Hair Transplant For Alopecia Areata: Does It Work?

Hair transplants are one of the most successful types of hair restoration. But it’s not suitable for every hair loss patient. While there are fantastic hair transplant success rates for those with androgenetic alopecia, hair transplants don’t usually work for people with alopecia areata.

In this article, you’ll learn why hair transplants are unsuitable for alopecia areata patients, and what alternative treatments are available.

What is alopecia areata and who is affected?

Alopecia areata affects 1 in 170 people in the UK [1]. It’s an autoimmune condition in which your white blood cells attack your hair follicles, causing your hair to fall out. Alopecia areata creates small round bald patches across the scalp, which can join together to form larger patches.

Two patients with bald patches characteristic of alopecia areata.

Alopecia areata can affect anyone, but it’s more prevalent in people aged 25-40, and those of non-white ethnicity [1]. Sometimes it develops into more severe hair loss conditions, such as alopecia totalis (total loss of scalp hair) or alopecia universalis (total loss of body hair).

Why don’t hair transplants work for people with alopecia areata?

Lack of healthy hair follicles

Hair transplants rely on taking healthy hair follicles from one area of the head and moving them to balding areas. In patients with pattern baldness, the band across the back and sides of the head is known as the safe donor area. Follicles in this area are unaffected by the hormones that cause androgenetic alopecia, so they can be safely extracted and moved to the thinning areas.

Alopecia areata patients have no safe donor area. The condition can spread quickly to other areas of your scalp. So it’s possible that your transplanted hairs will fall out just as your original ones did, making a hair transplant an ineffective procedure for alopecia areata.

High rate of spontaneous remission

Alopecia areata also has a high rate of spontaneous remission. In up to 80% patients, it clears up by itself without intervention within a year of developing symptoms [2]. That means your hair may regrow by itself without the need for surgery. Performing FUE or FUT on these patients can put their scalp and hair through unnecessary trauma.

Are alopecia areata hair transplants ever successful?

In very rare instances, some doctors have had success in treating alopecia areata with hair transplants. This is usually only the case if hair loss has remained unchanged for several years (i.e. no further hair growth or hair loss).

In one study, a patient with alopecia universalis regrew all body hair except his eyebrows following a course of non-surgical therapy. Because his eyebrows didn’t respond to therapy in the same way as the rest of his body hair, the surgeon gave him an eyebrow transplant. After 2 years, he had 80% brow regrowth [3].

However, his original eyebrow hair later grew back spontaneously [4]. The transplanted hairs then had to be removed. Soon after that, his scalp and eyebrow hair fell out again.

Original eyebrow regrowth following hair transplant in a patient with eyebrow alopecia areata, creating the appearance of two sets of eyebrows.

While the hair transplant was a success, this shows why it’s generally unsuitable for alopecia areata patients. It’s a volatile condition that can disappear and return at any time, so hair transplants are likely to be ineffective in the long term.

What treatments are effective for alopecia areata?

Because alopecia areata is so erratic, it’s notoriously difficult to treat. But there are several treatments that have proven success, including:

• Corticosteroid injections
• Steroid creams for hair loss
• Minoxidil
• Anthralin cream
• Contact immunotherapy
• Olumiant, a JAK inhibitor
• Pfizer alopecia drug ritlecitinib (still in FDA/EMA approval phase)
• Immunosuppressant drugs
• Antihistamines
• Some new studies suggest artificial hair transplants like Biofibre may work for total alopecia areata [5].

See these Minoxidil before and after photos to see the effectiveness of this treatment for alopecia areata. Then speak to your doctor or a trichologist to create a treatment plan to restore your hair.

What types of hair loss can a hair transplant treat?

Hair transplants are usually used to restore hair loss following male pattern baldness or female pattern hair loss. These are the most common types of hair loss, and they affect far more people than alopecia areata. So if you don’t have a confirmed diagnosis yet, book an appointment with a hair loss specialist to find out why your hair is falling out.

At the Wimpole Clinic, we diagnose and treat all kinds of hair loss conditions. We’ll create a personalised treatment plan to restore your hair as quickly as possible. Book a free consultation to find out more.

Sources:

1. The epidemiology of alopecia areata: a population-based cohort study in UK primary care
2. Guidelines for the management of alopecia areata
3. Hair transplantation for therapy-resistant alopecia areata of the eyebrows: Is it the right choice?
4. Long-term result of hair transplantation for therapy resistant alopecia areata of eyebrows
5. Artificial Hair: By the Dawn to Automatic Biofibre® Hair Implant