Hair Transplant Scar Revision

  • Best Results8-10 months
  • Treatment Recovery1-4 days
  • Procedure Time2-8 hours
  • Skin SpecialistDermatologist
  • Duration of ResultsLong lasting
  • AnaestheticBlocks, sedation
  • Back to Work2-7 days
  • Cost$$-$$$$$

Hair Transplant Scar Revision

Hair transplant scars can be improved using various techniques including lasers, surgical removal of pre-existing scars & hair plugs, FUE as well as scalp micropigmentation. In many cases it is a combination of procedures that will give the best results. Early treatment of scarring can mitigate long term scars.

FactsFacts on Hair Transplant Scars

  • FUT scars are linear & often take several years to mature
  • Itchy & raised scars can be easily treated with anti-inflammatory injections & topicals
  • Hair plugs are best treated with removal, dissection then re-implantation
  • Rotational flap surgical scars can be treated with FUE or scalp micropigmentation
  • FUE scars are primarily hypopigmented or lighter than the normal scalp skin
  • FUE scars can be treated with scalp micropigmentation
  • In most cases combination therapy gives the best outcomes

What types of scars are commonly seen after hair transplantation?

The most common scarring nowadays is after FUE or follicular unit extraction, as this is the most popular type of hair restoration surgery. Scarring can be true scarring (raised lesion) or pigmentation changes (more common). Pigment changes are more commonly seen in darker skin types with dark hair,  as there is a contrast between normal scalp tissue, hair, & hypopigmentation from the punch (more on how to fix later).

FUT scars are less common, & in most cases can be hidden with longer hair. The use of trichophytic closure reduces the look of these scars. FUT scars can be raised (hypertrophic), red, hypopigmented & have absence of hair follicles, refer below as to how to fix.

Hair plugs can give contracted scars as well as islands of dense follicular units in a sea of low hair counts. This type of scarring requires removal of the old plugs, suture of the donor area, then replanting of harvested follicles.

Rotation flap surgery gives a large, long scar that extends from one side of the scalp to the other. There are often contour changes within the scar line.

What are hair plugs?

Prior to 2000, the majority of hair transplant procedures involved hair plugs. These plugs measure 3 to 4 mm in diameter and consist of multiple follicular units. The contraction of plugs in addition to the spacing between hair plugs gives an unnatural look- namely islands of densely packed hair follicles.

Hair plugs are best excised, then replanted in a more natural distribution with 1 to 4 follicular units.

How do you camouflage previous hair restoration surgery?

It really depends on the clinical findings. If previous surgery was of the FUE or FUT type & involves prominence of hair follicular units consisting of primarily two, three and four terminal hairs, the solution may be as easy as transferring one-unit grafts in front of these areas. This provides a natural hairline that camouflages the previous surgery.

On the other hand, If the larger grafts (three to four unit, densely packed grafts) are too close to the frontal hairline, or are simply pointing in the wrong direction, camouflage alone will not correct the problem. In some cases, it involved reducing the density of hairs in some areas by transferring units with more terminal hairs & replacing them with single hairs. It really depends on the clinical findings. 

How to fix scars from FUE?

In most cases FUE scarring is characterised by pigment changes, namely tiny 0.7 to 1.1 mm areas of decreased pigment. This is only visible if hair is cut short & if you have high contrast between skin type, hair & scalp colour.  This type of pigmentation contrast can be treated effectively with scalp micropigmentation. I also use melanocyte migration topicals such as Latiesse & tacrolimus, together with small spot thulium lasers.

Papular scarring is very rare. These can be improved with lasers, CS drip, CS lotions & low-level light emitting diodes. True scarring takes 1-2 years before settling down.

Davin’s Viewpoint on Scars Following Hair Restoration

I still encounter hair restoration procedures conducted 35 to 50 years ago, namely scars & plugs from punch hair transfer & rotational flaps. Treatments discussed on this page.

The most common scars nowadays are following FUE & FUT procedures. In the context of FUE, it is most apparent in the donor sites. Fortunately, most are pigment changes, rather than true raised scars. Treatment is primarily aimed at reducing the contrast between scalp skin & hair colour. SMP or scalp micropigmentation can make a huge difference.

FUT scars are normally raised, widened or pigmented (red). Young ethnic men, with little scalp laxity are more prone to scarring. I suspect with trichophytic closure the ingrown hairs cause more inflammation which invariably leads to raised scars. Early management with topicals, ILCS or topical CS, silicone & small spot lasers can help reduce scarring.

Join the conversation

Join Dr Davin Lim on Instagram to stay up to date


Enquire now!

Get In Touch

Quick Contact

Dr Lim has unparalleled experience in dermatology. Fill in the form below and he will get back to you with your query
This field is for validation purposes and should be left unchanged.