Dr Bonaros is often asked, “Can anyone get a hair transplant?” Unfortunately, the answer is no. Despite medical advancements, not everyone suffering from hair loss is a good hair transplant candidate.
If you are considering this procedure, it is essential to educate yourself about who is eligible for a hair transplant.
Reviewed by Dr Epameinondas Bonaros
Determining if you are a good candidate for a hair transplant procedure depends on several factors. These are always considered in conjunction with one another. While a patient might have a low density of hair follicles in the donor areas, other favourable characteristics can offset this disadvantage.
Here are some key factors Dr Bonaros will consider during your consultation to determine if you are a good candidate for hair transplant surgery.
Before undergoing a hair transplant, it is crucial to determine the underlying cause of your hair loss. There are many possible causes of hair loss, and not all of them can or should be treated with hair transplantation.
Male and female pattern hair loss is the primary indication for hair restoration surgery. Other common examples include:
Please note that only licensed physicians and trichologists should perform the diagnostic evaluation and consultation of patients presenting with hair loss.
In men, the diagnosis of androgenetic alopecia is generally straightforward. It is based upon the characteristic pattern of associated hair loss, as well as signs present in trichoscopy. If these signs are absent, further examination may be necessary.
When it comes to women, determining the exact cause of hair loss can be more difficult. In some cases, an underlying condition such as hypothyroidism may have to be treated before the patient can undergo hair transplant surgery.
Male and female pattern baldness usually affects hair follicles on the front and top of the head. Those on the sides and back of the head remain largely unaffected and may be transplanted successfully to thinning areas.
Diffuse Unpatterned Alopecia (DUPA) is a relatively uncommon condition, affecting only 2–6% of men with hair loss. Unlike with androgenetic alopecia, DUPA lacks a stable donor zone considered safe for surgical transplantation.
With DUPA, hair thinning takes place along the front, top, back and sides of the scalp, and the majority of hairs are or will eventually become miniaturised. Hair transplantation, therefore, is not a viable treatment option.
A hair transplant performed on a patient with DUPA may look good for a few years, but the transplanted hairs are likely to thin out over time. In addition, existing hair in the donor area may appear severely depleted. Keeping this in mind, it is best to manage DUPA with non-surgical medical treatment options like minoxidil, finasteride, and low-level laser therapy.
Hair transplantation is generally not recommended for patients with DUPA or Alopecia areata
Alopecia areata, also known as spot baldness, is an autoimmune condition in which hair loss occurs in some or all areas of the body. It can cause bald patches on the scalp, each about the size of a penny. Generally, patients with alopecia areata are not candidates for hair transplantation.
Hair transplantation can be considered if the affected area is small, has remained unchanged for several years, and a scalp biopsy shows no evidence of inflammation below the scalp. However, this would require a very detailed discussion with an expert physician. Additionally, patients need to be aware of and accept the risk that the transplanted hair is susceptible to falling out again at any time.
Scarring alopecia, otherwise known as cicatricial alopecia, is a condition most common in women between 30 and 50 years of age. It refers to irreversible inflammatory follicular damage — the immune system permanently damages hair follicles’ stem cells, resulting in scarring and hair loss.
Primary scarring alopecias include:
Lichen planopilaris and frontal fibrosing alopecia patients are not ideal candidates for hair transplant surgery
Hair transplantation is not recommended for patients with active cicatricial alopecia. Not only is the risk of failure high – graft survival rates are usually less than 50% – but the procedure can also exacerbate the condition.
Before considering surgical hair restoration, patients with inactive scarring alopecias must undergo an evaluation by a hair transplant surgeon. This will help determine if they are a suitable candidate for an FUE hair transplant.
While there are no age restrictions for hair transplants, an ideal candidate is over 25 years old.
According to the ISHRS 2017 practice consensus, the majority of male hair transplant patients were aged 30–39. There is no upper age limit for a hair transplant procedure. As long as a patient is healthy, they can undergo a minimally invasive FUE hair transplant.
In order to be a good candidate for a hair transplant, you need to be in good general health. This will help you recover quickly and prevent complications.
Although hair transplantation is a simple procedure, there are a few contraindications for the surgery. These include:
Patients with contraindications to hair transplant surgery may experience poor hair growth and other suboptimal results. In some cases, they may even experience worse hair density due to a flare-up of an underlying hair disease.
Other contraindications include:
Recent childbirth is another contraindication to hair transplantation. Approximately 90% of new mothers suffer some degree of temporary hair loss between three and six months after giving birth. While hair transplants are a safe, proven, and effective method of treating hair loss in women, the procedure should not be undertaken for at least a year postpartum.
Patients with body dysmorphic disorder (BDD) are excessively preoccupied with non-existent or minimal appearance flaws involving several parts of their bodies. While hair loss is their second most common concern, BDD patients will usually present with trivial defects that are not even apparent to hair loss experts. Patients with BDD are at a high risk of being dissatisfied with transplant results, seeking ever-more corrective surgeries.
Trichotillomania is also a contraindication to hair loss surgery. This obsessive-compulsive disorder involves incessant hair pulling and plucking. Before undergoing treatment for their hair loss, patients with trichotillomania should seek psychological support.
Before undergoing hair transplant surgery, it is crucial to ensure that your surgeon is fully aware of any medication you take and any long-term health conditions you have.
Several medications, including immunosuppressants, can affect your hair growth. Others, such as antiplatelet and anticoagulation medications, should be stopped before surgery to reduce your risk of bleeding.
The stability of your hair loss is always assessed during your initial consultation with Dr Bonaros. It is safe to proceed with surgery if your hair loss has not changed or accelerated recently, and if the recipient area has not undergone extensive miniaturisation.
Hair calibre, hair colour, and hair texture are three important cosmetic features for transplant patients.
In general, patients with thicker hair should be able to achieve better results than those with thinner hair. This is because balding appears when light penetrates past the hair and is reflected off the scalp.
Patients with high donor hair density are generally good candidates for hair transplantation.
For example:
At our Glasgow hair loss clinic, we ensure patients understand the potential limitations of hair restoration surgery and set realistic expectations.
During your consultation, Dr Bonaros will explain the exact hair transplant procedure, as well as the timelines for healing and hair growth and the results you can expect.
Based at his established hair loss clinic in Glasgow, Dr Bonaros is a leading hair restoration specialist. Not only is he a full member of the British Association of Hair Restoration Surgery (BAHRS), but he is also Scotland’s only full member of the International Society of Hair Restoration (ISHRS).
When you choose our clinic, you can rest assured that you will receive compassionate and professional care. Dr Bonaros offers various hair loss solutions, including FUE transplants. During your consultation, he will provide you with tailored treatment plans to address your unique situation and concerns.
If you are experiencing hair loss, schedule a consultation with Dr Bonaros to discuss your options, including whether you are a good candidate for hair transplant surgery.
Can Women Have Hair Transplants? Hair loss can be a distressing experience; no gender is spared. However, while hair transplantation is commonly associated with male pattern baldness and receding hairlines, women also take great care to consider hair restoration treatments. So, can women have hair transplants? Read further as we
Dr Bonaros is committed to providing the best possible guidance and care for patients suffering from hair loss.
Male pattern hair loss, also known as androgenetic alopecia (AGA), is one of the most common conditions affecting men.
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