Can You Have a Hair Transplant for Alopecia Areata?'

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Name: Manon

Question: I have no hair on my head from Alopecia Areata. Can I get a hair transplant? Will this correct it?

Answer: Hi, Manon. The hair loss you describe suggests you have one of the more extensive Alopecia Areata phenotypes, all thought to be caused by an autoimmune disorder.

Alopecia Areata causes patchy hair loss which, whilst it may be widespread across the entire scalp, does not lead to total baldness. Both Alopecia Totalis and Alopecia Universalis, however, do lead to a bald scalp. In the case of Alopecia Totalis facial hair, including brows and lashes, may also be lost, whilst Alopecia Universalis causes the entire head and body to become hairless.

In order to have a hair transplant it is necessary to have donor hair follicles; these should be of good quality, capable of normal healthy hair growth and they should be available in sufficient quantity to fill the required recipient site.

The problem with hair restoration surgery for any form of Alopecia Areata, but particularly the more severe forms, is the lack of properly functioning hair follicles to act as donors. Although some highly-specialised surgeons may use body hair as donor follicles where scalp follicles are unsuitable or missing, this is a novel and far from widespread approach, and therefore one which you would need to seek advice on directly from a reputable practitioner. Given chest hair is typically used, it is also not likely to be viable for women or those with hairless chests.

Due to the loss of body hair, in cases of Alopecia Universalis this would not be an option, however, in any patient with these kinds of autoimmune-related hair loss, the procedure is unlikely to produce satisfactory results. The reason for this is the volatility of these conditions. Especially where the scalp-only mild-to-moderate phenotype is concerned, Alopecia Areata hair regrowth may spontaneously resume, though bald spots may reappear at a later date and may present anywhere on the scalp - not necessarily in the same position each time. If or when this may happen cannot be predicted and the chance of natural hair growth re-starting lessens in line with the severity of the form of Alopecia experienced.

For these reasons in particular, we consider a hair transplant for Alopecia Areata to be inadvisable regardless of the particular phenotype. However, there are alternative, non-surgical hair loss solutions which may be worth exploring via your GP; they can also update you on the treatments currently in development - the first of which are expected to be released by 2022 - to treat Alopecia Totalis and Universalis.

Although Belgravia clinics offer Alopecia Areata treatment, this is for adults with the scalp-only phenotype and is not suitable for those with the more extensive forms.

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