Major or visible scarring on your body is extremely common and can be distressing. In the developed world, more than 100 million people acquire scars each year from surgery, trauma, or conditions like scarring alopecia [1]. No matter what causes it, scalp scarring can leave long-term marks that are difficult to hide.
Scarring is often stigmatised in society [2]. That’s why many people with scalp or facial scarring consider getting a hair transplant into scar tissue to cover them. In this article, you’ll discover:
Yes — you can have a hair transplant on a scar. But it’s often more complicated than a standard hair transplant.
Healthy hair follicles on unscarred skin are fed by strong blood supply, which provides them with the nutrients and vitamins needed for hair growth. The skin is also flexible and thin enough for hair to grow with ease.
Scar tissue is different. When your skin is damaged, the hair follicles are destroyed. Dead hair follicles can no longer produce hair. The tissue is also affected by poor blood flow and stiffness, which makes hair transplantation into scar tissue more challenging [3-4].
However, it’s not impossible. Hair transplants on scar tissue often take longer, and you may need multiple rounds of surgery. However, if you choose a qualified and experienced hair transplant surgeon, you’re more likely to get results.
The technique for transplanting hair into scars is similar to traditional hair transplants. In a standard FUT (Follicular Unit Transplantation) or FUE (Follicular Unit Extraction) hair transplant surgery, your transplant surgeon extracts hair grafts (tiny clusters of hair follicles) from the side or back of your head. They then implant them into the thinning or balding areas (usually your crown and/or temple) where your follicles no longer produce hair.
However, certain complications make hair transplants on scar tissue a more complex procedure.
When your skin is scarred, the hair follicles that existed in the original skin are usually lost. That means it’s more difficult to see where your original hair grew. The best hair transplant surgeons make your new hair look as natural as possible by following the direction and placement of your original hair, which is more difficult without existing hair follicles to guide them.
In addition, the stiffness of the tissue makes it harder to transplant hairs precisely. So hair transplants into scars are often more time-consuming and difficult to perform.
When newly grafted hair follicles are transplanted into scars, they must take root and connect with the surrounding capillaries before hair will begin to grow. Scar tissue is prone to poor blood supply, so it’s harder for transplanted follicles to get the nutrients needed for healthy hair growth [3-4].
Surgeons often leave more space between hair grafts on scar tissue so there’s enough blood supply to nourish the grafts.
Many patients who want a hair transplant on their scars need multiple surgeries [5]. This allows a hair transplant surgeon to fill in the gaps from earlier grafts. Graft survival rates are also much lower on scarred skin, so you may need more than one hair transplant to get the coverage and density you want.
While scar repair hair transplants aren’t always as straightforward as other procedures, there’s lots of evidence that they can be successful.
You’ll need to take extra special care of grafts transplanted into scar tissue. This might include taking more time off work after a hair transplant, or waiting longer to exercise after a hair transplant. Allowing extra downtime after a hair transplant gives your follicles the best possible chance of survival in your scarred area.
Many different types of scars can be treated or covered with hair restoration surgery, including:
One study found that transplanting hairs into scars caused by burns was more successful than in other types of scarring, perhaps because burn scar tissue is typically shallower than in other scar types [3]. Artificial hair transplants can also be a good solution for scalp scars and burns.
A patient with burns scarring pre- and post-hair transplant (source: ABHRS).
Other researchers have had success in treating scarring hair loss with FUE hair transplant surgery. Their results showed a high graft survival rate of almost 81%. This rivals survival rates on regular skin tissue, which can be as high as 90% with a skilled surgeon [6].
One case study showed that FUE hair transplant procedures can be used to successfully cover scarring alopecia caused by a scalp MRSA infection [7]. Learn more about hair transplant infections.
A patient with scarring following MRSA infection pre- and post-hair transplant (source: ABHRS).
FUT hair transplant surgery involves removing a strip of skin from the donor area. The wound is then closed surgically, leaving a small scar.
If your surgeon doesn’t have the skill or experience to create a narrow or well-hidden scar, your FUT transplant scar might be thick, raised, or visible through your hair. This can be a telltale sign that you’ve had hair transplant surgery — in fact, it’s one of the giveaways of Elon Musk’s hair transplant.
A hair transplant can cover up your FUT scar if you’re prepared to have additional surgery. But there are alternative ways to disguise a FUT scar, including scalp micropigmentation, changing your hairstyle, and using hair thickening sprays or hair fibres after FUE.
Minoxidil is a popular topical solution that’s proven to promote hair growth [8-9]. So can it improve hair growth on scars ?
The evidence isn’t clear on how well Minoxidil works for scarring alopecia [10]. However, an animal study found that Minoxidil promoted blood vessel formation and encouraged follicle growth in the skin affected by burns [11]. So it may be a first-line treatment option for those with thin scar tissue.
Minoxidil is also effective at promoting growth after an FUE hair transplant on scar tissue [12]. Since hair transplants into scar tissue have notoriously low survival rates, it’s essential to use a solution to encourage hair growth and stimulate blood flow to the scalp in the days and weeks after your transplant surgery.
Hair restoration surgery is a successful way to disguise scars on your face and scalp if they’re performed by a skilled hair transplant surgeon. If you choose a black market hair transplant in Turkey or elsewhere, you could end up with more scarring. Almost all ISHRS surgeons report that a quarter of their patients are looking for repairs after a hair transplant that’s gone wrong at a black market clinic [13].
Choosing a Harley Street hair transplant clinic ensures you’re working with the best hair transplant surgeons in the UK. At the Wimpole Clinic, we have more than 45 years’ of experience providing fantastic FUE and FUT procedures including hair transplants on scarred skin.
Explore our clinic, then book a free consultation to see how we can help you:
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