Who is Suitable for Hair Replacement Systems?
While hair replacement systems offer numerous benefits, not everyone is a suitable candidate for this non-surgical alternative. It is crucial to identify individuals who may not be appropriate candidates to ensure optimal outcomes and avoid potential complications. Here are some factors to consider when selecting candidates for hair replacement systems:
Diffuse Unpatterned Alopecia (DUPA)
Diffuse unpatterned alopecia (DUPA) is a condition that affects the entire scalp, resulting in a loss of density and miniaturization of hair follicles. Patients with DUPA are not suitable candidates for hair transplantation as the donor area, typically spared in patterned alopecia, may also be affected. This condition requires medical treatment rather than surgery.
Cicatricial alopecias, such as lichen plano pilaris (LPP) and discoid lupus erythematosus (DLE), involve scarring of the scalp and can mimic patterned hair loss. Hair transplantation is contraindicated in active cicatricial alopecias as it can exacerbate the disease and lead to poor outcomes. Surgery should only be considered when the disease is inactive for an extended period.
Unstable Hair Loss
Patients with rapidly progressing hair loss or unstable hair loss patterns are not ideal candidates for hair replacement systems. These individuals may experience shock loss and unsatisfactory results following surgery. Stabilizing the hair loss through medical therapy before considering surgery is recommended to minimize the risk of complications.
Insufficient Hair Loss
Generally speaking, men (and women) with insufficient hair loss, where thinning is not yet significant, may not be suitable candidates for non-surgical hair replacement systems. Toppers may be an option, as well as low-level laser hair loss treatment. Monitoring the progression of hair loss and considering medical therapy until the threshold for transplantation is reached is advisable in these cases.
Unrealistic Hair Transplant Expectations
Managing patient expectations is essential in any hair restoration procedure. Individuals with unrealistic expectations, such as desiring superdensity or believing that surgery will eliminate all signs of hair loss, may be an ideal candidate for hair replacement systems. Educating potential clients about the limitations of hair transplant procedures and ensuring they have reasonable expectations is crucial for successful hair transplant outcomes.
Patients with psychological disorders, such as body dysmorphic disorder (BDD) and trichotillomania, may not be suitable candidates for hair replacement systems. These conditions can lead to unrealistic expectations, and fixation on perceived defects. In the case of trichotillomania, we have found full cranial prosthetic hairpieces or wigs can help alleviate hair pulling in some clients. It is important to address the underlying psychological issues and ensure patients are psychologically fit for the procedure.