Hair Transplants: Do They Last Forever? - The Truth

Hair transplants are often described as a "permanent solution" to hair loss. But is this really true? The answers are more nuanced (and fascinating) than you might expect. In 1959, Dr. Norman Orentreich published the first robust study on human hair transplants for the treatment of androgenic alopecia (AGA). Over a 2.5-year period, Dr. Orentreich showed that healthy hairs transplanted from the backs of men's scalps into balding regions kept growing just fine; they remained resistant to hair follicle miniaturization. The implication? That scalp hairs are "donor dominant", that our scalp environments do not influence the onset of baldness, and that hair follicle miniaturization is likely genetically predetermined within each hair follicle itself. Over the following years, other investigation groups confirmed Orentreich's initial findings... and the hair transplant industry was born. Today, hair transplants are considered one of the most reliable ways to restore a receding hairline, fill in a bald spot, and add density to thinning regions. Studies also show that transplant surgeries are overwhelmingly effective and that they improve the quality of life for patients. As such, they should remain a staple procedure in our fight against hair loss. Having said that, more and more transplant surgeons are now admitting, contrary to popular belief, that transplanted hairs do thin... and for reasons probably linked to recipient site influence and not just donor dominance. This is especially true for patients 10-30 years post-procedure. But it may also be true over shorter time horizons. After all, a recent study found, over a four-year period, that 90% of patients showed a loss of transplanted hairs (despite their transplants originally growing in just fine). So, how can we reconcile these new findings with the original studies from Orentreich – the ones suggesting that transplanted hairs will last a lifetime? The answers, as always, are complicated! This video provides my take on the data, and why I think recipient site influence might one day be leveraged to improve hair loss outcomes for everyone. -- Interview with Dr. Nilofer Farjo and Dr. Maksim Plikus:    • An Interview with the Advances in Hai...   About Rob English: -Editorial board member of Dermatology and Therapy -Medical editor specializing in hair loss disorders -Peer-reviewed publications: perfecthairhealth.com/publications/