Can Patients with Trichotillomania have a Hair Transplant?

Trichotillomania: Is it possible to have a Hair Transplant?

Trichotillomania is a hair loss disorder whereby individuals pull out their own hair.  About 1-2 percent of the population meet the diagnostic criteria at some point in their lives.  The condition is classified as an impulse control disorder.  A previous blog discussed the features of this condition.

In the early stages of the condition, hair regrowth is possible if the patient can be helped (either with medications or psychotherapy) to stop pulling.  If the pulling goes on long enough, the resultant hair loss may be permanent.  This is because scars develop around the damaged hair follicles and these scars block further hair growth.

Patients with trichotillomania often ask if a hair transplant is possible.  In some cases it can ben possible, but certainly not in all cases.   Generally, I look for four features to be present in order to determine if a patient with trichotillomania can have a transplant:

Candidacy for Hair Transplantation in Patients with Trichotillomania

1. The patient has not had the compulsion to pull their hair for at least 1 year

2. Patient has no ongoing scalp symptoms like itching, burning, pain or tingling

3. The area of hair loss has not enlarged over a 1-2 year period.

4. The patient is medically fit, has a good donor supply of hair, and is over 18 years of age.

These are general guidelines that I use in my practice which have been very helpful. Patients with ongoing symptoms like itching in the scalp and who have ongoing compulusion to pull, twist of pluck hairs are not good candidates because the the transplanted hair may be ultimately pulled out again.