Surgical hair restoration in blacks is similar in most respects to surgical hair restoration in whites and other ethnic groups. Blacks with hair loss should have no hesitation in consulting with a hair restoration doctor.
Some hair and skin characteristics are unique to African-Americans and others with black African ancestry. These are evaluated in the patient’s medical history and physical examination:
Some medical conditions that are more common in black skin than in white may increase risk for post-surgical hair restoration complications.
Keloids— Black skin is more prone to formation of keloids (irregularly shaped, elevated scars with uncontrolled growth) in response to injury. Although this is not a widespread problem, patients with a history of keloid formation are evaluated carefully in regard to their existing scars. A very small "test procedure" may be performed to determine if healing proceeds normally.
Postoperative skin discoloration— Both loss of skin color and increased skin color occur more commonly in black skin than in white skin after injury or surgery. The patient’s medical and family history may indicate any predisposition to postoperative skin discoloration. In many instances the discoloration may be temporary, or may be covered acceptably with cosmetics.
Ingrown hairs— Problems with ingrown hairs are more common in black skin than in white. A patient’s history of ingrown hairs and associated minor skin infections may indicate increased risk for postoperative ingrown hairs. A very small "test procedure" may be performed to evaluate the risk.
The characteristic curl of hair in people of black ancestry usually gives an impression of good hair density. This can be an advantage in surgical hair restoration. In a white-skinned person with substantial hair loss and very low hair density, hair transplants or other surgical procedure may not be possible if enough donor hairs cannot be obtained from a donor site. Under the same hairloss conditions, a black patient may be an acceptable candidate because fewer donor hairs are needed to create a satisfactory impression of hair density.
Harvesting of black, curly hair from a donor site for hair transplants requires a slightly modified technique. In whites, the scalp hair generally grows straight. In people of African ancestry, both the follicles and hairs have a degree of curvature in relation to the scalp that must be accommodated in the harvest of donor hair.
In summary, surgical hair restoration is as available to African-Americans and others of black African ancestry as it is to whites, and is equally successful. Some unique characteristics of black hair and skin require preoperative evaluation.