Autologus Hair Transplantation Vs Skin Expansion in Management of Cicatricial Alopecia; A Comparative Study

Background: The bad impact of cicatricial alopecia among population lead to increase the desire of correction of that type of hair loss. Although, there are many methods of hair restoration but the efficacy of each, indications and possible hazards has not yet been clearly identified. Objective: To compare between hair transplantation using follicular unit extraction and skin expansion surgeries in the field of hair restoration in secondary cicatricial alopecia regarding aesthetic outcome, operative duration, optimum patient selection and complications of both techniques. Subjects and methods: Twenty four patients suffering from alopecia were involved in this study 15 males (62.5%) and 9 females (37.5%). Patient’s age ranged from 7 to 26 years old. Patients were divided into two groups according to the procedure done. Group (A) 12 patients done hair transplantation surgeries. Group (B) 12 patients done scalp expansion surgeries. Results: There was a non-significant difference between both groups regarding the mean age or the mean operation duration (P > 0.05). The mean values of the surface area of alopecia, in tissue expander group (B) was significantly larger than that of hair transplantation in group (A) (P < 0.001). However the time since exposure to the causative injury was significantly longer in group (A) than that of group (B) (P < 0.01). Hair transplantation tends to have less recovery time highly indicated in adults with smaller non-dependent areas of alopecia, while expanders with long recovery period solve bigger problems of alopecia in younger patients. Conclusion: Multiple factors interfere with the surgical plan age, gender, occupation, size and site of alopecia and time since injury. Both hair transplantation and skin expansion are very useful in the field of cicatricial alopecia treatment. While hair transplantation has less hazards during anesthesia, less post-operative scars and less recovery time, skin expansion is a good solution for bigger problems like big area of alopecia or younger patients.