When you’re losing your hair permanently, you can take some comfort in the fact that hair transplant exists. People who start experiencing hair in their early 20s are eager to get this surgery so that they can continue normally with their lives. No matter the age at which you start losing your hair, restoration surgery seems to be a viable solution. However, what if you’re not a candidate for a hair transplant?
There are some cases in which it is not possible to perform the surgery entirely. In others, it may be possible, but there’s a higher risk of postoperative complications and poor results. In the latter case, the decision comes down to the patient if they do or don’t want to proceed with the surgery. Here, we’ll outline all those instances in which you’re not suitable for a hair transplant or if you are but can’t get good results from it.
Who’s Not A Candidate for A Hair Transplant?
Let’s take a look at the cases in which a patient’s not suitable for hair transplant surgery.
Temporary Hair Loss
It’s easy enough to panic if you’ve lost a lot of your hair in a short period of time. However, that’s usually a result of a health condition. Once that’s treated, your hair is likely to grow back within a matter of months. In this case, you’re not suitable for a hair transplant. You just have to wait for the condition to be treated.
Of course, you’d need to go to your dermatologist for a diagnosis of your hair loss. If the hair loss is due to a permanent condition like androgenetic alopecia/pattern baldness, they will examine your scalp. During this, they will check if the hair loss truly does have a pattern and if you’ve lost more than 50% of your hair in a specific area of the scalp. Moreover, they’ll determine whether or not you are suffering from any other health condition which may be causing the hair loss.
You may be experiencing temporary hair loss because of the following:
- Illnesses (syphilis, HIV, Graves disease, lupus, etc)
- Seasonal changes
- Stress (pregnancy, hormonal changes, COVID, etc)
- Scalp dryness
- Medications (Steroids, statins, etc)
- Chemotherapy and radiotherapy
- Weight loss
These don’t always cause temporary hair loss. Sometimes the conditions can trigger other conditions that can cause permanent hair loss. Or the prolonged use of medication causes irreversible damage. Also, in some cases, the condition becomes too severe, which can result in permanent hair loss.
However, to determine whether or not the hair loss is temporary or permanent, you need to consult your doctor. If the hair loss is temporary, you are not a candidate for a hair transplant as your hair will grow back on its own.
Hair Loss Is Diffuse
While androgenetic alopecia may have a classic pattern, it isn’t always the case. It can occur diffusely all over the scalp. In this case, the person does not have a stable donor area where there is hair that is resistant to the effects of the hormone DHT. Even if these hair grafts are transplanted into the scalp, they will miniaturize and stop growing any hair eventually. Therefore, you cannot undergo a hair transplant successfully.
Both males and females can have diffuse unpatterned hair loss, which is androgenetic alopecia. However, it’s more common for women to have this kind of hair loss. If this is the kind of hair loss that you’re experiencing, a hair transplant is not for you.
Keep in mind that a patient can have lost more than 50% of their hair in a particular region of the scalp while still experiencing thinning all over. If this is the case, it might be possible for you to have transplant surgery. In any case, have your dermatologist examine you.
Hair Loss Has No Stable Pattern
This is more important for those who want to get a hair transplant at a young age. In the early 20s, if you’ve already started experiencing hair loss due to pattern baldness, your pattern is not yet “set/stable.” That means that it isn’t yet clear which parts of the scalp are going to be affected by the DHT hormone.
You may have a small bald patch in the beginning, but it is quite likely that the surrounding hair will eventually fall because of the hormones. So, you have to wait till you have clearly, demarcated regions on the scalp where DHT won’t do anything to the hair follicles since these are the ones that are going to be used for restoration surgery. That means that if you’re a young person with androgenetic alopecia, you’re not a candidate for a hair transplant yet.
Once you do come back, the dermatologist will ask about your hair loss history: the time for which you’ve been losing hair, how quickly you’ve been losing it, and for how long has your hair been in this pattern? If everything’s good on this front, you’re a good candidate for hair transplant surgery then.
Low Donor Hair Density
For a successful hair transplant to take place, you need to have a high hair density in the donor region of the scalp. That’s the area from where the hair is going to be used for relocation to the balding regions. You’d need anywhere between 50-80 grafts per cm2 for natural coverage of the balding area.
However, if the donor area doesn’t have enough hair to make that possible, you’ll have low hair density. Not just that, but you might be left with permanent bald patches in the donor area from where the follicles are taken. Therefore, you need to have a healthy donor area to have a hair transplant.
Certain mental health issues can result in hair loss. Other than body dysmorphic disorder, there’s trichotillomania where a person voluntarily pulls their hair out from the scalp, eyebrows and eyelashes due to reasons such as:
- Obsessive-compulsive disorder (OCD)
If this is the reason why the person is pulling their hair out and going bald, they need help for the treatment of these psychological conditions first. That’s because their habits will also affect the transplanted hair grafts.
It is possible for a person with these conditions to also have androgenetic alopecia. However, to ensure a successful surgery, patients should first get treated for these psychological conditions. Your surgeon will screen you for it to determine if you’re a suitable candidate for a hair transplant.
Poor Scalp Health
Patients need to have a healthy scalp to have a hair transplant surgery. Many people who suffer from chronic illnesses can also have androgenetic alopecia. They’d have to wait for the active flare-up to go into remission before they can get the surgery. This may be the case if you have psoriasis, lupus, or eczema.
If you have alopecia areata along with pattern baldness, you have to wait for the condition to resolve to get treatment. If you have scars on your scalp, also known as cicatricial alopecia, you’re likely unsuitable for a hair transplant surgery. Hair transplant on burnt skin is possible in some cases, though.
Since hair transplant is not a medically necessary procedure, the surgeon will advise delaying it while the woman is pregnant. That’s because it may be harmful to the woman and the baby. The recovery process won’t be easy either, which can further negatively impact the health of the mother and fetus.
There are two types of diabetes. Type 1 sufferers have insufficient insulin in the body and need injections for the maintenance of blood glucose. Those with Type 2 diabetes find themselves in a situation where their body is unable to make use of the insulin produced.
If a diabetic patient has stopped responding to the given treatments and is facing problems in wound healing and blood clotting, they cannot have a hair transplant. However, if the patient is responding to treatments and is in a stable state, then they can get a hair transplant. Still, here too, consultation before surgery is very important.
Hepatitis and HIV
If you have hepatitis, a hair transplant is not possible until you’re cured. Your blood should be clear of the pathogen. In the case of hepatitis C, you cannot ever undergo this procedure. This also goes for AIDS. As the patient’s immunity is quite weak, it will take a lot of time for the small wounds to heal, and they will be more vulnerable to infections.
Patients who suffer from cardiovascular illnesses take blood-thinning medications. This is dangerous as it can cause excessive bleeding during the surgery, which is why they may be not a good candidate for hair transplant. However, it is still possible for them to undergo it in some cases. It’s not suitable for those who constantly have high blood pressure and find difficulty controlling it.
You need to have realistic expectations from your hair transplant surgery. Sometimes, it’s simply not possible for the patient to have high hair density, so they have to be prepared for the final results. You can’t simply assume that you’ll get the same before and after results as other patients.
That’s because your hair type, quality, and anatomy are unique to you. And if your donor area isn’t as strong, you can’t expect to have full coverage where there’s no chance of the scalp showing through. Therefore, you’re not a candidate for a hair transplant if you don’t have realistic expectations from the surgery.
In addition, if you smoke or drink alcohol before and after the surgery (not according to the instructions provided by the clinic), it’s quite likely that you’ll experience a lot of complications during the surgery and after it. That will also affect the results. Therefore, if you’re unwilling to make lifestyle changes, you should have realistic expectations about what you can achieve from a hair transplant.
Unfortunately, in the instances mentioned above, you cannot have a hair transplant. Alternatively, you can consider getting scalp micropigmentation, or you can wear hair systems like wigs, extensions, toupees, etc.
Keep in mind that if you send us edited pictures of your scalp to be considered for the surgery, it’s not going to make it possible. That’s because our surgeon will perform a physical exam in face-to-face consultation when you arrive at the clinic. And it’s then that they might decide that you’re not suitable for the surgery.
It will, of course, cause problems for you and the clinic, especially in terms of the resources used. For that reason, it is also important that you honestly fill out your medical history form. Also, to avoid the cancellation of your surgery, you should make sure that the payment is all clear and completed.
Reviewed and Approved by Dr. Hassan Soueid.