Hair transplantation is a surgical procedure that relocates hair follicles from one part of the body to balding or thinning areas, aiming for a fuller appearance. Its applicability for completely bald individuals depends significantly on the availability of suitable donor hair.
The Foundation of Hair Transplants
Hair transplantation moves existing hair follicles from a dense donor area, typically the back and sides of the head, to a balding or thinning recipient area. Follicles are harvested and reimplanted, not created. These donor hairs are genetically resistant to dihydrotestosterone (DHT), a hormone linked to pattern baldness. This resistance allows them to maintain growth after transplantation. Transplant success depends on the quality and quantity of these resilient donor follicles.
The Limits of Donor Hair Supply
The primary limitation for hair transplantation in completely bald individuals is the finite supply of viable donor hair. “Completely bald” typically refers to a stage, often Norwood scale 6 or 7, where insufficient healthy follicles remain on the scalp for effective transplantation. This involves significant baldness across the crown and frontal areas, leaving only a horseshoe-shaped band of hair.
If traditional donor areas at the back and sides of the head are depleted or too thin, a conventional transplant may not be possible. While alternative donor areas like the beard or chest exist, their supply is often insufficient for complete coverage of a fully bald head. Covering a completely bald head can require over 5,000 to 6,000 grafts, which is challenging to harvest without compromising the donor area’s appearance.
Options Beyond Traditional Transplants
For individuals not candidates for traditional hair transplants due to complete baldness or insufficient donor hair, several alternatives exist. Scalp micropigmentation (SMP) tattoos tiny pigment dots onto the scalp, creating the illusion of hair follicles. This technique provides the appearance of a closely shaved head or adds density to thinning areas, suitable for extensive baldness. Wigs and hairpieces offer immediate, non-surgical coverage. These systems come in various styles and materials, providing natural-looking, customizable solutions. Other non-surgical options, such as medications (e.g., minoxidil, finasteride), platelet-rich plasma (PRP) therapy, and low-level light therapy, primarily slow hair loss or stimulate growth in areas with existing follicles. They are less effective for completely bald scalps where follicles are no longer active.