#1444 How does a hair transplant work?

How does a hair transplant work? The basic idea is to take hair from the part of your head that still has it (usually the back) and transplant it to the part of your head that no longer has hair (usually the front or the top).

Baldness is fairly common, and it is estimated that almost 50% of men are partly bald by the time that they are 50. This increases with age. There are several causes of hair loss, but the most common is in men, and it is male-pattern baldness. It is an inherited trait. Hair grows from hair follicles all over our bodies. There is a blood supply and stem cells at the bottom of the follicle. The stem cells activate and grow a hair. The hair grows for about seven years, then the hair follicle shrinks, and the hair dies and falls out. The hair follicle returns to normal, and the cycle starts again. In bald people, a hormone called dihydrotestosterone attaches to the receptors in the hair follicle and prevents proteins, vitamins, and minerals from reaching the hair. The hair follicle shrinks and goes to sleep. The hair follicles on top of the head are far more sensitive to this hormone than other places, which is why baldness is usually centered on the head. The follicle is not dead, and researchers have managed to wake them up in mice, but not yet in humans. Until they do work out how, and a cure for baldness is introduced, the only three options are to live with it, wear a wig, or have a hair transplant.

Hair transplant technology has improved a lot from when it was first introduced, but the outcome does depend very much on where you have the procedure done. Some cheaper places might produce a hair transplant that the customer will live to regret. So, how does a hair transplant work? The only hair follicles that go dormant are on the top of the head. The hair follicles at the back and the side of the head continue to grow and produce hair. The idea with a hair transplant is to move these follicles to the place where the hair isn’t growing.

There are two ways to do it. The first is called follicular unit transplantation (FUT), and the second is called follicular unit extraction (FUE). Recently, FUE is far more common than FUT because it is more successful and causes less damage. With FUT, grafts of skin that contain three or four hair follicles are removed from the back of the head and implanted into incisions on the top of the head. Once the whole area has been covered, the donor area at the back of the head is sewn up. There will be a scar in the donor area, usually at the back of the head, which should only be visible if you shave your head. FUT is not that popular these days because it is a painful procedure, and it takes a while for everything to heal. The final hair can also look patchy, making it look obvious and like hair plugs.

FUE is more popular because it leaves less of a scar and it heals faster. It also looks more natural than FUT. With FUE, a micropunch is used to remove a single hair follicle from the back of the head. This follicle is then inserted into the scalp, where there is no hair. Because they are single hair follicles, it is much easier to make the position and the angle more natural. That means when the hair grows, it is more difficult to tell. Removing hair follicles from the back of the head will make the hair thinner there, but we have so many hair follicles that it won’t really be noticeable. There are roughly 100,000 follicles on a human head. The one problem with FUE is that it is quite expensive. Clinics usually charge per number of follicles that are transplanted. The result can also vary widely depending on the quality of the clinic you go to and how many procedures that doctor is performing in a day. You will also need to have follow-up procedures throughout your life, though, as the hair continues to thin. It sounds like a great idea, but I think I will stick to my shiny head, at least until they work out how to wake up my hair follicles. And this is what I learned today.

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Sources

https://www.healthline.com/health/cosmetic-surgery/everything-to-know-about-a-fue-hair-transplant#overview

https://my.clevelandclinic.org/health/treatments/21519-hair-transplant

https://www.nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/hair-transplant

https://en.wikipedia.org/wiki/Hair_loss

https://www.aad.org/public/diseases/hair-loss/causes/18-causes