Completely Bald Hair Transplant: Can It Be Done?

So, can you get a hair transplant if you’re completely bald?

The short answer is yes. Though the reality is that you’re not likely to get a sweeping mane of hair, you may be able to at least have a natural-looking hairline restored. Hair transplants are carried out through an Follicular Unit Extraction surgery (FUE) and/or strip surgery, both of which rely on removing healthy follicles from a donor site elsewhere on your body.

The scalp may not be a viable donor site if you’re completely bald. However, it may sometimes be possible to use other areas of the body as the donor area. Of course, not all people are candidates for this type of procedure, as the success rate of any hair transplant first relies on donor supply. In these cases, you may need to consider other forms of hair restoration. If a hair transplant is viable with the use of a different area of the body as a donor area, an FUE will most likely be the best option, as this leaves minimal scarring in noticeable places. Some research suggests FUE is the only appropriate method for harvesting body hair [2a].

This only applies if your hair loss isn’t caused by an autoimmune condition like alopecia areata. Hair transplants for alopecia areata or alopecia universalis patients are rarely recommended.

Which is the best donor area?

Opting for an alternative donor site to the scalp means that the look and feel of the hair will likely be different in coarseness and colour. However, it should not be a significantly noticeable difference.

After the scalp, the second most common donor area is in fact the beard, as beard hair continues to grow despite the presence of DHT (dihydrotestosterone) in the body [3]. This type of hair is coarse and may be slightly different in colour compared to the head. However, it can provide good coverage to the crown area if you’re considering a crown hair transplant.

If the scalp is completely bald, using chest and abdomen hair along with beard hair on the scalp can create good coverage, as well as a natural-looking hairline.

How bald is too bald for a hair transplant?

The level of hair loss that men experience is usually measured against the Norwood Scale, which shows the 7 progressive stages of male pattern baldness (the female pattern baldness equivalent being the Ludwig Scale). Your Norwood stage can determine the possibility of a hair transplant, as most transplants rely on a donor area from the scalp.

At Norwood stage 7, which is the most advanced level of hair loss, you will typically have a single band of hair around the back and sides of your head, and be bald across your crown. Norwood stage 6 can also appear as almost total baldness.

Some men with aggressive hair loss begin to lose hair in the safe donor area. This is known as retrograde alopecia. Those who are completely bald are at a more advanced level than any stage of the Norwood scale. So you are most likely past losing hair. This does not mean that you cannot receive a hair transplant, however. Even if you are completely bald, you may have a healthy supply of hair in other donor areas.

Throughout the process of a hair transplant, surgeons must keep the safe donor area in mind. This establishes a safe number of grafts that a surgeon can extract from the donor area to avoid overharvesting the follicles. Therefore even if you have some hair present, it may not be usable if it’s not in the safe donor area.