Is Every Patient of Hair Loss a Candidate for Hair Transplant?

Posted by Akshay Sharma on January 5th, 2023

Hair transplantation is not for everyone. Yes, you read that correct. There is a definite candidacy for the individuals who would like to go through the transplantation procedure. The hair transplantation candidates have to have certain qualities. Certain factors are considered to be good whereas some factors are considered to be bad when it comes to individualistic characteristics when going in for a hair transplantation procedure.

There is a certain candidacy that must be fulfilled for all hair transplantation candidates to go through a hair transplantation procedure.

According to hair restoration specialists:

To begin with, the person must have an obvious recipient area. There must be a clearly demarcated recipient area where the transplantation is to be done. A good recipient area makes an obvious difference after the results are seen. There is a good visual difference in the before and after appearance of an individual. A recipient area where there is still hair left that are in the different stages of miniaturization, it is a good option to only opt for medications and not go on for a transplantation procedure. In cases where there are sufficient gaps in between two pre-existing grafts, new grafts can be transplanted to give density. It is basically a conservative hair transplantation approach. When there are only vellus hair on the scalp then new grafts can be transplanted on top of them because vellus hair cannot be revived even with the use of medications. These vellus hair have completely miniaturised and will eventually disappear along with the roots in the near future.

A good donor area is an asset when the transplant is being performed. A choice of grafts when the recipient is being transplanted is a joy for the surgeons to work with. A good donor area provides an array of grafts for the hair restoration specialist to work with. Differently numbered grafts are available which leads to a good mixture of the grafts on the recipient area. In cases where the scalp donor is poor, beard and body hair donor areas are also considered. Hair transplant men with a good beard can give a large amount of donor grafts from the beard also. The beard grafts can be used in the mid scalp as fillers. However, there is an obvious difference in the beard and scalp graft textures. Also, the growth rate and length of the beard grafts differ from those of the scalp grafts. For hair transplant men, the body hair grafts also have a separate candidacy on their own. The body hair grafts have to have a good hair calibre. They also have to have a certain length. They need to attain a certain length even after being transplanted on the scalp. A test grafting can also be done to check the survival rate of the body hair grafts.

If the baldness has stopped progressing, then it is a plus point. It is definitely favourable when, after the transplantation procedure, the baldness does not progress. If the baldness has delayed progression, then there will be no requirement for the additional procedures in the future. A progressive baldness requires multiple procedures through progression of time. Usage of Finasteride can also help delay the progression of baldness. In patients where there are no side effects, this medication can be very instrumental in preserving the pre-existing as well as the transplanted hair. When in some cases patients experience some side effects with the use of Finasteride, natural alternatives such as Saw Palmetto can be uses for the delaying of the progression of baldness.

Usually, baldness tends to progress rapidly in the early ages of 20s. There is a gradual decrease in the speed of the progression of baldness in the 30s. Baldness really slows down its progression during the 40s. By the 50s, baldness tends to stabilize to a good extent. Patients who are in the latter ages are good candidates for the transplantation procedure. Even for patients who have their baldness stabilized during their early ages, transplantation is a good option. If transplantation is done for cases where the baldness is progressive, then in the absence of Finasteride, new areas shall be empty and thus facilitate for multiple transplants in the future. We also have noticed that younger people tend to ignore their medications which leads to a rapid progression of baldness. The older population are more aware and careful of their habits with regards to the medications that they have to take. Individually also, the characteristics of the baldness are different and unpredictable. Baldness is unpredictable regardless of gender, genetics and age. In some cases, there might be a rapid progression whereas in some cases there might not be any progression at all.

For patients who are willing to take finasteride, transplantation can be a viable option to preserve their pre-existing as well as their transplanted hair. The hair on the donor areas is less immune to dihydrotestosterone in comparison to the hair on the recipient areas. However, they are not completely immune. In some cases, the immunity of the donor hair is less. It depends from cases to case. Hence, the use of Finasteride can help preserve even the donor areas in such cases.

In cases of alopecia areata, burns, scars etc, there is a detailed screening do the problem. The pros and cons of the transplant and the possibility of a transplant in such cases are never generalized and vary from one person to another. The hair transplant surgeon would customise the treatment in each case. Each case presents a different challenge in such scenarios. Hence one mist be extremely careful while handling such cases.

It is very important that patients go through a strict screening process and understand their candidacy prior to going for the transplantation procedure. A lack of information can create a situation where the patient is confused or unaware of what is to be done. It can lead to a loss for the patient as well as the surgeon. A doctor and the patient need to have a very transparent conversation and discuss the details of the eligibility of a patient prior to the surgery.