Hair transplantation in scar reconstruction.

BACKGROUND: Scar alopecia following burns, trauma, and congenital conditions present a significant psychosocial burden. Conventional reconstructive approaches, including tissue expansion and scar excisions, can restore hair-bearing skin but are frequently limited by geometric constraints, residual scars, prolonged treatment timelines and an inability to recreate natural hairline transition zones. Hair transplantation is widely recognised within aesthetic practice, however its role as a reconstructive modality for post-traumatic scars may be underappreciated by clinicians less familiar with hair transplantation METHODS: This narrative review synthesises reconstructive principles and contemporary hair transplantation techniques, and contrasts these with conventional non-transplantation approaches to scalp and facial hair reconstruction. Clinical considerations, patient selection and clinical prioritisation relevant to reconstruction of scars in hair bearing areas are discussed, supported by illustrative clinical cases.

RESULTS: Hair transplantation enables anatomically unrestricted transfer of follicular units to areas of aesthetic priority, facilitating restoration not only of natural hairline morphology but also of facial hair-bearing subunits. Transplantation offers great flexibility in reconstructive planning, reduced treatment morbidity, and avoidance of visible scarring, with high levels of patient acceptability and is performed as staged local anaesthetic day-case procedures.

CONCLUSIONS: Hair transplantation represents a powerful flexible reconstructive option for reconstruction of scar alopecia secondary to burns or trauma permitting targeted restoration of hair-bearing units without the geometric limitations of conventional non-transplantation techniques.