What is the role of surgery in the treatment of androgenetic alopecia?

Updated: Feb 12, 2018
  • Author: Robert P Feinstein, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Answer

Surgical treatment of androgenetic alopecia has been successfully performed for the past 4 decades. Although the cosmetic results are often satisfactory, the main problem is covering the bald area with donor plugs (or follicles) sufficient in number to be effective. Micrografting produces a more natural appearance than the old technique of transplanting plugs.

A 2009 review of surgical procedures concluded that both patients and physicians alike are pleased with the results of contemporary hair transplantation. [36] Patients with less than 40 follicular units/cm2 in their donor areas are poor candidates for the procedure. Scalp reduction has been attempted to decrease the size of the scalp to be covered by transplanted hair. However, the scars produced by the reduction technique often spread and become more noticeable with time.

A South Korean study noted the effect of a 1550-nm fractional erbium-glass laser in women with androgenetic alopecia. The patients received 10 treatments at 2-week intervals. Global photographs taken at baseline and at the end of laser treatment showed improvement in 24 (87.5%) of the 27 patients studied. However, 2 patients reported mild pruritus after treatment. [43]

Hair weaving techniques are available, and, together with hairpieces, they offer the patient a prosthetic method of coverage.

Also see the Medscape article Hair Transplantation.


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