Hair transplants being the only permanent treatment for hair loss, are understandably the most sought after hair restoration treatment. However, as is the case with anything that is too good to be true, hair transplantation can only treat three categories of alopecia. To understand why hair transplantation has its limits, we need to address how the treatment works.
How hair transplants work
In order for hair transplants to be successful, one essential condition needs to be met. The first requirement is sufficient donor hair. Donor hair is healthy hair on the scalp unaffected by hair loss and is the source from which follicular units will be harvested and relocated to bald areas. Depending on a person's supply and state of donor's hair; their candidacy can either be accepted or rejected.
With that being said, hair transplants are not effective in all categories of alopecia.
The types of alopecia hair transplants can reverse
1- Androgenic alopecia
Androgenic alopecia is the most prevalent type of alopecia and affects nearly 50% of men. Hair loss in androgenic alopecia stems from a property known as androgen sensitivity in follicular units. Androgen sensitivity refers to follicular units inability to withstand persistent attack from male hormones, leading, over time, to their premature closing.
Luckily for most men suffering from androgenic alopecia, hair loss takes on a particular pattern: receding hairline and crown, with a linear strip of hair around the scalp. The notorious model of hair loss is the result of diversity in terms of androgen-resistant properties within follicular units. The hairs in the back of the scalp tend to be resistant to androgen attacks. The reverse is true for the hairs nearing the crown and hairline.
Since androgenic alopecia meets the first requirement of donor hair availability, patients suffering from this condition can restore their crown's glory with hair transplantation. Upon relocating the viable follicular units to deserted areas, the anti-androgenic properties will not fade. On the contrary, the grafts will continue to initiate growth in the new regions.
2- Traumatic alopecia
Traumatic alopecia refers to the category of hair loss that results from accidents or direct trauma to the skin. If the damage penetrates through to the follicular units, unfortunately, there is nothing much the medical field can do to revive them back. Although the damage is irreversible, hair transplant is the silver lining for those who suffer from the condition.
If the damage is not widespread, and a patient finds they meet the qualifications of hair transplants in terms for donor hair supply, then a session of hair transplantation can bring life to areas that lack it.
3- Traction alopecia
Obsessive behaviors such as hair pulling or tight styling fit into the category of traction alopecia. Rigid styling and hair pulling exhibit repeated harm to follicular units. Upon prolonged periods, the follicular units begin to close. Often, traction alopecia wears off by itself once the destructive behaviors are eliminated. However, in some instances, the condition may be permanent. In instances when the damage is irreversible, doctors would then recommend hair transplantation based on the patient's state and supply of donor's hair. If the patient meets the requirements for the microsurgery, they may then proceed with the procedure to reverse the damage.
The types of alopecia hair transplants cannot reverse
1- Alopecia areata
Alopecia areata refers to hair loss that results from an autoimmune disorder. In an autoimmune disease, the immune system, the barrier of defense against foreign bodies malfunctions. As a result of this peculiar condition, the immune system loses the ability to differentiate between body cells and foreign invaders, attacking by that the body's own cells. Unfortunately, the defense system does not spare follicular units leading to hair loss. While alopecia areata may not be permanent, and the patient may have donor hairs, hair transplants are out of the question.
The reason behind rejected alopecia areata is the unpredictable behavior of the immune system. While a patient may get hair transplantation, there is no guarantee on how well the results will be. Neither is there a guarantee on how well the transplanted hair will behave.
In order to restore the lost hair in alopecia areata, the patient needs to resolve the underlying issue, which in this case is autoimmunity.
2- Alopecia Universalis
Alopecia Universalis refers to total loss of hair in the scalp and body. Consequently, the condition does not meet the requirements for hair transplants as it lacks the presence of donor hair supply.
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