Can you have a hair transplant if you have diabetes, high blood pressure or hepatitis?

Can you have a hair transplant if you have a chronic illness?

Diabetes, high blood pressure (hypertension) or hepatitis is not, on its own, a definite obstacle to a hair transplant. What matters is that your condition is under control and that, where necessary, we get the opinion of the doctor who treats you. That is why we look less at the name of the condition and more at whether it is monitored regularly, how it responds to treatment and whether it affects your other organs.

A hair transplant is a surgical procedure performed under local anesthesia (only the area being treated is numbed). Grafts (small pieces of tissue carrying one or more hair roots) are taken from the donor area at the back and sides of the head and placed in small channels opened in the thinning area. This creates many small wounds in both areas. Whether these wounds bleed only a little during the procedure and close well afterward depends on how well your blood clots, on the blood supply to the tissue and on your immune system. Chronic illnesses can also affect these.

If the condition is not under control, we may postpone the transplant until your health allows it; sometimes a hair transplant may not be the right option for you. We explain the general suitability criteria in our article on who should not have a hair transplant.

How does diabetes affect a hair transplant?

When blood sugar stays high for a long time, small blood vessels and nerves can be damaged, and the white blood cells that fight germs may not work as well. That is why, in people whose diabetes is not well controlled, surgical wounds may take longer to heal and wound infections may be more common. When blood sugar is kept stable, this likelihood is lower.

Most of what is known about this comes from other surgical procedures; research specific to hair transplants is limited. If you have diabetes, we go over the following with you before the procedure:

• Your recent readings: We look at your blood sugar readings and, if necessary, an HbA1c test (a test that reflects your average blood sugar over the past few months).
• Medicines and meals: If you use insulin or diabetes medicine, we plan your meal and medicine times for the day of the procedure in advance. Do not change the dose or timing on your own.
• Medicines that may be used during the procedure: Cortisone-like medicines, which may be used to reduce swelling, can temporarily raise blood sugar. Knowing that you have diabetes also affects which medicines we choose.
• During the procedure: If you notice signs of low blood sugar such as shaking, sweating or dizziness, or if you do not feel well, tell the team straight away.

Why do high blood pressure and heart disease matter?

When your blood pressure is high, small wounds can bleed more. In a hair transplant, this can mean more bleeding during the procedure, an area that is harder to see while we work, and bleeding that goes on longer after the procedure. For many people whose blood pressure is kept stable with medication, a transplant can be planned; even then, the decision is made during the examination.

To reduce bleeding, a substance that narrows blood vessels, such as adrenaline, is usually added to the local anesthetic. Adrenaline can briefly speed up your heartbeat and raise your blood pressure. If you have a condition such as a heart rhythm disorder, coronary artery disease or heart failure, we may ask for a cardiologist’s opinion.

Your blood pressure is measured on the day of the procedure. Anxiety and nervousness can also raise blood pressure temporarily; if your blood pressure does not come down to a safe level, we may recommend postponing the procedure. Do not stop taking your blood pressure medicine on your own; we discuss in advance how you should take it on the day of the procedure.

If you take a blood thinner, be sure to tell us, and do not stop taking it on your own. These medicines are often prescribed to protect you from serious clot-related problems; whether to pause one is decided by the doctor who prescribed it. We cover what to do about your medicines before the procedure in our article on preparing for a hair transplant.

What changes if you have hepatitis B, hepatitis C or HIV?

From a medical point of view, these blood-borne infections are not, on their own, considered a definite obstacle either; the real question is how the infection affects your health.

The liver produces most of the substances that allow blood to clot, and the medicines commonly used for local anesthesia are also broken down largely in the liver. If liver disease is advanced, the tendency to bleed may increase and the body may clear these medicines more slowly. If liver inflammation has only recently started, the procedure may also need to be postponed. That is why we look at your liver and clotting test results and, if necessary, ask for the opinion of the doctor who monitors your hepatitis.

With HIV infection, what matters is how well treatment is suppressing the virus and the state of your immune system. Some of the medicines used for these infections can interact with medicines that may be used during the procedure, so please bring a complete list of your medicines.

Measures such as single-use materials, sterilization of instruments, gloves and protective equipment are standard rules that must be followed with every patient, even when it is not known who carries an infection. We would still like to know about your situation; we do not ask in order to judge you, but so that we can assess your health properly and make a safe plan.

You are also welcome to ask us how instruments are sterilized and which materials are single-use. We have gathered other questions you can ask when choosing a clinic in our article on questions to ask when choosing a clinic.

What other conditions should you tell us about in advance?

Other conditions can also affect the plan. Be sure to mention the following during the examination:

• A tendency to bleed, a clotting disorder or a blood disease
• All the medicines you take, including blood thinners, pain relievers, herbal products and supplements
• Kidney or thyroid disease
• Cancer treatment, medicines taken after an organ transplant, or immune-suppressing medicines such as cortisone that you have taken for a long time
• An allergy to local anesthetics or other medicines
• A skin problem on the scalp, such as psoriasis, eczema or an infection
• Problems with wound healing after previous operations, or thick, raised scars (for example, keloids)

How do we use the examination and tests to decide?

During the examination, we ask how long you have known about your condition, which medicines you take and what your recent readings are. If you have test results, a list of your medicines or a report from your doctor, bring them with you. You do not need to write your health information in the hair analysis form; we discuss it during the examination.

If necessary, we ask for blood tests before the procedure. Which tests we ask for varies from person to person; they may include a blood count, clotting tests, blood sugar, liver and kidney values, and screening for hepatitis B, hepatitis C and HIV.

Which values count as acceptable varies with the person and with the course of the condition, so we do not give a cut-off value here. The doctor makes the decision by looking at your examination findings and test results as a whole. The outcome may be to plan the transplant, to postpone it until your health has stabilized, or to suggest a different approach.

If you notice increasing pain, redness or swelling, discharge, a fever or bleeding that does not stop after the procedure, contact us without waiting for your follow-up appointment; we also list these signs on our hair transplant aftercare page. If your blood sugar or blood pressure rises unusually high, let the doctor who treats you know as well. In an emergency, or if you cannot reach us, go to the nearest healthcare facility without delay.

Whether you are suitable for a hair transplant is determined during the examination; the healing process and results also vary from person to person. The written aftercare instructions we give you after the procedure take priority over the general information here. If you have any questions, you can write to us through our contact page.