Can hair restoration surgery be performed on patients with alopecia areata?

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Can Hair Restoration Surgery Be Performed on Patients with Alopecia Areata?

Initial Answer

Hair restoration surgery is generally not recommended for patients with active alopecia areata due to the unpredictable nature of the condition, which can cause transplanted hair to fall out. However, in cases where the condition has been inactive for a significant period, surgery might be considered after careful evaluation.

Expanded Information

Alopecia areata is an autoimmune condition characterized by sudden, patchy hair loss on the scalp and other areas of the body. The immune system mistakenly attacks hair follicles, leading to hair loss. Given the nature of alopecia areata, there are specific considerations when it comes to hair restoration surgery:

Challenges of Hair Restoration Surgery in Alopecia Areata

  • Unpredictability: Alopecia areata can be unpredictable, with episodes of hair loss and regrowth. This makes it challenging to ensure the longevity of transplanted hair.
  • Autoimmune Response: Since the condition involves an autoimmune response, there is a risk that transplanted hair follicles could also be attacked, leading to the loss of transplanted hair.
  • Patchy Loss Patterns: The patchy nature of hair loss in alopecia areata can make it difficult to achieve uniform and natural-looking results with hair transplantation.

When Hair Restoration Surgery Might Be Considered

In certain cases, hair restoration surgery might be considered for patients with alopecia areata:

  • Inactive Periods: If alopecia areata has been inactive for an extended period (typically at least a year), and there are no signs of active hair loss, surgery may be considered.
  • Stable Condition: Patients with a stable condition, where the affected areas have not changed for a long time, might be candidates for hair restoration surgery.
  • Small, Localized Areas: Surgery may be considered for small, localized areas where hair loss has been stable and persistent.

Pre-Surgical Evaluation

Before considering hair restoration surgery, a thorough evaluation by a qualified hair restoration specialist is essential:

  • Medical History: A detailed medical history and assessment of the alopecia areata condition, including the duration of inactivity and stability of hair loss, are crucial.
  • Scalp Examination: A scalp examination to evaluate the condition of the donor and recipient areas, and to check for any signs of active disease.
  • Alternative Treatments: Exploring non-surgical treatments such as corticosteroid injections, topical immunotherapy, or other medical therapies to manage the condition.

Post-Surgical Considerations

If hair restoration surgery is performed, careful post-operative care and monitoring are essential:

  • Regular Follow-Ups: Frequent follow-ups with the surgeon to monitor the progress and detect any signs of alopecia areata recurrence early.
  • Continued Medical Management: Continuing medical treatments to manage alopecia areata and reduce the risk of recurrence.
  • Realistic Expectations: Setting realistic expectations about the potential outcomes and risks associated with the surgery.

Alternative Treatments

For many patients with alopecia areata, alternative treatments may be more suitable than surgery:

  • Medications: Treatments such as corticosteroids, minoxidil, and other immunosuppressive drugs can help manage symptoms and promote hair regrowth.
  • Topical Immunotherapy: Application of chemicals like diphencyprone (DPCP) to induce an allergic reaction that can stimulate hair regrowth.
  • PRP Therapy: Platelet-Rich Plasma (PRP) therapy can promote hair growth by using growth factors from the patient’s own blood.


Hair restoration surgery for patients with alopecia areata is challenging and generally not recommended for those with active or unstable conditions. However, for patients with a stable and inactive condition, surgery might be an option after a thorough evaluation. Non-surgical treatments often provide more predictable results for managing alopecia areata.

For more detailed information on hair transplant procedures and choosing the right surgeon, you can visit our articles on FUE Surgery and FUT Surgery.

If you have concerns about hair restoration surgery for alopecia areata or need assistance in selecting a reputable surgeon, chat with our support team at the FUE Surgeons Directory. We provide access to vetted doctors, before and after photos, and numerous reviews to help you make an informed decision.

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