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The Risks of Hair Transplant in Scarring Hair Loss
A permanent, scarring form of hair loss where the immune system attacks and destroys hair follicles, primarily along the front hairline and temples.
Scarring: Destroyed follicles are replaced by smooth, shiny scar tissue. Hair cannot regrow naturally.
Progressive: The hairline slowly but steadily recedes over time.
Autoimmune: An inflammatory condition, not standard genetic baldness.
Mostly affects: Postmenopausal women, but can occur in men and younger women.
FFA is permanent, scarring hair loss. Destroyed follicles will not regrow hair naturally. A scalp biopsy is mandatory to diagnose FFA, as the primary goal is medical treatment to stop progression. Hair transplant during active FFA is strongly contraindicated.
Band-like recession of the frontal hairline, often symmetrical.
Complete or partial loss of eyebrows (a hallmark sign).
Smooth, pale skin where hair once was (no visible pores).
“Lonely hair” sign: Isolated hairs remaining in a bald area.
Loss of body hair (eyelashes, arms, legs) in some cases.
Often symptom-free: No itching or pain, which leads to delayed diagnosis.
FFA is frequently misdiagnosed as a high forehead or female pattern hair loss. Proceeding without a confirmed diagnosis risks irreversible damage.
A scalp biopsy is essential before any treatment plan. It must be taken from the active edge of the hairline to confirm scarring and inflammation.
Undergoing a hair transplant for an undiagnosed, active FFA is one of the most regretful decisions in hair restoration. It can trigger the Koebner phenomenon, where surgical trauma causes new lesions and destroys both existing and transplanted hair.
Our fundamental principle is to preserve your lifetime donor supply. For FFA, this means surgery is strongly contraindicated in nearly all active cases.
Hair transplant is NOT an option if:
The hairline is currently receding.
There is any redness, scaling, or inflammation at the border.
A biopsy shows active immune activity.
You have had new hair loss within the last 2 years.
Transplantation might be discussed only after all these strict conditions are met:
Proven Stability: The disease has been completely inactive for 2-3 years, verified by serial clinical photos and exams.
Clean Biopsy: A recent biopsy from the recipient area shows no active inflammation.
Ongoing Medical Therapy: You are committed to long-term treatment to suppress disease activity.
Realistic Expectations: Understanding that graft survival may be lower and the condition could reactivate.
Even then, it is considered a high-risk procedure with guarded long-term outcomes. Many experts advise against it entirely.
Since lost hair cannot be regrown, the primary goal is to halt the immune attack and preserve existing hair.
Medical treatment focuses on controlling inflammation:
First-Line Therapies: Topical steroids, steroid injections, and oral medications like Hydroxychloroquine or Finasteride/Dutasteride.
Symptom Management: For any associated itching or discomfort.
Long-Term Monitoring: Tracking the hairline with photographs every 6-12 months is crucial.
FFA is permanent, scarring hair loss. Destroyed follicles will not regrow hair naturally.
A scalp biopsy is mandatory to diagnose FFA before any surgical discussion.
Hair transplant during active FFA is strongly contraindicated. It can worsen the disease and lead to graft failure.
The only path to surgery requires 2+ years of medication-induced stability, confirmed by a specialist, and carries significant, long-term risk.
The primary goal is medical treatment to stop progression, not surgical replacement of lost hair.
🔍 Is your hairline receding with eyebrow loss?
FFA must be ruled out immediately. Consult a doctor immediately for a medical review. Your doctor should advise on the critical next steps for diagnosis before any transplant can be responsibly considered.
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
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Our practice adheres to guidelines established by leading international organizations in Hair Restoration.
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.
