Can a Hair Transplant Be Performed on an African American?

Written by Robert J. Reese, DO on September 17, 2008

Can a hair transplant be performed on an African American? Every video or before and after photo I see has a Caucasian guy with minimal hair loss. He will have hair around the side and maybe slight balding around the crown. An African American male cannot hide their balding issue, or better yet doesn’t have the hair to spare for a hair transplant while maintaining a short hair cut. Has a successful hair transplant ever been performed on African American male to continue the growth of hair where it was lost mainly around the middle or back of the crown?
Thank you,
Mark
- - - - - - -

Mark:

Thank you for your question. Yes, hair restoration surgery can be successfully performed on African Americans and /or people of other ethnic origins. The African American patient in particular requires careful pre-operative assessment in several areas. Does the patient have a tendency to develop hypertrophic and/or keloid, (heavy, thick) scarring? Does the patients skin hypopigment, (become lighter colored) in response to a surgical procedure? When I consult with patients of African American descent I evaluate them for other surgical incisions, ear piercings etc. to document how they heal with other procedures that may have been performed. If they have not had any prior surgery, consideration for a scalp biopsy is made to monitor this small area for it’s healing characteristics. I would not want to perform an “aesthetic” procedure on a patient who may heal their scalp in an aesthetically displeasing fashion. Generally speaking, the density of hair growing follicles in the African American permanent donor zone is not as substantial as that which occurs in Caucasian patients, so the size of the transplant is not always as large for the African American patient. However, because of the natural curl of the hair, and narrow color contrast between the color of the hair and scalp, the African American patient can develop substantial “density” with their procedure. Another area that is different with the African American patient population is how the donor grafts are created. By this I mean that due to the natural curl of the African American hair, the grafts are cut a little “chubby” compared to the Caucasian patient. If I attempt to cut a graft that is too “perfect”, there is a higher likelihood that transection of the hair in the graft will occur, and this could lead to less hair growth than what I would anticipate with a transplant performed on a Caucasian patient. Donor hair can be harvested utilizing standard “strip” excision, or the follicular unit extraction, (FUE) technique. However, the size of the device for the FUE technique would be slightly larger, (to accommodate for the patients curly hair) and the patient needs to be informed that the FUE technique would not be “scarless”. Even a very small enlargement in the circumference of the FUE device leads to a significantly lager scar. In summary, the African American patient population can expect to have excellent and substantial results with modern hair restoration surgical techniques. However, it is mandatory that they undergo a careful pre-operative assessment, and have their procedure performed by a highly skilled hair transplant surgeon.

With Best Regards,

Robert J. Reese, DO
Member: International Alliance of Hair Restoration Surgeons
Member: American Hair Loss Association

Join the Hair Transplant Forum to connect with hair transplant veterans, ask questions to IAHRS Surgeons, watch videos and see actual hair transplant patient photo galleries. Click To Join
Lean more about your hair transplant surgeon at hairtransplantdocs.com