Hair Restoration in the Scarred Scalp

Hair Restoration in the Scarred Scalp

January, 2006

Your head is one of the parts of your body most vulnerable to injury. Head injury often includes injury to the scalp and eyebrows, with resulting destruction of hair follicles in those areas. The injured areas are often bald after healing.

A common cause of scalp injury is automobile accidents; jagged metal and glass can cause injuries that heal with extensive scarring. Some people suffer scalp injuries in childhood accidents and carry scars for the rest of their lives. Other causes of physical trauma to the scalp include sports injuries, industrial accidents and personal physical violence.

Burn injuries can cause extensive and deep scarring. Thermal burn injuries may be caused by direct exposure to fire, contact with hot substances such as metal, or scalding with hot water or other liquids. Chemical burns are caused by exposure of scalp skin to corrosive substances such as industrial acids or alkalies, or cleaning solutions. Radiation burns are caused by exposure to excessive amounts of ionizing radiation-x-rays or gamma rays.

A number of inflammatory diseases can damage scalp skin and leave scars of greater or lesser extent. These inflammatory diseases include discoid lupus erythematosus, lichen planopilaris, and severe forms of psoriasis. Acne occurs on the face, chest and back. Infectious and inflammatory conditions that look similar to nodular acne may leave scarred, bald tissue after healing.

Scarring can be caused by surgery-for example, neurosurgery that required an entry would in the skull. Face lifting may result in receding of hair in the temporal region as a consequence of tissue "back lifting".

Sometimes scarring can be self-inflicted-for example, scarring alopecia caused by tight braiding, corn rowing, or by trichotillomania, the compulsive plucking of hair. For more information, see other causes of hair loss.

Hair Restoration in the Scarred Scalp

Scalp injury and scarring destroy hair follicles. Hair does not naturally grow in scarred skin where follicles have been destroyed.

If scalp scars are small they may not cause any significant cosmetic problems. In some cases the person with scalp scarring can use hair styling to make the scars cosmetically invisible. However, the size and placement of some scars may make then impossible to disguise with hair styling.

Is hair restoration an option to consider for the scarred scalp?

The answer is "Yes" in the majority of cases. The method of hair restoration is usually hair transplantation. Skilled, experienced physician hair restoration specialists have been very successful in transplanting hair to scarred areas of the scalp.

Sometimes the scarred area can be reduced in size by surgical excision and repair, leaving a smaller area that requires hair transplantation. This is an option that the patient and physician should discuss in detail before it is undertaken.

Scalp expansion, scalp flaps and scalp reduction are alternative surgical approaches to consider. They may be a treatment of choice when a scarred area is large and cannot be reduced in size for hair transplantation. A combination of surgical hair restoration procedures may be used in a large scarred area-for example, a scalp flap or scalp expansion plus hair transplantation to "fill in" as needed.

Hair restoration in the scarred scalp is not undertaken lightly. It requires careful examination of the scalp and consideration of numerous factors that can influence the feasibility and outcome of surgical hair restoration. These factors can include:

After all necessary tests and physical examination, it is likely that hair restoration of the scarred scalp can be undertaken and have a successful outcome.

In the unlikely event that hair restoration cannot or should not be undertaken, the patient and physician hair restoration specialist can discuss hair prostheses for coverage of the scarred scalp. For more information, see hair pieces, hair extensions & weaves.