Hair transplant surgery is a surgical treatment that involves transplanting healthy hair follicles from the patient’s occipital scalp (or other areas of the body) that are not affected by androgens to areas of hair loss or thinning. It does not “cure” hair loss itself but improves appearance by redistributing hair follicles.
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### Indications for Hair Transplant Surgery
**Androgenetic Alopecia** is the most classic indication for hair transplantation. In males, it typically presents as recession of the frontal hairline and thinning of the vertex (M-shaped or O-shaped patterns), while in females, it often manifests as diffuse widening of the central scalp part (Christmas tree pattern). This type of hair loss usually has a clear family history, and the occipital hair follicles remain relatively stable. Before surgery, it is necessary to confirm that hair loss has entered a stable phase (no significant worsening for at least 6–12 months) and to assess that the donor area has sufficient hair follicle density.
**Cicatricial Alopecia** is also suitable for hair transplantation, such as permanent localized hair loss caused by burns, trauma, surgical incisions (e.g., facelifts, scalp tumor excisions), or infections (e.g., after healed tinea capitis). Prerequisites include good blood supply to the scar area, absence of active inflammation, and that the scar tissue has softened and matured (usually more than 6 months post-injury or surgery).
**Hair loss or thinning in areas such as the eyebrows, eyelashes, beard, and sideburns** can also be considered cosmetic indications. It should be noted that these areas have extremely high requirements for hair angle, thickness, and growth direction, and transplanted hair will continue to grow, requiring regular trimming.
**Certain congenital hair loss or developmental abnormalities**, such as a high frontal hairline (non-androgenetic alopecia) or congenital absence of eyebrows, can also be improved through hair transplantation. However, other systemic diseases must be ruled out.
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### Contraindications for Hair Transplant Surgery
**Active infections or skin diseases** are absolute contraindications. Conditions such as folliculitis, pustules, fungal infections (e.g., tinea capitis), severe seborrheic dermatitis, psoriasis, or acute eczema on the scalp may lead to infection spread or graft failure if surgery is performed prematurely. The underlying condition must be treated first, and surgery considered only after the scalp is healthy and stable.
**Severe uncontrolled systemic diseases** increase surgical risk. Examples include uncontrolled hypertension, diabetes, severe heart disease (e.g., recent myocardial infarction, angina), coagulation disorders (e.g., hemophilia, thrombocytopenia), active autoimmune diseases, or ongoing use of anticoagulant medications (e.g., aspirin, warfarin). Such patients should only consider surgery after evaluation and adjustment by an internist.
**Unrealistic psychological expectations or body dysmorphic disorder** are psychological contraindications for hair transplantation. Patients who expect to achieve “perfect hair density” or “complete cure of hair loss” with a single surgery, or who exhibit excessive anxiety over minor hair asymmetry and repeatedly seek revision surgeries, indicate psychological risk. Physicians should screen for these issues in advance and refuse unreasonable requests.
**Insufficient donor hair follicle reserves** is a technical contraindication. For example, advanced androgenetic alopecia (extensive vertex baldness) with very low occipital follicle density cannot provide enough graft units; or previous multiple hair transplant surgeries have led to scarring in the donor area. Forcing surgery in such cases may result in poor outcomes or visible thinning of the donor area.
**Age factors** require caution. Adolescents before puberty (typically under 18 years) have not yet experienced a stable pattern of hair loss, and the future progression is unpredictable. Hair transplantation may lead to an “island effect” (transplanted hair survives while surrounding native hair continues to fall out); surgery is generally not recommended. For individuals over 55, overall health status should be comprehensively evaluated.
**Pregnancy and lactation** are relative contraindications. Anesthetics, surgical stress, and postoperative medications (such as antibiotics and pain relievers) may pose potential risks to the fetus or infant. Surgery should be postponed until after the lactation period.
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Hair transplant surgery requires a detailed preoperative evaluation by an experienced physician, including hair loss grading, donor area density, scalp elasticity, overall health, and psychological status. Strict adherence to indications and contraindications is essential for ensuring safety and efficacy.
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For reference only, not a substitute for medical advice.