Diffuse alopecia and hair transplants: when does treatment make sense?

What is diffuse hair loss?

Diffuse hair loss means that the hair thins evenly across the whole scalp — there are none of the typical receding temples or bald patches seen with hereditary pattern hair loss. Often the hair loss is temporary and due to a treatable cause.

Causes of diffuse alopecia

• Chronic or acute stress (telogen effluvium)
• A lack of nutrients: iron, zinc, biotin, vitamin D
• Thyroid disorders (over- and underactivity)
• Hormonal changes: pregnancy, menopause, the pill
• Medication (chemotherapy, blood thinners, some antidepressants)
• Autoimmune diseases (alopecia areata, lupus)

Blood tests and diagnostics first

Before deciding on a transplant, possible causes have to be ruled out. Important parameters in the blood count: ferritin, TSH, vitamin D, zinc, testosterone, oestrogen. Where a treatable cause emerges, the hair loss often improves after therapy — without surgery.

When a hair transplant makes sense

A transplant with diffuse alopecia only makes sense if:

• The hair loss is permanent and stable (not reversible)
• The donor area is sufficiently dense (no hair loss there either)
• All possible causes have been ruled out
• Expectations about density are realistic

The central problem with diffuse alopecia: if the donor area has thinned too, the quality of the extracted grafts is questionable. A transplant can then lead to an unsatisfactory result.

Medical or regenerative pre-treatment

In many cases specialists first recommend pre-treatment with minoxidil, PRP or microneedling to stabilise the hair loss before surgery. Read more in stopping hair loss.

GO Medics arranges an honest first assessment with experienced dermatologists: Get free advice.