Question: I had a cyst removed on my scalp that has left a bald patch. Is it possible that the hair will eventually grow back? It’s been several months now. If it doesn’t, can I have hair transplanted to the area and how would this be achieved?
Answer: There can be several causes of hair loss at the site of previous trauma or surgery. One possible cause is a condition called alopecia areata. The exact nature of this condition is not fully understood, but it is believed to be some type of autoimmune response to stress, including surgery. In many patients it resolves within a few months, but it is useful to consult with a dermatologist or plastic surgeons regarding additional therapies, such as steroid injection, that may help accelerate the recovery. Another potential cause of hair loss at a surgical site is damage to or scarring across the hair follicles. Occasionally, hair follicles can cross through an area of scar tissue, but if it is a large, noticeable area, it is unlikely to appear normal without additional surgical treatment. Typically this involves excising the area of widened scar tissue and bringing the normal hair-bearing scalp back together, leaving a thin line scar that is easily hidden. Hair transplantation into an area of scar tissue is not recommended because it is unlikely for the hair follicles to survive or grow. The same is generally also true for alopecia areata, because the autoimmune process that is occurring will also affect the newly-transplanted hairs. Some hair restoration surgeons have had limited success with hair transplantation in patients with alopecia areata however.