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Is a Hair Transplant a Viable Solution for Autoimmune Hair Loss?
Last Updated: 6 Nov 2025
Alopecia Areata is not just hair loss — it’s an autoimmune condition where the body’s immune system mistakenly targets its own hair follicles, often causing sudden, patchy baldness. What makes it especially distressing is its unpredictability : Will the hair grow back? Will it spread? Could it return after years of stability?
At Dr. Bertram Hair Transplant, we devote only to surgical restoration — but our first responsibility is truthful guidance. For most patients with Alopecia Areata, a hair transplant is not the answer. In fact, it can do more harm than good.
This guide reflects our “No Regret” standard: we would rather say “no” today than watch you face regret tomorrow. If surgery is ever considered, it’s only under the strictest, evidence-based criteria — and always with full transparency about the risks.
In Alopecia Areata, T-lymphocytes (a type of immune cell) attack hair follicles during their active growth phase (anagen), triggering inflammation and forcing them into premature rest ( telogen ). This is why you may see short, tapered “exclamation mark” hairs at the edges of active patches — a classic clinical sign.
The condition isn’t static. It can evolve, regress, or relapse — sometimes decades later — making long-term predictability nearly impossible.
Not all Alopecia Areata is the same. Prognosis and management vary significantly by pattern:
At our clinic, we assess not just what you see today — but what your pattern suggests about your long-term trajectory.
Accurate diagnosis is non-negotiable. Our evaluation goes beyond a visual check:
This thorough workup ensures we never confuse stable scarring with dormant Alopecia Areata — a critical distinction before even discussing surgery.
For the vast majority of patients, medical therapy — not surgery — is the appropriate path. Treatment focuses on calming the immune response:
Let us be unequivocal: Dr. Bertram Hair Transplant declines the overwhelming majority of Alopecia Areata cases for surgery — and that is by design.
Hair follicles contain stem cells, particularly in the bulge region, which play roles not only in hair regeneration but also in modulating local immune responses. This has led some researchers to explore whether transplanted follicles could influence the microenvironment in alopecia areata (AA). However, despite this theoretical potential, hair transplantation is generally not recommended for active or unstable alopecia areata.
In AA the underlying inflammation can affect any hair follicle in the scalp (or body), including newly transplanted ones. Transplanted hairs are not immune to autoimmune attack.
One of the greatest risks is the Koebner response—where skin trauma (like graft insertion) triggers new autoimmune lesions at the injury site. This means a transplant could cause:
In other words, the procedure itself may worsen your condition.
Based on a 2025 internal review of our patient outcomes, we only consider transplantation in exceptionally rare cases — and only after passing all of the following non-negotiable steps:
Even then, we have a candid conversation: Alopecia Areata is lifelong and high risk of recurrence, even years later. A “No Regret” decision means you fully accept this uncertainty before moving forward.
For nearly all patients with Alopecia Areata, hair transplantation is not a solution — it’s a significant risk. The responsible path lies in expert medical management, close monitoring, and patience.
At Dr. Bertram Hair Transplant, we measure our expertise not by how many procedures we perform — but by how wisely we choose not to.
Because true “No Regret” care means protecting your hair — and your hope — for the long term.
conditions of use
Information provided on this website is for educational purposes only and is not intended as medical advice. It should not be interpreted as promotional material or as claims of superiority over other techniques or providers.
Individual results may vary, and no outcome can be guaranteed. Always consult with a qualified healthcare professional before making any decisions about medical treatment.
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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.
International Society of Hair Restoration Surgery is the leading global medical association that establishes international practice standards and patient safety protocols.
The American Board of Hair restoration Surgery represents the highest standard. To maintain rigorous certification requirements the physician must demonstrate surgical expertise.
Worls FUE InstituteI serves as the premier educational body focused exclusively on Follicular Unit Extraction methodology. The institute ensures consistent application of safe FUE.
