Treatment of scarring alopecia from trauma and surgical procedures in young patients using follicular unit hair transplantation

Introduction Hair loss due to scarring as a consequence of surgical procedures and trauma can impact young patients socially and emotionally. Recently follicular unit extraction (FUE) hair transplantation has been applied to scar treatment. Patients and Methods This report included four patients with scarring alopecia. All patients were female with a mean age of 12.5 years. Previous operations that caused scarring were sebaceous nevus excision with direct closure (n = 2), an extensive burn scar treated using an expander (n = 1) and cauterization for a congenital pigmented nevus (n = 1). The average size of the affected area was 10.5 cm(2). The FUE transplantation procedure was performed under local anesthesia. The number of grafts was set at approximately 25-30 grafts/ cm(2) of scar. An electronic punch with a diameter of 0.8 mm was used for graft harvesting, and a 0.6-mm electronic punch was used to make cylindrical holes on recipient site. The donor sites were shaved followed by graft harvesting in two cases. For the other two cases, harvesting was done without shaving. Results The number of transplanted grafts was 60 to 600 (mean 288), and surgical time was 38 to 220 minutes (mean 108). The average dose of lidocaine was 1.4 mg/kg. The average survival rate of the grafts was 85%. Conclusion Our experience in these cases suggests that this technique may be a viable option for the treatment of certain causes of scarring alopecia in the pediatric age group.