Who Is Not Suitable for a Hair Transplant? Conditions That Rule Out or Delay a Hair Transplant

A hair transplant is a surgical procedure that can be performed in men and women with hair loss; however, it is not suitable for everyone. Suitability is decided by the doctor after assessing the cause of the hair loss, the donor area, general health and expectations together. This article explains the conditions that rule out a hair transplant or mean that it should be postponed.

An Insufficient Donor Area

In a hair transplant, the person's own hair roots are taken, usually from the donor area at the back of the head and behind the ears. If the donor area does not have enough hair of suitable quality, or if the area to be covered is very large compared with the donor capacity, the desired density cannot be achieved. In some cases beard or body hair can be used as an additional source. Where there is no donor area at all, as in congenital absence of hair, a hair transplant cannot be performed; options such as hair systems (hairpieces) may be considered.

Hair Loss With an Unknown Cause

Hair loss caused by thyroid disease, iron deficiency, some medicines, severe stress or patchy hair loss (alopecia areata) usually improves by treating the cause, not with a hair transplant. In widespread hair loss across the whole scalp without a defined pattern, the donor area may also be affected, so a hair transplant is usually not suitable. For this reason the cause of hair loss should be assessed before a hair transplant. People who pull out their own hair (trichotillomania) first need treatment for this condition.

People Who Are Very Young

A hair transplant is usually not performed on people under 18. Because hair loss can continue to progress at a young age, a transplant done too early may lead to a mismatch between transplanted and non-transplanted areas in later years. In young people, the course of hair loss and the medical treatment options are assessed carefully.

Uncontrolled Health Problems

In serious health problems that are not under control, such as diabetes or heart, liver or kidney disease, a hair transplant is not performed or is postponed until the condition is under control. For conditions that are under control, the doctor decides on the basis of the necessary tests. For blood-borne infections, too, the doctor makes an assessment based on the person's health and the precautions required; it is important to share this information with the doctor.

Bleeding Problems and Blood-Thinning Medicines

In clotting disorders such as haemophilia, the risk of bleeding during and after the procedure is increased; a hair transplant is usually not suitable for these people or is assessed together with the relevant specialist. People taking blood-thinning medicines should not stop them on their own and should tell the doctor. Clotting is checked with blood tests before the procedure.

Allergy to Local Anaesthetics

A hair transplant is usually performed under local anaesthesia. Anyone who has previously had an allergic reaction to local anaesthetics must tell the doctor; the situation is assessed and a decision is made on whether the procedure can be performed.

Active Scalp Conditions

If there is active psoriasis, infection or a scarring hair loss condition such as lichen planopilaris on the scalp, a hair transplant is not performed or is postponed until the condition has been treated and brought under control.

Unrealistic Expectations

A hair transplant can increase hair density as far as the donor area allows; however, it may not fully restore the former hair density, and hair loss may continue in areas that were not transplanted. It is important to discuss expectations openly with the doctor during the consultation. For people who are not suitable for a hair transplant, medical treatments and other options can be discussed with the doctor. For the method you can read our article FUE Hair Transplant (Follicular Unit Extraction): How It Is Done, Advantages and Limitations and visit our FUE hair transplant page, and for aftercare our article Hair Transplant Aftercare: The First Days, Washing and Recovery.

Author: Op. Dr. Yücel Sarıaltın