretch the areas of his scalp that still grew hair to cover the areas that did not. However, the skin proved to be too thin to completely cover the hairless areas, and he was left with 2 areas of scalp with no or very sparse hair, each about 2″x3″. While he is comfortable with the grafts on his body, I know the hairless patches on his head really bother him. He has jokingly mentioned getting hair plugs in the past, but he doesn’t think his hair is thick enough to provide donor sites, and I think he worries that transplanting into thin or scarred skin would be impossible.

So, basically, my questions are, can living hair be transplanted into large areas of scar tissue? Can hair follicles be harvested without causing other noticeable thin spots, or can it be donated from another person with similarly textured and colored hair?

Thank you!

Yes, hair can be implanted into scar tissue to provide a cosmetic benefit. We have done that on many occasions, but the status of the skin is critical in making the determination to go forward. Skin grafts, for example, with no thickness to them may not be able to tolerate hair grafts. Your friend’s issues are not unique and there are patients who have had hair transplant surgery to cover the bald areas from such tragedy. We have done many with neurosurgery scars and face lifts scars that easily support hair grafting, but each and every patient is very unique and can pose challenges.

I really cannot answer your question without seeing the patient in person or at least seeing a photograph. If your friend is considering options, I would have them make an appointment with a good hair transplant surgeon to discuss those options. (Also, “hair plugs” is a term used for the outdated procedures done in decades past. Current techniques can create an undetectable result without a pluggy look.)