Alopecia Areata

Hair Transplant Risks in Autoimmune Hair Loss

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What is Alopecia Areata (AA)?

An autoimmune condition where your immune system attacks your own hair follicles, causing sudden, patchy hair loss.

Not genetic baldness: It’s an internal immune response.
Unpredictable: Patches may regrow on their own, stay the same, or expand. This uncertainty is the core challenge.
“Exclamation mark” hairs: A tell-tale sign—short, broken hairs at the edges of bald patches.

Sara’s Comment

Can you get a hair transplant for Alopecia Areata? Rarely, and only under the strictest conditions. AA is an unpredictable autoimmune condition. Surgery during active disease can trigger more hair loss and destroy transplanted grafts. We decline most AA patients for surgery to prevent long-term regret.

Why Hair Transplant is High-Risk for AA

1. The Koebner Phenomenon:
Surgical trauma (like making sites for grafts) can trigger new AA patches at the injury site. This can destroy both transplanted and surrounding native hair.

2. Transplanted Hair is Not Immune:
Grafts taken from your “safe” donor area are not resistant to the autoimmune attack. They can fall out if the condition becomes active again.

3. Unpredictable Disease Course:
AA can flare after years of stability. A successful transplant today could be lost tomorrow during a relapse.

Our "No Regret" Candidacy Criteria (Extremely Strict)

We may only consider surgery if ALL of the following are true:

Complete Stability: No new patches or expansion for at least 2 years.
Medical Proof: A scalp biopsy confirms no active inflammation.
Failed Medical Therapy: Standard treatments (like steroid injections) have been tried without success in regrowing the specific bald patch.
Realistic Expectations: You fully understand that AA is lifelong and grafts could still be lost to a future flare-up.

Medical Management: The First and Best Path

For the vast majority, non-surgical treatment is the correct approach. Options include:

Corticosteroid Injections: The first-line treatment to suppress inflammation in patches.
Topical Immunotherapy: Medications to modulate the local immune response.
JAK Inhibitors: Newer oral medications for severe, widespread AA.
The goal is to control the immune system, not just to replace lost hair.

Frequently Asked Questions

Q: My AA patch has been stable for 1 year. Can I get a transplant?
A: No. We require minimum 2 years of documented stability to even begin the assessment, as relapses are very common within this period.

Q: Will a transplant “cure” my AA in that spot?
A: No. A transplant does not change your underlying autoimmune condition. It only surgically replaces hair in a specific scarred area.

Q: What if I just want to fix one small, old patch?
A: Even a single, old patch requires the same rigorous proof of long-term stability. The risk of reactivation is never zero.

Key Takeaways

Alopecia Areata is an autoimmune disease, not standard hair loss. Surgical solutions carry unique, high risks.
The Koebner phenomenon means surgery can worsen AA, causing loss of grafts and native hair.
Hair transplant is almost never appropriate during active or recently active AA. A minimum 2-year stability period is mandatory for consideration.
Medical management is the primary treatment path. Successful control of the immune response is the foundation of any long-term plan.
Our clinic declines most AA patients for surgery. Our “No Regret” ethic prioritizes protecting you from poor outcomes over performing a procedure.

🔍 Do you have a stable AA patch you wish to evaluate?

The first step is confirming true, long-term stability. Send details and photos of your patch for a free preliminary medical review. We will provide honest guidance on whether you meet the exceptional criteria for a surgical consultation.

MEDICAL - DISCLAIMERS

Images & Information shown are for reference only

Information on this website is provided for general educational purposes only and does not constitute personalized medical advice. It is not intended to promote our service or imply superiority over another.

Individual results in hair restoration vary significantly and no outcome can be guaranteed. The before-and-after images shown represent possible results — not promises. We recommend seeking independent medical advice to discuss your options … Read More

Pre-Consultation Review

Ensure You're a Good Candidate for FUE hair transplant

Why pay for a consultation if you’re not a candidate? Start with our free WhatsApp assessment — the first step in our ‘No-Regret’ protocol to see if hair transplant is a realistic solution for your hair loss.

Still Have Questions ?

If you want to get a personalized answer from our medical team, you can reach us using this form here. We will cantact you as soon as possible.

Our ‘No Regret’ Safety & Precision Protocol

At Dr. Bertram Hair Transplant, we only offer what aligns with natural results, minimal risk, and realistic expectations. Since 2009, our FUE protocols are in strict accordance with evidence-based guidelines from ISHRS and WFI. Every procedure is internally audited against ABHRS surgical benchmarks.

ISHRS

International Society of Hair Restoration Surgery is the leading global medical association that establishes international practice standards and patient safety protocols.

ABHRS

The American Board of Hair restoration Surgery represents the highest standard. To maintain rigorous certification requirements the physician must demonstrate surgical expertise.

WFI

Worls FUE InstituteI serves as the premier educational body focused exclusively on Follicular Unit Extraction methodology. The institute ensures consistent application of safe FUE.