8
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Hair transplantation in burn scar alopecia

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Treating patients with burn alopecia or hair loss can often be a challenge to both the surgeon and the patient. As with other reconstructive procedures that are required in the post-burn phase, this is usually a multiple stage process often requiring surgery over several years. This is because graft take is not as reliable as in healthy non-scarred skin and may need repeating to achieve adequate density. Also, different areas of hair loss may need to be addressed in separate procedures. There are several limiting factors that will determine whether or not a patient is a candidate for hair restoration which includes but is not limited to the amount of hair loss and the availability of suitable donor hair. Here we discuss how the current surgical technique of hair transplant surgery by follicular unit extraction (FUE) or strip follicular unit transplant (FUT) has become the treatment of choice for alopecic areas that require a more refined aesthetic result. Eyebrow, eyelash, beard and scalp hair loss can all have a negative impact on a burn survivor’s self-esteem and even if surgery is not a possibility, there are non-surgical options available for hair restoration and these are also discussed.

          Lay Summary

          This article explores the procedure of hair transplantation in the context of general options for hair restoration for individuals that have suffered hair loss due to burn injuries. Treating hair loss due to burns can often be a difficult process for both the surgeon and the patient. As with other surgical procedures that are required in the post-burn phase, hair restoration is usually a multiple stage process often requiring surgery over several years. This is because transplanted hairs are not as reliably successful as in healthy non-scarred skin and many repeat treatments may be needed to achieve adequate density, which is important for a natural look. In addition, different areas of hair loss may need to be addressed in separate procedures. There are several factors that will determine whether or not a patient is a good candidate for hair restoration which includes such things as the amount of hair loss and how much suitable donor hair (the donor is the area from which hair is taken, or donated) is available if the scalp has been affected by scarring. Eyebrow, eyelash, beard and scalp hair loss can all have a negative impact on a burn survivor’s self-esteem and confidence. Even if surgery is not a possibility there are non-surgical options, outlined in this article, which may be available for hair restoration. In this article we explain why the current surgical technique of hair transplant surgery has become the surgical treatment of choice for restoring areas of hair loss, especially in areas that require a more refined and natural result such as eyebrows.

          Related collections

          Most cited references17

          • Record: found
          • Abstract: found
          • Article: not found

          Male pattern baldness: classification and incidence.

          The need for a widely accepted, accurate, and reproducible standard of classification for male pattern baldness has increased with the advent and increasing popularity of hair transplant surgery. This report establishes such a classification, and reports its use in determining the incidence of male pattern baldness at various ages in 1,000 white adult male subjects. The action of testosterone as an incitant in male pattern baldness is well known, but this study points out the continued effect of time, even in later years. Since most hair transplant surgery is peformed on subjects with male pattern baldness, and because the success of hair transplant surgery is largely dependent on proper patient selection, a complete understanding of male pattern baldness is essential for consistently good results with hair transplantation.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Finasteride in the treatment of men with androgenetic alopecia. Finasteride Male Pattern Hair Loss Study Group.

            Androgenetic alopecia (male pattern hair loss) is caused by androgen-dependent miniaturization of scalp hair follicles, with scalp dihydrotestosterone (DHT) implicated as a contributing cause. Finasteride, an inhibitor of type II 5alpha-reductase, decreases serum and scalp DHT by inhibiting conversion of testosterone to DHT. Our purpose was to determine whether finasteride treatment leads to clinical improvement in men with male pattern hair loss. In two 1-year trials, 1553 men (18 to 41 years of age) with male pattern hair loss received oral finasteride 1 mg/d or placebo, and 1215 men continued in blinded extension studies for a second year. Efficacy was evaluated by scalp hair counts, patient and investigator assessments, and review of photographs by an expert panel. Finasteride treatment improved scalp hair by all evaluation techniques at 1 and 2 years (P < .001 vs placebo, all comparisons). Clinically significant increases in hair count (baseline = 876 hairs), measured in a 1-inch diameter circular area (5.1 cm2) of balding vertex scalp, were observed with finasteride treatment (107 and 138 hairs vs placebo at 1 and 2 years, respectively; P < .001). Treatment with placebo resulted in progressive hair loss. Patients' self-assessment demonstrated that finasteride treatment slowed hair loss, increased hair growth, and improved appearance of hair. These improvements were corroborated by investigator assessments and assessments of photographs. Adverse effects were minimal. In men with male pattern hair loss, finasteride 1 mg/d slowed the progression of hair loss and increased hair growth in clinical trials over 2 years.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Follicular unit extraction: minimally invasive surgery for hair transplantation.

              Follicular Unit Transplantation (FUT) is performed using large numbers of naturally occuring individual follicular units obtained by single-strip harvesting and stereo-microscopic dissection. Donor wound scarring from strip excision, although an infrequent complication, still concerns enough patients that an alternative solution is warranted. The purpose of this paper is to introduce Follicular Unit Extraction (The FOX Procedure), in which individual follicular units are removed directly from the donor region through very small punch excisions, and to describe a test (The FOX Test) that determines which patients are candidates for this procedure. This paper explores the nuances, limitations, and practical aspects of Follicular Unit Extraction (FUE). FUE was performed using 1-mm punches to separate follicular units from the surrounding tissue down to the level of the mid dermis. This was followed by extraction of the follicular units with forceps. The FOX test was developed to determine which patients would be good candidates for the procedure. The test was performed on 200 patients. Representative patients who were FOX-positive and FOX-negative were studied histologically. The FOX Test can determine which patients are suitable candidates for FUE. Approximately 25% of the patients biopsied were ideal candidates for FUE and 35% of the patients biopsied were good candidates for extraction. FUE is a minimally invasive approach to hair transplantation that obviates the need for a linear donor incision. This technique can serve as an important alternative to traditional hair transplantation in certain patients.
                Bookmark

                Author and article information

                Journal
                Scars Burn Heal
                Scars Burn Heal
                SBH
                spsbh
                Scars, burns & healing
                SAGE Publications (Sage UK: London, England )
                2059-5131
                1 October 2015
                Jan-Dec 2015
                : 1
                : 2059513115607764
                Affiliations
                [1-2059513115607764]Farjo Hair Institute, Manchester and London, UK
                Author notes
                [*]Greg Williams, Farjo Hair Institute, 70 Quay Street, Manchester M3 3EJ, UK. Email: dr.greg@ 123456farjo.com Twitter: @Drgregwilliams
                Article
                10.1177_2059513115607764
                10.1177/2059513115607764
                5965333
                89f89ab0-5e09-42b2-bbde-fcb5d3284837
                © The Author 2015

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License ( http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

                History
                Categories
                Original Article
                Custom metadata
                January-December 2015

                burns,hair transplantation,burn scar,alopecia,strip follicular unit transplant,follicular unit extraction,hair loss,hair restoration,scalp,beard,eyebrows,eyelashes

                Comments

                Comment on this article