Can an FUE Hair Transplant Be Performed on an Afro-Caribbean Man With Central Centrifugal Cicatricial Alopecia (CCCA) ?

My boyfriend has a form of CCCA (Central Centrifugal Cicatricial Alopecia) as well as mild Follicutis Keloidalis on the nape of his neck. I am looking to get him the FUE procedure done (Follicle unit extraction) and wanted to know if you guys can deal with or specialize in Afro-caribbean scalps and hair types. I can send photos of his scalp if needed.
Kind regards,
Leeanne
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Dear Leeanne:

Thank you for your letter and question. The diagnosis of a scarring alopecia, such as CCCA, will require that there is evidence that the process is not active before surgical intervention may be considered. There is no correct answer as to when surgery may be performed but there should probably be a minimum of one year during which there is no active inflammation. The dermatologist that is following your friend should be able to assist in this determination. There is also a risk that the condition can be reactivated by surgery in the involved areas. Occasionally a “test session” can be performed to see if this is a possibility. CCCA, also called “hot comb” alopecia, has been linked to physical and chemical trauma of the scalp by certain hair-care practices. I will assume that if this is the cause of your friend’s hair loss, these practices have been discontinued.

The presence of acne keloidalis in the potential donor area may pose a challenge to the successful treatment of your friend. There is some evidence that acne keloidalis is itself a scarring alopecia and therefore the condition may be exacerbated by performing follicular unit extraction in the area. A suggestion, similar to the one made for the recipient area, is that the condition should be under control and a test session may be helpful to determine if the procedure will cause any problems.

FUE using the proper instrumentation can be performed in some African American patients, but the success depends on the degree of curvature of the follicles. In the last year I have required a test session to see if the procedure is feasible in a particular patient. You should check with the hair restoration surgeon, who should also have extensive experience in FUE, to see if they are comfortable with an FUE procedure in an African American patient.

To summarize, active inflammation in the donor and recipient area should have been treated and the condition quiet for at least one year prior to the consideration of surgery. A test session to assess the feasibility of FUE and to ascertain the impact on the donor and recipient area of FUE should be conducted. The test areas should be observed for at least 3-4 months before a large scale hair restoration session is scheduled.

I hope that this discussion answered some of your questions and shed some light on the issues involved.

Sincerely,
James A. Harris, MD, FACS
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

James Harris, MD, FACS James A. Harris, MD, FACS is an internationally prominent surgeon in the field of hair restoration surgery, and a published author of both medical and consumer publications. He is a faculty member of the University of Colorado School of Medicine, where he teaches hair transplantation to resident physicians in training and community physicians. As director of the Hair Sciences Center of Colorado (HSC), he has established a practice dedicated exclusively to providing the very best in medical and surgical treatments for hair loss. As part of this commitment, patient education and the highest standards of care are his first priority. Dr. Harris personally consults with every patient and is always the physician performing the surgery at HSC. Supported by an exceptionally experienced team of nurses and technicians specialized in hair replacement surgery, Dr. Harris' standard of care does not end with surgery. Personalized follow-up attention is provided after the procedure, starting the very next day. This care continues until the hair is grown out and the patient is satisfied. Dr. Harris is a member of the International Alliance of Hair Restoration Surgeons and recommended by the American Hair Loss Association. Visit Dr. Harris Website: www.hsccolorado.com

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