Hair transplant into scars

What is a hair transplant into scars?

Hair often does not grow in scars left by an accident, a burn, surgery or a previous hair transplant, because the hair follicles in that area are damaged as the scar forms. In a hair transplant into scars, we take grafts one by one from the donor area using the FUE method and place them into the scar tissue.

Our aim is to cover the scar or make it less noticeable. A transplant does not remove the scar itself.

Which areas do we work on?

• Scalp: scars from surgery, accidents or burns; a strip scar from a previous hair transplant, or a donor area that has become sparse because too many grafts were taken.
• Eyebrows: scars that split an eyebrow or leave a gap in it. We describe eyebrow transplants separately on the eyebrow transplant page.
• Beard and mustache: areas where no hair grows because of scars from wounds, burns or acne. You can find the details on the beard transplant page.

In the eyebrows, beard and mustache, we work mainly with single-hair grafts. In these areas, the direction and angle of the hairs are especially important for how the area looks.

Why is scar tissue different?

Scar tissue does not behave like healthy skin: its blood supply is usually weaker, and the tissue may be firmer or thinner. Whether grafts take hold and grow depends largely on this blood supply. That is why hair growth in scar tissue is less predictable than in a transplant into healthy skin.

We plan with this in mind: so as not to strain the blood supply of the tissue, we usually place the grafts less densely in scar tissue.

Which scars may be suitable?

For a transplant, the scar needs to be mature: a scar that has faded in color, softened and is no longer changing. If the scar is new, still red or still changing, we recommend that you wait.

The cause of the scar matters too. Scarring hair loss (cicatricial alopecia) occurs not only after accidents, burns or surgery, but also in some hair and skin diseases that damage the hair follicles. If such a disease is involved, we can only discuss a transplant once a diagnosis has been made and the disease has stayed inactive for a long time; an assessment by a dermatologist may also be needed for this. If the disease is active, we do not plan a transplant.

Situations in which it may not be suitable

• If the scar is new or still changing
• If the disease that caused the scar is active, or the cause of the scar is not clear
• If the blood supply to the scar tissue is poor, or the tissue is very firm or very thin
• If there is not enough hair in the donor area, or the scar is larger than the donor area can cover
• If there is a large gap between your expectations and the result that is possible

For some scars, another treatment or surgical revision of the scar may be the better option; if so, we will tell you. Whether a transplant is suitable for your scar becomes clear during the examination.

Why might a test session be needed?

For some scars where we cannot be sure of the blood supply of the tissue, it may be better to first place a small number of grafts in a small part of the scar and see the result. This is called a test session. We decide together during the examination whether one is needed.

Seeing the result of a test session also takes time: it takes months for new hair to grow, and this varies from person to person. This wait gives us an idea of how your scar responds to a transplant before we move on to a larger one; we then plan the rest of the area accordingly.

Limitations and realistic expectations

A transplant into scars has some limitations, and we want you to know them from the start:

• The density that can be achieved in scar tissue may stay lower than in the healthy skin around it.
• For some scars, one session may not be enough. We decide on a further session together with you after we have seen the result of the first transplant.
• Even if a scarring disease has been inactive for a long time, it can become active again after a transplant.
• Small, dot-like scars also remain in the donor area where we take the grafts.

During the examination, we talk openly about what is possible for your scar, and to what extent.

The process and aftercare

The process consists of the initial call, examination and planning, the day of the procedure, and follow-up. During the examination, we look at the scar, the skin around it and your donor area; we ask how and when the scar formed and which treatments it has had so far. If you have surgical or treatment reports about the scar, please bring them with you to the examination; this information makes planning easier.

We harvest and place the grafts under local anesthesia. In the days after the procedure, you may notice redness, mild swelling or scabbing. Healing in scar tissue may follow a different course from healing in healthy skin.

In the weeks after the procedure, some of the transplanted hair or the hair around it may fall out temporarily; this is called shock loss. New hair, on the other hand, takes months to grow. Both the extent of shock loss and when the result becomes clear vary from person to person; we review your progress together at follow-up appointments.

We give you written aftercare instructions on washing, sleeping and returning to daily life; always follow those instructions rather than the general information on this page.

Frequently asked questions