How We Verify What We Publish

Doctor identity & education

Which surgeon is who, and where they trained.

✔ 3 · Original document sighted by us

• Istanbul University, Faculty of Medicine — Doctor of Medicine, 2011
• Demiroğlu Bilim Üniversitesi — Health Services Vocational School — Emergency First Aid, associate degree, 5 July 2019
• İstanbul Medipol Üniversitesi — Health Services Vocational School — Anaesthesia, associate degree, 8 June 2017

○ 1 · Documentation requested

Professional memberships & certifications

Society memberships, board certifications and registration records.

✔ 1 · Original document sighted by us

• Hair Transplantation Practitioner certificate — Republic of Turkey Ministry of Health, registered 5 December 2025

○ 2 · Documentation requested

Experience & procedure volume

Career history, and how many procedures a surgeon has performed.

○ 8 · Documentation requested

Procedure responsibilities

Which steps of the operation are performed by a doctor rather than a technician.

✔ 2 · Documented by a first-party source

• Channel opening is carried out by physicians
• Grafts are inspected under optical magnification before implantation, in every case

Clinic & facility information

Rooms, daily patient numbers, languages supported.

✔ 2 · Documented by a first-party source

• Patient support in nine languages — English, French, German, Russian, Romanian, Italian, Arabic, Spanish and Turkish
• Ten treatment and procedure rooms, plus one emergency intervention room, two washing rooms and one PRP room

○ 1 · Documentation requested

Regulatory authorisation

Whose Ministry of Health health tourism authorisation the treatment is arranged under, checked against the Ministry's own register.

✔ 1 · Verified against an official registry

• İstanbulvita Sağlık Hizmetleri Ltd. Şti., trading as Medistanbul Turizm Seyahat Acentası in Şişli, Istanbul, holds International Health Tourism Authorisation Certificate AK-0595 issued by the Republic of Türkiye Ministry of Health, and is listed as an authorised health tourism intermediary on the Ministry's HealthTürkiye register. HealthTürkiye register of authorised agencies, Republic of Türkiye Ministry of Health, 2026 →

✔ 1 · Documented by a first-party source

• The authorised health tourism intermediary for treatment arranged through this website is İstanbulvita Sağlık Hizmetleri Ltd. Şti. (Medistanbul Turizm Seyahat Acentası), holder of certificate AK-0595. AfroHairClinicTurkey holds no International Health Tourism Authorisation Certificate of its own.

Pricing

What a procedure costs and what moves the number.

✔ 1 · Documented by a first-party source

• Price varies with the scope of the package — accommodation, length of stay, hotel, transfers and any additional services — rather than being a single published rate

Travel & package information

What an all-inclusive package covers.

✔ 1 · Documented by a first-party source

• Packages are built per patient and include hotel accommodation, VIP transfers, post-operative care products and an orthopaedic travel pillow; every package includes one PRP session, two oxygen therapy sessions and one laser therapy session

Aftercare

What support continues after you fly home, and for how long.

✔ 2 · Documented by a first-party source

• A designated patient coordinator can be contacted whenever support is needed, and reaches the medical team when necessary
• Post-operative follow-up and support for one year after the procedure

Medical claims

Statements about hair, skin and surgical risk. These additionally require a published source.

✔ 94 · Supported by primary literature

• Keloid scarring occurs more often in Black patients than in white patients; the reason for the difference is not established. Dermatologic Clinics 1988 →
• In tightly curled hair the follicle sits curved beneath the skin rather than straight, with a bent, golf-club-shaped bulb and an asymmetric root sheath. Br J Dermatol 2005; Int J Dermatol 2007 →
• The curvature is built into the follicle itself — it persists in hair grown in culture, and it tracks with curl pattern rather than with ethnic origin. Br J Dermatol 2005; Int J Dermatol 2007; J Struct Biol 2006 →
• Traction induces inflammation and follicle damage, and the risk rises with styles that hurt — pain from a hairstyle is a warning sign rather than something to tolerate. Dermatologic Clinics 2014 →
• Traction alopecia can progress to permanent hair loss if the styling that causes it continues. J Am Acad Dermatol 2016 →
• In a population study of 874 African adults in Cape Town, traction alopecia was found in 31.7% of the women examined. Br J Dermatol 2007 →
• Traction alopecia was most common among women whose usual style was extensions attached to chemically relaxed hair, affecting 48% of that group. Br J Dermatol 2007 →
• In the same Cape Town population, central centrifugal cicatricial alopecia was found in 2.7% of women, rising to 6.7% of women over 50. Br J Dermatol 2007 →
• Central centrifugal cicatricial alopecia is the most common form of scarring alopecia among women of African ancestry. N Engl J Med 2019 →
• Variants in the PADI3 gene, which encodes a protein needed to build the hair shaft, have been associated with CCCA. The association does not explain every case: most patients studied carried no such variant. N Engl J Med 2019 →
• In a case-control survey of 101 African American women, no correlation was found between the use of hot combs or chemical relaxers and the development of CCCA, contrary to what had long been assumed. J Am Acad Dermatol 2009 →
• The same survey did find a strong association between CCCA and sewn-in weaves, and between CCCA and cornrows or braids using artificial extensions. Women with CCCA were also more likely to report pulling and tenderness from those styles. J Am Acad Dermatol 2009 →
• Hair transplantation has been reported as safe and effective in CCCA, but only in two published cases, and only where the disease was end-stage and a scalp biopsy showed no remaining inflammation. Dermatol Surg 2014 →
• In a case series of 18 patients with tightly curled hair, conventional rotary punches either failed outright or produced excessive transection in 8 of them, while a curved non-rotary punch kept transection below 5%. Plast Reconstr Surg Glob Open 2016 →
• In a retrospective series of 64 patients of African descent, the mean transection rate was 3-6%, and scalp thickness and firmness affected it more than hair curliness did. Dermatol Surg 2023; Clin Cosmet Investig Dermatol 2023 →
• For context, a study of 42 patients undergoing conventional FUE with a 1 mm punch found transection in 6.3-7.4% of grafts. Transection is not unique to textured hair; it is a feature of the technique. Plast Reconstr Surg Glob Open 2017 →
• Punch geometry is the lever surgeons have used against transection: shapes that keep the cutting edge away from the follicle beneath the skin have been reported to reduce it. J Cosmet Dermatol 2020 →
• Scalp biopsies from 22 African American and 12 white patients found total hair density significantly lower in the African American group. Arch Dermatol 1999 →
• The Norwood classification of male pattern baldness reports its incidence data from 1,000 white adult male subjects. South Med J 1975 →
• A 2026 review of complications in follicular unit excision reports that the incidence of shedding at the recipient site varies widely between studies, ranging from 0.15 to 15 percent. The studies inside that range counted in different ways: one single-surgeon record of 2,896 operations noted it in three patients, while a 621-patient series that looked for it specifically found it in 23. Front Med 2026 →
• A 2026 review of complications in follicular unit excision states that female sex has been identified as a major risk factor for shedding at the recipient site, with older age further increasing susceptibility among women. Front Med 2026 →
• A 2026 review of complications in follicular unit excision reports that shedding at the recipient site typically occurs within two to eight weeks after surgery, with regrowth usually beginning around three months afterwards. Front Med 2026 →
• In the two biopsy-confirmed cases of localized telogen effluvium after hair transplantation reported in Annals of Dermatology in 2018, shedding began three to four weeks after surgery, no treatment was given, and both patients had fully recovered within ten months. Ann Dermatol 2018 →
• In a single-centre retrospective series of 621 follicular unit excision patients in Japan, 23 developed temporary shedding at the recipient site: 9 of the 554 men and 14 of the 67 women. Sex was the only risk factor the study identified, with an odds ratio of 30.18 and a 95 percent confidence interval of 9.43 to 96.55. Aesthetic Plast Surg 2024 →
• In a single surgeon's record of 2,896 hair transplant patients operated over ten years, shedding at the recipient area was noted in three patients and at the donor area in one. Indian J Plast Surg 2021 →
• The true incidence of shedding in the donor area after follicular unit excision is unknown. A 2026 review states that only isolated case reports and small series have been published, and the authors of a 2023 case report say the same. Front Med 2026; Skin Appendage Disord 2023 →
• A series of 28 patients described shedding that began one to three days after surgery in a linear pattern, associated with dense-pack grafting at the receding temples. The authors suggest it could be the result of dense packing causing reduced oxygen supply around the recipient area and loss of miniaturised hairs there, and report that these effects were fully reversed in three months. Actas Dermosifiliogr 2023 →
• In a series of four men who had between 2,200 and 3,500 grafts extracted, patches of non-scarring hair loss appeared in the donor area two to three weeks after the procedure, and the hair pull test was positive in all four. J Cutan Aesthet Surg 2020 →
• Patchy hair loss in the donor area after follicular unit extraction can resemble alopecia areata both clinically and on trichoscopy, where black dots, exclamation-mark hairs and the coudability sign were all present. On biopsy the picture was different: dilated capillaries around the follicles, mucin deposition around the arrector muscles, dermal oedema and only a few lymphocytes, resembling a healing wound. The authors conclude that it should not be confused with alopecia areata. J Cutan Aesthet Surg 2020 →
• In the series of four patients with donor-area patches, all four were treated with intralesional triamcinolone and all four showed moderate to good improvement. The report does not state that the hair returned completely. J Cutan Aesthet Surg 2020 →
• Although post-transplant shedding is usually named telogen effluvium, the authors of a four-case series with biopsies hypothesise that compromised blood supply and trauma to the existing hairs may produce an anagen effluvium instead. A 2026 review takes a similar view, suggesting donor-area shedding probably spans both phases rather than being a pure telogen process. J Cutan Aesthet Surg 2020 →
• A systematic review searching the literature from 1960 onwards found that hair transplantation had been successful in three patients previously diagnosed with CCCA. Those cases used a combination of pre-transplant tests, a biopsy of the recipient site, and between six months and two years of anti-inflammatory treatment after the transplant. Skin Appendage Disord 2019 →
• The same review included 15 reports covering 34 patients with primary scarring alopecia of all types. Twenty-six experienced moderate to positive results, while 8 experienced negative results or recurrence of disease. Skin Appendage Disord 2019 →
• The authors of the systematic review state that they were unable to find evidence on how to precisely diagnose disease activity, or on when after disease activity it is appropriate to perform surgery. They also state that the commonly suggested two-year rule for hair transplant surgery after disease activity was not substantiated in their review. Skin Appendage Disord 2019 →
• The review names positive reporting bias as the biggest challenge it encountered: only cases with viable and positive outcomes are reported in this literature. Its authors conclude that no concrete, evidence-based recommendations can be made on hair transplantation in primary scarring alopecia at this time. Skin Appendage Disord 2019 →
• A scoring tool for CCCA disease activity was published in 2025. The C-CAT scores five things from 0 to 2 each: pain, itching, redness, scalp resistance and disease progression. In the 82 patients it was developed on, all of them African-American and 98 percent women, the average score at the first visit was 3.3; after treatment 88 percent improved and 48 percent reached a score of zero, which the tool defines as remission, over an average of 195 days. Skin Appendage Disord 2025 →
• The C-CAT was built to guide and track medical treatment. Hair transplantation, surgery and post-operative shedding are not mentioned anywhere in the paper that introduces it, and it offers no way to tell a flare apart from shedding caused by something else. Skin Appendage Disord 2025 →
• In a series of 32 patients with lichen planopilaris, a different scarring alopecia, surgery was performed only on inactive disease, and graft survival was 78.62 percent at twelve months and 79.96 percent at twenty-four months. The histopathology variables examined at the time of transplantation, including epidermal atrophy, fibrosis and inflammatory infiltrate, were not found to have any effect on graft survival. Dermatol Surg 2021 →
• In the series that named the fringe sign, 35 of 41 women with traction alopecia had a retained strip of hairs along the frontal or temporal rim, and every woman whose traction involved the marginal hairline had one. A later review describes the preservation of that fringe as a clue that distinguishes traction alopecia from frontal fibrosing alopecia, where it is lost. Dermatol Online J 2011 →
• Fourteen biopsies from that series were available for review. Fibrotic fibrous tracts were present in all of them, and a decrease in terminal hairs in all of them, alongside retained sebaceous glands in all, an increase in vellus-sized hairs in half, and sparse lymphocytic inflammation in just over half. Dermatol Online J 2011 →
• A review of traction alopecia states that there is currently no cure, and that in its later stages the disease may progress into an irreversible scarring alopecia if traumatic hairstyling continues without appropriate intervention. Clin Cosmet Investig Dermatol 2018 →
• A 2026 systematic review of hair transplantation in lichen planopilaris and frontal fibrosing alopecia, covering 13 studies and 113 patients, reported graft survival of 80 to 100 percent at six to twelve months, 71 to 100 percent up to twenty-four months, and below 41 percent after the second year. The authors identified no prospective studies or clinical trials, and noted a clear decline in graft survival after the second year. An Bras Dermatol 2026 →
• In that same review, transplantation was performed on patients with no clinically active disease in ten of the studies, covering 101 patients. The length of time the disease had been quiet before surgery varied widely between studies, ranging from none at all to sixty months. An Bras Dermatol 2026 →
• In a review of 15 patients with scarring alopecia of the scalp margin, six gave a history of relaxing or straightening their hair, six denied hair care practices sufficient to cause traction alopecia, and in three the history was unknown. The author reports that scarring at the margin is difficult to diagnose both clinically and histologically, and that the absence of a history of severe traction in half the patients casts doubt on whether traction is the only cause. Br J Dermatol 2009 →
• In a retrospective review of 216 patients with traction alopecia at a single institution in the Bronx, 98.6 percent of whom were women and 72.7 percent Black or African American, 49.1 percent attended a follow-up visit. Of those who did, 42.5 percent noted improvement in hair loss or symptoms across all visits. Clin Exp Dermatol 2023 →
• A systematic review of platelet-rich plasma as an adjunct to hair transplantation identified only three eligible prospective controlled studies, covering 217 participants. It reported that none of those studies employed standardized evaluation tools or trichoscopic analysis, which limited the consistency and comparability of their findings. Cureus 2025 →
• Objective trichoscopic assessment in studies of androgenetic alopecia is reported using named measures: target area hair count, target area hair width, and the terminal-to-vellus hair ratio, each recorded in defined scalp regions, alongside a physician global assessment and a patient-reported outcome questionnaire. Int J Dermatol 2026 →
• A review of traction alopecia states that histopathology can distinguish traction alopecia from alopecia areata, frontal fibrosing alopecia and patchy central centrifugal cicatricial alopecia, and that dermoscopy can detect ongoing traction through the presence of hair casts. Clin Cosmet Investig Dermatol 2018 →
• In the two published CCCA transplant cases, both patients had a scalp biopsy and a hair transplant test session before the full procedure, and hair growth at the recipient sites was first observed between four and five months after the test session. Dermatol Surg 2014 →
• A systematic review of hair transplantation in primary cicatricial alopecia, covering eight observational studies and 123 patients, reported weighted graft survival of 82.7 percent at 7 to 12 months, 73.3 percent at 13 to 24 months, 58.4 percent at 25 to 36 months, 55.4 percent at 37 to 48 months and 39.6 percent at 49 to 72 months, concluding that survival peaks at one year and diminishes over time. Dermatol Surg 2025 →
• In the same review, four of the 123 patients developed reactivation of their scarring disease after the transplant. Dermatol Surg 2025 →
• A network meta-analysis of eight studies covering 31,964 keloids and 373,390 people without keloids found the pooled odds of keloid formation among Black individuals to be 6.14 times those among White individuals, with a 95 percent confidence interval of 3.75 to 10.07. Plast Surg (Oakv) 2026 →
• A review of cosmetic surgery in Black patients states that the myth that all Black patients develop keloids or pigment changes after surgery should be dispelled, but that in patients with a history of keloid formation or hypertrophic scarring, elective cosmetic procedures should be either withheld or performed with extreme caution. Clin Plast Surg 1993 →
• A review of keloids states that they extend past the area of trauma and once present tend to remain stable; that they are found most commonly on the ear lobes, shoulders, upper back and mid-chest; and that although many treatments exist, most have had limited success. Dermatol Clin 1988 →
• Keloid scarring is described as a rare complication of hair transplantation, usually associated with strip harvesting rather than follicular unit extraction. It has nevertheless been reported at the donor site after follicular unit extraction, including one extensive case, and one report advises particular awareness in patients with previous keloidal tendencies. A scoping review found hypertrophic scarring or keloid formation to be the most common donor-site complication after strip surgery, at up to 15.1 percent. J Cutan Aesthet Surg 2020; Int J Trichology 2017; Aesthetic Plast Surg 2025 →
• Acne keloidalis nuchae is a chronic inflammatory condition of the hair follicles of the occipital scalp, classified as a primary cicatricial alopecia, that presents as papules, pustules and keloid-like plaques. In a multicentre series of 142 patients it affected men almost exclusively, and three quarters reported previous trauma to the nape; in a separate series of 101 treated patients most responded to treatment but very few had full resolution. Dermatol Pract Concept 2024; Cutis 2026 →
• A current review of hair transplantation describes the procedure as based on the principle of donor dominance, under which transplanted hair retains its genetic characteristics in its new location, and attributes long-lasting results to advances in devices and technique together with medical therapies to maintain hair density. Dermatol Surg 2025 (review); principle first described by Orentreich, Ann N Y Acad Sci 1959 →
• In a retrospective series of 112 men who had a single session of strip surgery for Norwood grade 4 or worse hair loss, photographs at four years were compared with photographs at one year by a dermatologist outside the surgical team. At four years the density of the transplanted hair was unchanged in 8.92 percent, slightly reduced in 27.67 percent, moderately reduced in 55.35 percent and greatly reduced in 8.03 percent; the authors concluded that transplanted grafts may not last permanently for all subjects. J Cutan Aesthet Surg 2020 →
• In the same four-year series, 73.21 percent of the men were still using minoxidil and 35.71 percent finasteride four years after surgery; the authors reported that the influence of either on the longevity of the transplanted follicles was not statistically significant, and that hair density could not be counted because the study was retrospective. J Cutan Aesthet Surg 2020 (full text) →
• In 11 men with male pattern baldness, grafts were placed into tattooed templates of 1.5 square centimetres and counted over the first year: 47.3 percent of follicular units were present at one month and 57.4 percent at three months, while 92.0 percent of the transplanted hairs were present at six months and 90.4 percent at twelve months. The authors note that about half of the transplanted hairs fell out in the first month. Dermatol Surg 2001 →
• In a study of 19 patients whose scalp hair had been transplanted to the eyebrows, the growth rate and greying rate of the transplanted hairs were lower than those of hairs near the donor site for most patients; the authors concluded that the recipient site may have an influence on transplanted hairs, and noted that few studies had tested the assumption that its influence is negligible. Dermatol Surg 1999 →
• A classification proposed for hair restoration surgery states that pattern baldness in men and women is progressive and unrelenting, that a satisfactory short-term outcome can evolve into a disappointing result because of progressive hair loss, and that this lifetime risk is higher the younger the patient and the larger the area transplanted. Dermatol Surg 2022 →
• In a randomised, double-blind, placebo-controlled trial of 79 men aged 20 to 45 with androgenetic alopecia, finasteride 1 mg daily from four weeks before until 48 weeks after a hair transplant improved the non-transplanted scalp hair surrounding the transplant compared with placebo on both photographic assessment and hair counts; visible increases were recorded in 94 percent of the finasteride group and 67 percent of the placebo group. Dermatol Surg 2005 →
• A current review of complications in follicular unit excision describes unnatural results as one of the most frequent aesthetic complications and a major cause of dissatisfaction, states that the primary cause is iatrogenic, most often inadequate preoperative planning or lack of surgical experience, and lists improper hairline design, inaccurate graft angulation, direction or height, irregular density distribution, and large multi-hair grafts in the frontal region producing a pluggy or tufted appearance; it adds that careful graft handling and depth control minimise pitting or elevation. Front Med 2026 (full text) →
• The same review states that management of unnatural results focuses on aesthetic revision: surgical excision or removal of misplaced grafts, redistribution, or camouflage by adding single-hair follicular units, with laser hair removal or electrolysis in selected cases to soften excessively dense or misplaced grafts. An earlier repair review describes the same three routes: punch or linear excision, which allows poorly planted grafts to be relocated; removal without reimplantation, which can be done by laser or electrolysis in special situations; and camouflage. It notes that the available donor supply is limited by hair density, scalp laxity and scar placement. Front Med 2026 (full text); Dermatol Surg 2002 →
• In a series of 120 men treated with follicular unit transplantation, interviews with earlier transplant patients had identified two complaints: a straight anterior hairline that looked unnatural, and hair that looked like sprouted grass. The surgeons responded by seeding irregularly instead of in rows and placing single hairs along the anterior hairline in the direction of growth, and concluded that hair texture is very important, with additional care needed for dark-coloured and hard hair. J Plast Reconstr Aesthet Surg 2006 →
• A repair-strategy review states that the use of small grafts alone does not protect the patient from poor work, and that errors in surgical and aesthetic judgment, performing procedures on non-candidates, and failure to communicate realistic expectations remain major problems; a separate review states that recipient-site problems can arise from either surgeon or assistant error, and that assistants contribute greatly to success or failure through graft dissection and placement. Dermatol Surg 2002; Facial Plast Surg Clin North Am 2013 →
• In a series of more than 40 patients dissatisfied with previous hair restoration surgery, the causes of unfavourable results were classified as technical errors, poor planning or complications; the author reports improvement in each of them, by amounts ranging from small to significant, in his own assessment. The challenges named were limited donor hair, reduced scalp laxity, vascularity that may be reduced by scarring, and patient scepticism; the complications of repair included one case of poor growth after extensive small-graft transplanting and one case of scalp scarring after removing a large number of plug grafts in a single procedure. Plast Reconstr Surg 1999 →
• In a retrospective comparison of 27 patients who developed recipient-area folliculitis after follicular unit transplantation and 28 who did not, lesion onset ranged from 2 days to 6 months after surgery with a mean of 1.44 months; lesions were mostly pustules, healed without scarring regardless of management, did not affect graft growth, and were not associated with patient characteristics or the number of grafts. Dermatol Surg 2010 →
• In a multicentre retrospective cohort of 1,090 hair transplant patients, persistent redness around the grafts was mild in 16.33 percent, moderate in 5.14 percent and severe in 0.92 percent; patients with it shed more hair shafts and had lower graft survival, folliculitis was a significant risk factor with an odds ratio of 6.061 for mild redness, and an untimely first postoperative wash was associated with the moderate and severe forms. Aesthet Plast Surg 2024 →
• In the largest published series of recipient-site necrosis, 18 patients seen after follicular unit excision elsewhere, the commonest risk factors were smoking in 66.7 percent, hypertension and diabetes; all had had a single session averaging 3,899 follicular units, and scarring and graft failure occurred in every patient. A current review lists the technical risk factors as dense packing above 50 follicular units per square centimetre, sessions above 3,500 to 4,000 grafts, deep or overlapping slits, excessive tumescence and high epinephrine concentrations. Aesthet Plast Surg 2024; Front Med 2026 (full text) →
• In 980 women who had hairline-lowering surgery, transplanted hair grew back kinky or severely curly in 38, or 3.9 percent; in 36 of them the curl appeared around four months after surgery, and in two it appeared at six to eight months when growth was obstructed by existing hair. J Craniofac Surg 2024 →
• Two proponents of dense packing, the practice of placing more follicular units per square centimetre in one operation than conventional transplantation, describe it as desirable in principle but state that not all patients are suitable and that it is not possible to achieve in certain patients, giving coarse or curly hair as the example; their ideal candidates have sufficient donor availability, reasonably stable hair loss and high hair-to-skin colour contrast. Facial Plast Surg Clin North Am 2013 →
• The earliest published account of hair transplantation in Black patients reports its author's own observations that, with slight modifications in how donor grafts are obtained, the integrity of the hair shafts and papillae is maintained, and that aesthetic results are generally comparable to those in white patients and often achieved with considerably fewer grafts. It reports no method, no count and no follow-up. J Dermatol Surg Oncol 1977 →
• A review comparing the two harvest methods concludes that follicular unit excision and strip surgery are equally effective in generating high-quality grafts and differ in their scarring of the donor region: strip surgery leaves a linear scar, excision leaves punctate scars that are typically easily concealed; distinct subgroups of patients are eligible for one method, the other, or both. Dermatol Surg 2020 (review) →
• In 88 patients who had strip harvesting, donor scar width measured ten months after surgery correlated positively with preoperative scalp laxity and elasticity, and patients in the upper thirtieth percentile of elasticity, at ten millimetres or more, had significantly wider scars than the rest. Dermatol Surg 2017 →
• In 10 patients who had follicular unit excision after an earlier strip harvest, the strip scar averaged 2.47 millimetres wide, hair density was 155.4 hairs per square centimetre above the scar and 130.8 below it, hair angle differed above and below, and transection during excision was doubled below the scar; the author concludes that strip surgery leaves impacts on the donor area other than the scar. J Cosmet Dermatol 2020 →
• A review of graft placement states that the implanter, which creates the incision and places the follicular unit in one motion, was introduced by Choi and was popular first in East Asia because Asian hair is typically straight and thick with units of one or two hairs; that the uniform graft size of follicular unit excision and the possibility of delegating placement were key attractions in its adoption; that forceps allow safe placement in the hands of well-trained teams; and that the greater fragility of excision grafts has led to growing acceptance of implanters. Facial Plast Surg 2024 (review) →
• In a prospective observational study of 1,000 patients at one centre, graft survival was reported as 94.7 percent with a sapphire blade and 88.9 percent with a steel blade, implantation was 1.3 hours shorter with double-forceps insertion, and two-day full-head operations reached 43.2 grafts per square centimetre with a satisfaction score of 9.4; patients were divided into groups rather than randomised, and the abstract does not state how survival was counted. J Maxillofac Oral Surg 2026 →
• In four Korean men, single-hair follicular units were placed with an implanter into tattooed one-square-centimetre templates at 20, 30, 40 and 50 per template and counted at ten months; survival was higher at 20 and 30 per square centimetre than at 40 and 50, and the authors note the small sample and the limitation to single-hair units. Dermatol Surg 2006 →
• In 38 young adults born in central and western Africa, phototrichograms of three scalp areas gave a hair density of 190 plus or minus 40 hairs per square centimetre, ranging from 90 to 290, against 227 plus or minus 55 in previously studied white volunteers of comparable age; African hair also grew more slowly, at 256 against 396 micrometres a day, with a higher telogen fraction. Br J Dermatol 2001 →
• In a cross-sectional trichoscopy study of 909 Nigerians aged 5 to 45, hair density ranged from 113 to 660 per square centimetre with a median of 330, and the authors concluded that the hair density of Africans is high. The abstract's definitions of strands per follicular unit are not internally consistent, the full text is not openly available, and we have not been able to verify how hairs were counted. West Afr J Med 2024 →
• In 2,249 young adults without alopecia from 24 ethnic groups on five continents, measured with non-invasive validated techniques on three scalp areas, African hair had lower density and a slower growth rate, Asian hair a thicker diameter with faster growth, and white hair a high total density. Eur J Dermatol 2016 →
• In the 122 South Africans of the trichoscopy reference study, mean hair shaft thickness was 62.59 micrometres, with the frontal scalp showing the thickest shafts and the highest follicular unit density, the temporal scalp the largest share of thin hairs, and the occipital scalp the highest proportion of three-hair follicular units. Int J Dermatol 2025 →
• In more than 2,000 hairs from 12 African volunteers who had not used chemical treatments, light microscopy showed hairs that appear as a tightly coiled spring-like structure, knots in 10 to 16 percent of shafts against 0.15 percent in other groups, shafts that appear broken, features consistent with repeated breakage on electron microscopy, and, examined in place on the scalp, interlocking of the hair shafts. J Am Acad Dermatol 2000 →
• Hair density in people of African descent has been measured five times: by scalp biopsy in 22 African Americans against 12 white patients, by phototrichogram in 38 African-born adults, in 2,249 adults from 24 ethnic groups, and by trichoscopy in 122 South Africans and in 909 Nigerians. Four of the five found it lower than white or worldwide comparisons; the Nigerian study reported a median of 330 hairs per square centimetre and called it high, and its counting rule could not be verified. None measured a donor area, and none measured what curl adds to how much scalp each hair covers. Arch Dermatol 1999; Br J Dermatol 2001; Eur J Dermatol 2016; West Afr J Med 2024; Int J Dermatol 2025 →
• Laboratory measurements of hair fibres from white, Asian and African subjects, using X-ray analysis, cross-sectional measurement, tensile testing and water swelling, found no differences in the internal structure of the fibre between the three groups, while geometry, mechanical properties and water swelling differed according to ethnic origin. J Am Acad Dermatol 2003 →
• In native and grafted scalp follicles taken from 2 patients who had earlier undergone strip transplantation, electron and light microscopy showed a marked enlargement of the grafted follicles with an increase in hair shaft diameter, a thickened dermal sheath and a denser vascular network; the authors conclude that the grafted follicles underwent marked morphological change during their residence in the recipient site. Am J Dermatopathol 2016 →
• A review of the biology of curly hair states that all human hair fibres share the same basic structure while the three-dimensional shape of the fibre varies from very straight to the tightly sprung coils of African hair, that how the follicle forms a coiled fibre remains relatively unexplained, and that the genetic factors thought to be responsible include, in a genome-wide comparison of low- and high-curl individuals in South Africa, variation in trichohyalin, the copper transporter CUTC and keratin 74. Exp Dermatol 2017 (review) →
• In an interventional study of five men with grade 6 to 7 pattern baldness, one follicular unit from the scalp, the beard and the chest was implanted into each of three marked one-square-centimetre blocks in the same head and followed for a year; anagen effluvium in the first two months was 40 percent for scalp and 30 percent for beard against 53.3 percent for chest hair, and survival at one year was 94.7 percent for beard, 88.7 percent for scalp and 75.3 percent for chest. J Cutan Aesthet Surg 2019 →
• The only published system for grading a beard donor area deems beard grafts unsuitable for harvesting if the donor area is restricted to the perioral area, the density is under 8 follicular units per square centimetre, the diameter is under 60 micrometres or the angle to the skin is under 10 degrees; it then scores diameter, curliness and colour contrast with the native hair, and states that beard grafts used for hairline correction have thinner diameters of 60 to 80 micrometres, straight shafts and minimal colour contrast, while beards used for the parietal area have thicker diameters above 80 micrometres. Dermatol Surg 2025 →
• In a report of three severely bald men who had hair transplanted from the chest, abdomen, legs, shoulders or beard as well as the head, two of whom had undergone previously unsuccessful hair transplant surgeries, approximately 80 to 85 percent of the transplanted grafts survived; the author names hair length and quality, surgery time and the requirement for improved surgical skills as remaining challenges. Ann Plast Surg 2011 →
• Two technique reviews state that not all body hair is suitable for transplantation and that only hairs similar in appearance and behaviour to scalp hair are suitable for transplantation to the scalp, that the best non-scalp sources are the beard and the anterior torso, and that body hair characteristics such as thickness, length and hair cycle may not completely match those of scalp hair while the harvesting techniques are more time consuming and require a higher degree of skill than regular scalp excision. Indian J Plast Surg 2021 and Indian Dermatol Online J 2017 (reviews) →
• A review of pseudofolliculitis barbae states that it is a chronic inflammatory disorder of follicular and perifollicular skin characterised by papules, pustules and post-inflammatory hyperpigmentation, that it occurs more frequently in men of African and Asian descent, that the curved shape of the hair follicle allows the downward curvature and penetration of the growing hair tips into the skin especially in the beard area, and that keloids have also been known to develop after the onset of pseudofolliculitis barbae, giving rise to extensive unsightly scars. Clin Cosmet Investig Dermatol 2019 (review) →

✔ 1 · Supported by a professional guideline

• There is no established standard of care for treating CCCA. A 2024 Delphi panel of 27 hair-disorder dermatologists reached strong consensus on only 20 of 70 statements they considered. J Am Acad Dermatol 2024 →

○ 10 · Documentation requested

Patient outcomes

Results, timelines and what patients can expect.

○ 1 · Documentation requested