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- Presentation
Hair Transplant in Scarring Alopecia: When and How
Description
The presentation covers hair transplantation in cases of scarring alopecia, particularly focusing on Frontal Fibrosing Alopecia (FFA), which is of significant cosmetic concern for patients. The speaker emphasizes that hair transplantation should only be conducted when the condition is in a stable, inactive state, typically confirmed after 2-5 years of monitoring. Key indicators for suitability include the absence of inflammation and stable conditions in both the affected and donor areas. It is noted that detailed histopathological analysis is necessary, as patients may present with non-visible inflammation. The speaker also discusses the importance of patient selection, utilizing regenerative methods like PRP and fat transfer to enhance blood supply before transplantation, and mentions various hair transplantation techniques. For cases of secondary scarring alopecia, adjunctive treatments like fractional CO2 laser therapy can improve scar texture and vascularization prior to surgery. The overall message is that careful assessment of the patient’s condition, combined with proper treatment techniques, can lead to successful hair transplantation outcomes.
View moreConclusions
- Hair transplantation in scarring alopecia, particularly frontal fibrosing alopecia (FFA), should only be performed in patients with stable, inactive disease.
- Evidence of inactive disease must be confirmed through clinical evaluation, dermoscopy, and histopathology over a period of 2-5 years.
- Transplanted hair can remain viable for years, as shown in long-term follow-up cases, but patients must be informed about the potential for disease recurrence.
- Regenerative techniques such as PRP and tissue suspension are beneficial before transplantation to enhance success rates.
- Hair transplant candidates include those with linear or pseudo-fringe-sign patterns of FFA, while those with diffuse patterns and concomitant conditions should be avoided due to risks of further hair loss.
- Laser therapies can improve scarring texture and vascularity, which can enhance the success of hair grafts in secondary scarring alopecia cases.
- Histopathological evaluations reveal significant findings in both lesional and non-lesional areas, indicating that FFA can affect broader areas than visibly apparent.
- Kittipong Wantavornprasert MD, Jade Wititsuwannakul MD, Ratchathorn Panchaprateep MD PhD. Involvement of Non-Lesional Occipital Areas in Frontal Fibrosing Alopecia: A Clinical, Histopathological and Trichoscopic Study.
- Ratchathorn Panchaprateep, MD, PhD. Hair Transplant in scaring alopecia: when and how.