Treatment of Radiotherapy Induced Focal Scalp Hair Loss
by Hair Transplantation.
by Dr Richard Rogers MB ChB LTTS
Stratford Health Care, Arden Street, Stratford On Avon, Warwickshire. CV37 6HJ
Tel: 01789 414 203
3/11/05
This article is published by Dr Richard Rogers Past President of The Society (a specialist in hair restoration techniques)
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A female patient aged 41 was diagnosed with a frontal lobe Astrocytoma in 1997 confirmed by biopsy as grade 2-3. This was initially monitored but after further biopsy, she received localised cranial radiotherapy in 2000.
She subsequently suffered an area of hair loss over the right vertex and temporal region which did not grow back except a few fine hairs (see before pictures). She had a small central vertex "dent" in the bone caused by the two biopsies, associated with some scalp scarring. The surrounding hair remained healthy with dense, thick calibre hair.
She found hair pieces difficult and uncomfortable to wear and enquired further from her consultant as to alternative options. He was unaware of any other treatments but research produced a list of Trichologists produced by The Trichological Society (www.hairscientists.org).
She was thereupon referred to me for consultation in May 2003.
Realistically, only two options were available that would bring significant cosmetic improvement after three years, as it was unlikely that any more improvement would occur spontaneously. She had already tried hair pieces; the other choice was hair transplantation.
Hair transplantation was originally developed by Dr Okuda in Japan in the 1930's but failed to catch on until the Americans independently reinvented it in the 1950s. It involves taking hair from the patients' donor area (which is usually the occiput) and moving it to the recipient area where it is needed. All performed under local anaesthetic, it has become a very successful specialist technique. Although commonly used for male pattern hair loss, it has a number of other uses such as eyebrow restoration or replacing sideburn hair lost due to facelifts or covering burns on the scalp.
After discussion concerning risks, we decided a small procedure of 500 hair grafts would be appropriate. Although her skin appeared to be in good condition, there was a possibility that the vascularity had been compromised, so a cautious approach seemed prudent. Her consultant was happy for the surgery to place.
Her first hair transplant took place in August 2003 and was uneventful. All the grafts appeared to take well, with no complications of either infection or necrosis. A further surgery was performed in November 2004 which involved 750 hair grafts, the results of which are shown below. She has now had a third and probably final procedure of 650 hair grafts in November 2005.
She is very pleased with the results. She can style her hair normally although the density will look sparser than normal if she currently exposes the new hairline too much.
1 Post Radiotherapy
Post hair transplant (2 nd procedure)
3 Close up of Follicular micrografts