Hair transplant on a scar

Often, yes. Indian dermatology guidelines list selected cases of scarring hair loss among the uses of a hair transplant. But scar tissue has a less reliable blood supply than normal skin, so growth is harder to predict and more sessions are common.

Two kinds of scar hair loss

A 2021 review in the Indian Journal of Plastic Surgery separates two kinds:

• Scars from an injury, a burn or surgery. Damage to the skin destroyed the follicles.
• Scarring hair loss from a skin disease, such as lichen planopilaris. Here the disease destroys the follicles. The review says the disease should have been quiet for about 2 years before surgery, because it can flare up again and affect the grafts.

A 2019 review of 34 people with scarring hair loss from skin disease found that 26 had moderate to good results and 8 had poor results or a return of the disease. Its authors warn that good results are more likely to be published.

So the first step is a diagnosis from a dermatologist, especially if you do not know what caused the scar.

How well grafts grow in a scar

In the experience of the authors of a 2015 paper on burn scars, the share of grafts that grow in scar tissue ranges from 0% to 90%, depending on the blood supply of the scar. Because of that:

• grafts are placed less densely than in normal skin
• doctors may start with a small test session and wait about 6 months to see how it grows
• a second session is usually advised 9 to 12 months after the first
• for burn scars, at least three sessions may be needed to look like normal density, and the full course can take years

Very large burn scars are often made smaller first by other surgery, before any grafting.

What it costs

We do not have a separate estimate for scar work. Our FUE estimate is a starting point, per session:

Smaller scars need fewer grafts, but clinics often have a minimum charge. Multiply by the number of sessions your doctor expects, and ask whether a test session is priced separately.

Two things can lower the cost:

• GST. GST is generally charged on cosmetic hair transplants, but treatment to restore appearance after an injury, burns or a congenital condition may be exempt. Ask the clinic.
• Insurance. Most Indian health policies exclude cosmetic surgery, but the standard wording allows reconstruction after an accident, burns or cancer. Your own policy wording decides, so check with your insurer before treatment. See hair transplant on EMI for the exact exclusion.

Other options

Scalp micropigmentation, a specialised tattoo, can make a scar less visible without surgery. A hair system can cover a large area. See hair transplant or hair patch.

Questions to ask

• What caused my scar, and is it stable?
• Would you start with a test session?
• How many sessions do you expect, and how far apart?
• What density can I expect in the scar?
• Will you write the reason for treatment, for my insurer?