A number of hair replacement procedures–including micro-grafting, slit grafting, punch grafting, and scalp reduction–are available to treat permanent hair loss. Find out who qualifies as a candidate.
Hair loss, or alopecia, is very common. Many conditions can cause it. Hair loss is divided into 2 categories:
The vast majority of hair loss is nonscarring. It includes such conditions as pattern baldness and telogen effluvium, or excessive hair shedding.
The majority of hair loss in both men and women is pattern baldness, also referred to as androgenetic alopecia. Both genetic (family) and hormonal factors play a role in pattern baldness.
Another common cause of hair loss is excessive hair shedding. Common triggers for hair shedding include a major illness, surgery, rapid weight loss, nutritional deficiency, thyroid problems, stress, and certain medications.
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Hair replacement is not recommended for the following patients:
Therapies for hair loss include:
The type of hair loss, as well as the patient’s circumstances and desires, determine which hair replacement procedures are most suitable.
Grafting is an outpatient procedure performed in the dermatologic surgeon’s office. Micro-grafts contain only 1 to 2 hairs per graft, while slit grafts contain between 4 and 10, and punch grafts hold 10 to 15 hairs. A local anesthetic is injected into the scalp and sedation is available, if needed, for relaxation and comfort.
The dermatologic surgeon first removes a disc-shaped portion of the hair-bearing scalp from the back of the head. Then, the surgeon cuts the removed scalp into small segments with varying amounts of hair in each graft to achieve a very subtle thickening and "natural" look with this technique.
With each session, 100 to 1,000 hair-bearing segments are transplanted. "Donor" sites are closed with stitches, which usually are then concealed by the surrounding hair. After the grafting session is complete, the scalp is cleaned and covered with gauze and, if necessary, a bandage. Stitches will be removed approximately 10 days later.
Three to four sessions may be needed to achieve satisfactory "fullness." After each session, a healing process of 2 to 4 months is usually recommended prior to the next procedure.
A scalp reduction is the removal of non-hair-bearing skin from the scalp so that the remaining hair-bearing skin can be stretched to fill in the bald area of the head. Scalp reduction can reduce as much as half of the bald area. It is a procedure performed to cover bald areas on the top and back of the head and is not found to be beneficial for the frontal hairline.
The scalp is injected with local anesthetic and a bald segment of scalp is removed. The surrounding skin is then loosened and gently stretched so that the sections of hair-bearing scalp are brought together and closed with stitches. This procedure may also be performed during punch grafting sessions.
Most side effects that come with a hair transplant usually go away within 1 to 3 weeks. Among the most common side effects are:
Last reviewed by a Cleveland Clinic medical professional on 05/10/2016.
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