Can You Get a Hair Transplant if You Are Completely Bald?

There is a great deal of conflicting information about whether a hair transplant is possible for a client who is entirely bald or has a primarily bald scalp, facial hair growth, or eyebrows.

Much depends on whether there are alternative donor sites and enough healthy follicles to replenish the target area, with the right characteristics, density, texture and growth direction to slot seamlessly into the pattern and aesthetic of any residual hairs.

For clients who are completely bald and have reached Norwood Scale stage six or above, the most advisable way forward may be to consider hair activation therapies like Plasma-Rich Platelet Therapy or Laser Therapy.

Non-surgical treatments and medications can often stimulate growth in dormant follicles. Where a hair transplant cannot achieve the outcomes and aesthetics you aspire to, a course of treatment sessions may be far more likely to provide the results you want.

The Complexities of Hair Transplantations for Blad Clients

Data from the International Society of Hair Restoration Surgeons indicates that 93% of the donor hairs used during hair transplant are selected from the back of the scalp. 

This is because most people with male or female pattern hair loss see thinning and loss at the top, front and sides of the head.

Where there are residual healthy follicles on the back of the scalp, they can be used to achieve a hair transplant as part of the restoration process—as long as those follicles have the right appearance and texture.

However, this becomes less achievable if there are no hairs to use or if a small selection of potential donor follicles is insufficient to fill the hair-loss area fully.

Likewise, we would not proceed with a hair transplant with minimal donor hairs in one location since collecting all the donor follicles from one place could create less-than-ideal outcomes or mean a small patch without growth.

Causes of Partial or Total Baldness

Hair loss can be complex and might be related to numerous potential factors. However, most people see thinning and patchy hair due to genetics and age – also known as pattern hair loss or androgenetic alopecia.

This means hair begins to fall out without subsequent regrowth, usually starting around the front and sides of the hair that frame the face and moving gradually backwards.

Other possible factors that might be connected to hair loss and baldness include:

• Scarring around the scalp due to previous injuries, surgeries, burns or substandard hair transplantation procedures.
• Autoimmune conditions, including varied types of alopecia.
• Hormonal issues, including thyroid problems and PCOS.  Hair loss can also be attributed to hormonal changes during pregnancy and following childbirth.
• Trichotillomania – a mental health condition where sufferers feel compelled to pull and tug at their hair.
• Anagen effluvium, which causes hair follicles to become dormant, is often caused by medical treatments like chemotherapy.

While a hair transplant is a positive solution for most hair loss concerns, it may not always be recommended or advisable.

For example, people with trichotillomania are normally not candidates for a hair transplant unless the condition has been well-controlled for some time due to the stress of the procedure and the potential to reactivate the condition. 

Shock loss, or telogen effluvium, also wouldn’t usually require a hair transplant.

This condition is largely temporary and is a typical part of the healing process after a hair transplant. In this situation, we’d advise medication or non-surgical therapy to expedite healing since a further transplant might not prove corrective.

Scenarios Where a Hair Transplant May Not Be Possible

The best way to ascertain whether a hair transplant is a potential solution for your hair loss concerns is to book a complimentary consultation with your preferred KSL Clinic location. 

While the following circumstances might mean your scalp is not suited to a hair transplant, it’s equally worth speaking with a skilled hair transplant consultant to explore all the options.

If any of these indications apply, a hair restoration treatment or alternative medication might be a better option either before or alongside a future hair transplant:

• People with alopecia areata – this autoimmune condition contributes to spots or patches of badness. Hair transplants can be successful but require careful evaluation to ensure enough donor follicles and to advise that an ongoing condition could mean the need for subsequent treatments.
• Alopecia universalis patients rarely have a successful hair transplant. This form of alopecia typically attacks the transplanted follicles, making the cost and recovery period unlikely to provide long-term results.
• Men with pattern hair loss at Norwood Stage six to seven or beyond. Complete baldness, usually due to male pattern baldness, could mean a transplant isn’t appropriate.

The Norwood Scale is a commonly used clinical way to evaluate and pinpoint the extent of hair loss, although this can present differently between individuals.

Scale six hair loss usually means there will be an unaffected area of donor follicles around the back and sides of the head—although this doesn’t always mean there are enough healthy hairs to restore the full area of hair loss.

Equally, stage seven hair loss usually refers to complete baldness, but a hair transplant specialist can advise whether a transplant or alternative treatment could, in time, achieve full regrowth.

Indicators That it May Be Too Late for a Hair Transplant

Clients with a bald head without any hair growth whatsoever are usually less viable candidates for hair transplant surgery due to the factors we’ve explained.

However, if you have experienced extensive hair loss but have some remaining follicles, this could be possible, usually combined with additional therapies and treatments.

As a very rough guide:

• Hair loss around zone one, to the side of the temples, is usually easily treatable, with an average of 1000 grafts needed to restore full growth.
• Zone two hair loss, which affects the area around the temples across the front of the hairline, can often be corrected with a hair transplant involving around 1,00-2,100 grafts.
• Hair loss in zone three, in the centre of the temple, or the inverted section of a widow’s peak, is also treatable, with an average of 1000 grafts – plus those needed for other areas.
• Thinning or bald patches in zone four, across the width of the scalp horizontally, require roughly 1,750 grafts to correct, using follicles normally harvested from the back of the head.
• Zone five hair loss that affects the area behind the crown can be trickier to treat and depends on access to donor hairs – if possible, this transplant needs around 2,200 grafts.

The least common type of hair transplant is in zone six, which is to the very back of the head. That is because most pattern hair loss begins at the front of the hairline and recedes backwards – rather than the other way around.

While a patch of hair loss at the crown can absolutely be corrected, this will still rely on the availability of healthy donor hairs to complete a successful hair transplant.

Most clients with more advanced hair loss and partial or full baldness, where a hair transplant is possible, will need a higher number of grafts towards the upper end of the scale.

Common Misconceptions About Hair Transplants for Baldness

Dr Matee, our sector-leading hair transplant specialist, advises that there is a wide array of beliefs and assumptions about hair transplants, and speaking with an accredited, GMC-registered transplant surgeon is always the first port of call.

Working through the typical misconceptions he hears during KSL Clinic consultations, Dr Matee notes that:

‘A hair transplant cannot always and fully correct complete and progressive hair loss. However, a precise transplant can be an effective solution if you have enough natural hair to improve the density and appearance of the areas affected.

Most people with some degree of ongoing hair loss make great hair transplant candidates, although it is essential to book a consultation to ensure your aspirations are realistic and achievable.

There is little reason a professional, private hair transplant cannot deliver fantastic outcomes if you have baldness to the temples, crown, or sides of your head or relatively thin hair due to age-related hair loss.

Step one is to schedule a meeting at any of the KSL Clinic locations, where we’ll be able to assess your scalp and hair carefully and provide reliable, independent advice about the right way to move forward – whether that involves a transplant, a hair regrowth medication, or another treatment entirely.’