The surgical treatment of cicatricial alopecia

Walter Unger, Robin Unger, Carlos Wesley

Research output: Contribution to journalReview articlepeer-review

46 Scopus citations


Surgical correction of cicatricial alopecia can yield exceptional results when performed in the appropriate clinical scenario. To facilitate determination of the most suitable corrective therapy, we propose two new categories of cicatricial alopecia: "unstable" and "stable." Unstable cicatricial alopecia is intermittent and results in possible subsequent scarring hair loss in either new or old areas. Stable cicatricial alopecia, on the other hand, refers to fixed permanent scarring. While surgical excision is preferred to hair transplantation for both categories of cicatricial alopecia, this preference is even stronger in cases of unstable cicatricial alopecia due to its intermittent and progressive nature. Regardless of which corrective technique is used, analysis of specific physical patient characteristics coupled with a careful view towards the possible evolution of male pattern baldness or female pattern hair loss are essential to achieve superior long-term results. Herein we also outline guidelines for identifying these physical traits as well as for performing hair transplantation and surgical excision in order to achieve optimal cosmetic outcomes and minimize postoperative complications.

Original languageEnglish
Pages (from-to)295-311
Number of pages17
JournalDermatologic Therapy
Issue number4
StatePublished - Jul 2008


  • Alopecia reduction
  • Female pattern hair loss
  • Hair transplantation
  • Male pattern baldness
  • Stable cicatricial alopecia
  • Unstable cicatricial alopecia


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