Hair Transplant in Secondary Cicatricial Alopecia: Overcoming Hair Loss From Scarring

Discover how hair transplant in secondary cicatricial alopecia restores hair growth on scarred areas. Learn techniques, benefits, and success factors.

Hair transplant in Secondary Cicatricial Alopecia is a viable solution for patients experiencing permanent hair loss caused by scarring. This condition occurs when inflammation leads to the permanent destruction of hair follicles, replaced by scar tissue, making natural hair regrowth impossible without intervention.

However, with the right approach, hair transplant techniques can help restore hair in affected areas.

In this article, we will explore how hair transplant in secondary cicatricial alopecia can provide hope and improved outcomes for those seeking to regain their hair and confidence.

What is Secondary Cicatricial Alopecia?

Secondary Cicatricial Alopecia, also known as scarring alopecia, differs significantly from Primary Cicatricial Alopecia (PCA) in terms of its causes and implications for treatment.

While PCA is typically caused by inflammatory or autoimmune conditions directly targeting hair follicles, secondary cicatricial alopecia arises from external factors such as trauma, infections, or medical treatments.

In cases of secondary cicatricial alopecia, the destruction of hair follicles is secondary to a known external cause, leading to permanent hair loss in the affected area. Unlike primary cicatricial alopecia, where the inflammatory process directly destroys the follicle, secondary scarring often occurs as a consequence of an external event or condition that damages the scalp and results in scarring

Causes and Types of Secondary Cicatricial Alopecia

There are numerous causes of secondary cicatricial alopecia, which can vary widely in their origin and impact on the scalp. Unlike primary scarring alopecia, where the inflammatory process directly destroys hair follicles, secondary scarring often results from physical damage or medical conditions that disrupt the scalp’s structure.

Causes of Secondary Cicatricial Alopecia

The most common causes of secondary cicatricial alopecia include:

Physical Trauma: Injuries from accidents, surgeries, or burns can lead to permanent follicle destruction. This type of damage can cause scarring that significantly reduces hair density in the affected area. Trauma-related hair loss can also occur when lacerations or deep wounds disrupt the hair follicles and their surrounding structures, making natural regrowth unlikely without intervention.
Infections: Scalp infections such as folliculitis, cellulitis, or deep fungal infections can scar the follicles, resulting in permanent hair loss. These infections may cause inflammation severe enough to destroy the hair follicle completely, leaving behind fibrous scar tissue that inhibits future hair growth.
Medical Conditions: Conditions like lupus erythematosus or scleroderma may result in secondary scarring. These autoimmune diseases can trigger chronic inflammation and tissue damage, leading to hair loss that becomes permanent as scar tissue replaces the follicles.
Radiation Therapy: Patients undergoing radiation treatment, especially on the scalp, may develop permanent hair loss. Radiation can damage the hair follicles and surrounding skin structures, leading to cicatricial changes that make natural hair regrowth impossible.
Chemical Burns: Harsh chemicals, including those in hair treatments or accidents involving caustic substances, can cause severe scalp damage. This type of trauma often results in the destruction of follicles and permanent hair loss, necessitating surgical restoration through hair transplantation.

Types of Secondary Cicatricial Alopecia

Understanding the type of alopecia helps in planning effective treatments. Common types include:

Alopecia Areata: Although primarily non-scarring, severe cases of Alopecia Areata with inflammation can cause permanent loss when inflammation damages the follicles beyond repair.
Telogen Effluvium: Often stress-induced or resulting from systemic illness, this condition can transition to permanent loss if the underlying cause is severe and prolonged, damaging the hair follicles irreversibly.
Trauma-Induced Scarring Alopecia: Accidents or surgeries leaving deep scars can result in permanent follicle loss, making hair transplantation the primary option for restoration.

Diagnosing Secondary Cicatricial Alopecia Before a Hair Transplant

Accurate diagnosis is crucial before a hair transplant for secondary cicatricial alopecia. Diagnosis typically involves:

Medical History and Physical Examination: Evaluating past traumas, infections, or medical treatments. An in-depth understanding of the patient’s history helps identify the underlying causes and predict the transplant’s success.
Scalp Biopsy: Essential for identifying scarring patterns and determining the viability of a hair transplant. The biopsy provides insights into the extent of follicle damage and whether transplantation is feasible.
Dermatoscopy: Helps to assess follicular integrity and the presence of inflammatory markers. This tool aids in differentiating between active inflammation and stabilized scarring, guiding the transplant strategy.
Stabilizing the Condition: Stabilization is paramount to prevent graft failure. Treating underlying conditions, reducing inflammation, and ensuring scalp health are crucial steps before surgery. This may involve topical treatments, medications, or lifestyle changes aimed at minimizing inflammation and maintaining optimal scalp conditions.

Hair Transplants as a Solution for Secondary Cicatricial Alopecia

Hair transplant in secondary cicatricial alopecia can significantly improve aesthetic outcomes and patient confidence. However, the presence of scar tissue poses challenges to graft survival and blood supply.

Advantages of Hair Transplantation for Secondary Cicatricial Alopecia

Permanent Solution: Successful transplants offer a lasting result that helps patients regain their appearance and self-esteem.
Improved Aesthetics: Restores hair in scarred areas, giving a natural look that blends seamlessly with surrounding hair.
Tailored Approach: Techniques like FUE and DHI can be adapted to minimize trauma and enhance graft survival rates.

Best Techniques for Hair Transplant in Secondary Cicatricial Alopecia

Choosing the right technique is essential due to the altered scalp tissue. Follicular Unit Extraction (FUE) is often preferred due to its precision and minimal scarring. It involves extracting individual follicles and implanting them into scar tissue after adequate preparation, maximizing the chances of successful graft take.

Factors Affecting Eligibility for Hair Transplant in Secondary Scarring Alopecia

Extent of Scarring: The size and severity of the scar tissue in the affected area will influence the possibility of a successful hair transplant. Larger or more severe scarring may limit hair restoration options.
Donor Hair Quality: The density and quality of the donor hair, usually from the back or sides of the scalp, play a critical role in determining if a hair transplant is feasible. Insufficient donor hair may restrict the number of grafts available.
Health of the Patient: Overall health, including the absence of underlying medical conditions, is essential for a successful hair transplant. Conditions like active infections or autoimmune diseases can hinder eligibility.
Scar Tissue Condition: The texture and quality of the scar tissue itself can impact the viability of transplanting hair. Healthy skin and tissue are necessary for graft survival.
Treatment History: Previous treatments, such as medications or other interventions, may affect the healing ability of the scalp and influence whether a hair transplant is suitable.
Disease Activity: If the underlying condition causing secondary cicatricial alopecia is still active, a hair transplant should be avoided. Active inflammation or scarring can disrupt graft survival and healing. It’s essential to ensure that the disease is in remission before proceeding with surgery. This typically requires a period of stability, usually 1year, to ensure the area is free of active inflammation.

Challenges and Considerations for Hair Transplant in Secondary Cicatricial Alopecia

Despite its potential benefits, hair transplant in secondary cicatricial alopecia presents several challenges:

Scar Tissue Vascularity: Reduced blood flow can affect graft survival, requiring specialized techniques to improve circulation.
Active Inflammation: Persistent inflammation must be controlled before transplantation to ensure graft stability.
High Technical Demand: Advanced skills are needed to navigate scar tissue without further trauma.
Post-Surgery Care for Secondary Alopecia Patients: Proper aftercare is vital to maximize graft survival and healing.

Choosing the right hair transplant clinic is essential when dealing with secondary scarring alopecia, as not all clinics have the expertise to handle such complex cases. Most hair mills, where procedures are performed by technicians with no real medical background,lack the necessary experience and knowledge to address the unique challenges posed by cicatricial alopecia.

Improper techniques or inadequate planning can lead to further scarring and irreversible damage to the scalp. To ensure the best hair transplant results and minimize risks, it is essential to select a reputable clinic where qualified medical professionals with extensive experience in scarring alopecia perform the procedure.

At Civas&Akpınar Hair Transplant Turkey, our expert dermatologists carefully evaluate each case and use advanced techniques to achieve safe and natural-looking outcomes, prioritizing patient safety and satisfaction.

Dr. Civas’ Contributions to Hair Transplantation Research in Secondary Cicatricial Alopecia

Following his work with patients suffering from primary cicatricial alopecia, Dr. Civas initiated another significant study in 2019, this time focusing on 45 patients with secondary cicatricial alopecia. The main objective of this research was to assess the outcomes of utilizing hair transplant surgery as a treatment method for patients with secondary cicatricial alopecia

For a more comprehensive understanding of this research study, please click here.

Hair transplant in secondary cicatricial alopecia offers hope to patients struggling with hair loss from scarring. By utilizing advanced techniques and thorough pre-surgical assessment, specialists can achieve successful outcomes. At Civas&Akpınar Hair Transplant Clinic in Turkey, our expert dermatologists have extensive experience in handling complex alopecia cases, ensuring personalized solutions and long-lasting results.

Secondary Scarring Alopecia