Hairpiece Caused Me To Lose More Hair - Can a Hair Transplant Fix This?

Written by Bradley R. Wolf, MD on April 22, 2008

I think my hairpiece made me lose more hair. Is this possible and can I replace the hair that has been lost with a hair transplant?
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It is common to lose hair, permanently or temporarily, as a result of wearing any type hair piece. The hairs lost or damaged are generally those which were genetically programmed to eventually fall out but their loss is accelerated by the unnatural situation created by an appliance attached to the scalp. A warm, moist, dark environment with associated pressure from the base and attachment system can accelerate programmed (male pattern) hair loss. If there is traction from a glue-on system or from attachment clips, areas of permanent hair, not programmed to miniaturize and stop growing, can be lost due to traction alopecia. Alopecia is the medical term for hair loss. Placement of clips in the same location for months or years can cause circular areas of permanent hair loss.

Hair lost can be replaced with hair transplant surgery. Some of the most impressive before and after photos used in advertising are from patients who stopped wearing a hair piece, started minoxidil (Rogaine) and finasteride (Propecia) and received hair transplants. Much of the growth seen on the after photos is not from the transplants but from the damaged or stunted hair which has been brought back to life with the removal of the unfavorable environment and stimulation of growth with medical treatment. Patients are often surprised at the amount of hair that regrows when they take off the hair piece and stop clipping their hair short in anticipation of a hair transplant. It would be ideal to remove the hair piece and use the medications for 6-12 months to realize your actual baseline pre-operative hair volume.

While hair transplants cannot be used to replace every hair a patient has lost with or without a prior hair piece, it can greatly increase your volume of hair. Post-operatively, to realize full regrowth of the transplants, it is exceedingly important to wear your hair piece as little as possible. The actual regrowth of the transplants is directly proportional to the amount of time you are not wearing the hair piece. Ideally a patient should discontinue wearing the hair piece at all to get full and prompt regrowth. If you need to wear your hair piece while the transplants are growing, it is imperative to convert to the clip on system if you are not already using it, to secure the hair piece, not have any glue or tape on any of the grafts (especially the hairline), and wear the system as little as possibe. After surgery it should not be worn at all for a minimum of one week, preferably two weeks, then only worn during business hours and removed when sleeping and during weekends. You can wear a hat to cover the area.

Finally, patients who wear a hair piece are used to seeing a lot of hair volume. Often hair pieces are too thick making them noticeable. Hair transplants cannot replace this amount of hair. So the patient must be informed and ready to accept less hair than they see in the mirror when wearing a hairpiece. As a result, more than one surgery is often necessary to attain desired density. In my experience, when properly informed patients are ready to discontinue the cost and maintenance of a hair piece, if they follow the recommendations given above, they are thrilled with the results of properly performed hair transplantation surgery.

Bradley Wolf, MD
Medical Advisor, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association