Hair transplant surgery can restore coverage to CCCA-affected areas, but only under specific conditions. The scarring nature of CCCA creates unique challenges that do not exist in standard androgenetic alopecia transplants. Understanding these requirements helps set realistic expectations and avoid premature surgery that could fail.
Can You Get a Hair Transplant With CCCA?
Yes, but with strict prerequisites. The disease must be fully inactive before any surgical hair restoration is attempted. Transplanting follicles into actively inflamed tissue means the same inflammatory process that destroyed your original follicles will attack the transplanted ones.
Minimum Requirements for CCCA Transplant Candidacy
| Requirement | Details | Why It Matters |
|---|---|---|
| Disease stability | 12 to 24 months minimum with no progression | Active inflammation destroys transplanted grafts |
| Biopsy confirmation | No active lymphocytic inflammation on histology | Clinical observation alone is insufficient |
| Adequate donor area | Healthy, unaffected donor zone (sides and back) | CCCA can occasionally extend to donor areas |
| Realistic expectations | Understanding that results may differ from standard transplants | Scarred tissue affects graft survival |
| Ongoing medical treatment | Commitment to continued anti-inflammatory maintenance | Prevents disease reactivation post-surgery |
What Happens During a CCCA Transplant?
The Test Graft Approach
Most experienced surgeons start with a small test grafting session (50 to 100 grafts) placed into the scarred area. This test serves two purposes:
- Assess graft survival: If the test grafts survive and produce hair over 6 to 12 months, a full session can proceed
- Check for reactivation: If the surgical trauma triggers disease flare, the full procedure is postponed
This cautious approach prevents the loss of thousands of precious donor grafts to disease reactivation.
Surgical Technique Considerations
FUE (Follicular Unit Extraction) is typically preferred for CCCA patients because:
- It avoids the linear scar of FUT in the donor area
- Individual graft placement allows precise positioning around remaining healthy follicles
- The Choi Implanter Pen (DHI technique) offers controlled depth and angle in scarred tissue
- Recovery takes 7 to 10 days
Graft survival expectations: In non-scarring alopecia, FUE grafts achieve 90-95% survival. In CCCA, survival rates may be lower because:
- Scarred tissue has reduced blood supply
- Fibrotic tissue is denser, making recipient site creation more difficult
- The inflammatory environment, even when apparently quiescent, may be subtly hostile to new follicles
Surgeons experienced with CCCA transplants may report 70 to 85% survival rates in stabilized patients, though published data on large cohorts is limited.
Who Is NOT a Good Candidate?
Hair transplant is not appropriate for CCCA patients who:
- Have active disease (expanding areas, scalp symptoms, positive biopsy for inflammation)
- Cannot commit to long-term medical maintenance after surgery
- Have insufficient donor hair (if CCCA has affected the sides or back of the scalp)
- Expect the transplanted hair to look identical to a standard transplant result
- Have been stable for fewer than 12 months
How Many Grafts Are Needed?
Graft requirements for CCCA depend on the size of the scarred area:
| Scarred Area Size | Estimated Grafts Needed | Sessions |
|---|---|---|
| Small (under 2 cm diameter) | 300 to 800 | 1 |
| Moderate (2 to 5 cm) | 800 to 2,000 | 1 to 2 |
| Large (5 to 10 cm) | 2,000 to 4,000 | 2 to 3 |
| Very large (over 10 cm) | 4,000+ | Multiple |
These estimates assume standard follicular density targets. African hair follicular density averages 120 to 180 follicular units per cm2, compared to 170 to 230 for Caucasian hair. Curly hair texture can provide better visual coverage per graft because the curl creates more volume.
Cost Considerations
CCCA transplant costs follow the same per-graft pricing as other hair transplants, varying by location:
| Region | Cost per Graft (USD) |
|---|---|
| USA | $4 to $6 |
| UK | $3 to $5 |
| Europe | $2.50 to $4.50 |
| Turkey | $1 to $2 |
| India | $0.50 to $1.50 |
Additional costs specific to CCCA transplants include the preliminary test graft session, more frequent post-operative follow-up visits, and ongoing medical treatment to prevent disease reactivation.
Questions to Ask Your Surgeon
Before proceeding with a CCCA transplant, ask:
- "How many CCCA transplant patients have you treated?" (Look for at least 10+)
- "What graft survival rate do you see in scarring alopecia patients?"
- "Do you perform a test graft session first?"
- "Will you coordinate with my dermatologist to confirm disease stability?"
- "What is your protocol if disease reactivation occurs after transplant?"
Next Steps
If you have CCCA and are considering hair transplant, the path forward involves:
- Confirm your disease has been stable for at least 12 months through your dermatologist
- Review our CCCA condition overview to understand your condition fully
- Take our complete hair transplant candidacy guide to evaluate your overall suitability
- Use our free AI assessment at myhairline.ai/analyze to document your current hair density
The combination of disease stability, realistic expectations, and an experienced surgical team gives CCCA patients the best chance of a successful hair transplant outcome.
Medical disclaimer: This article is for informational purposes only and does not constitute medical advice. Hair transplant suitability for CCCA must be determined by both a dermatologist and a qualified hair transplant surgeon after thorough evaluation.