Hair
Restoration and the
Scarred Scalp
Baldness (alopecia)
secondary to certain
dermatologic
diseases or scalp
injury and
subsequent scarring
is called
cicatricial or
scarring alopecia.
In medical
terminology a scar
is called a
cicatrix. The common
causes of
cicatricial alopecia
are injury to the
scalp caused by
trauma, thermal
burns, chemical
burns, electrical
burns, and diseases
that destroy hair
follicles and scalp
tissue. Cicatricial
alopecia may involve
the complete scalp
or portions of the
scalp. The extent of
scarring and the
patient’s wishes
guide the selection
of hair restoration
procedure.
Nonsurgical Hair
Restoration
Hair pieces, hair
weaves and hair
extensions are the
only effective
nonsurgical
treatments for
cicatricial
alopecia. Hair
restoration drugs
are ineffective or
minimally effective
in scarred scalp
tissue.
Surgical Hair
Restoration
If cicatricial
alopecia is partial,
a hair-bearing
portion of scalp,
the occipital donor
area, may be
available as a donor
site. Procedures
that may be
considered include
free or pedicled
scalp flaps, scalp
reduction with or
without tissue
expansion, and
transplantation of
micrografts or
single hairs.
Multiple surgical
sessions may be
required if
cicatricial alopecia
is extensive and/or
scarring is severe.
Dermatologic
diseases causing
scarring alopecia
should be evaluated
carefully by an
expert. During the
active stages of
these diseases
treatment with
surgery is not
indicated, as the
transplanted hair
will be affected by
the same process
that caused the
original hair loss.
Patients with these
conditions can be
candidates for
surgery after the
disease is "burned
out" or no longer
active.
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