Keloid Risk After Hair Transplant

Keloid risk after hair transplant refers to the possibility of abnormal scar formation in susceptible individuals following surgical hair restoration. Keloids represent an exaggerated wound-healing response and may lead to permanent cosmetic concerns.

Although uncommon, keloid formation is one of the most important contraindications to elective hair transplantation.

What is a keloid scar?

A keloid is a type of pathological scar characterized by excessive collagen production that extends beyond the original wound boundaries. Unlike normal scars, keloids do not regress over time.

For an overview of surgical hair restoration, see:
What Is Hair Transplant?

Why keloids form

Keloids result from dysregulated wound healing involving prolonged inflammation and fibroblast overactivity. Genetic predisposition plays a central role.

Keloid vs hypertrophic scars

Hypertrophic scars remain within wound margins and may improve over time, whereas keloids extend beyond the wound and persist.

Incidence of keloids after hair transplant

The overall incidence is low, but the risk increases significantly in patients with a known keloid history.

High-risk patient profiles

Certain patient characteristics increase keloid risk.

• Personal or family history of keloids
• Darker skin phototypes
• Previous keloid formation after minor injuries
• Young age with active scar response

Common locations of keloid formation

In hair transplantation, keloids most commonly develop in the donor area, where skin tension and deeper wounds are present.

Donor vs recipient area risk

Recipient area keloids are rare due to superficial implantation, while donor sites carry higher risk.

Donor-related complications are discussed here:
Hair Transplant Scarring

Role of surgical technique

Larger wounds, excessive tension, and aggressive extraction increase scar risk.

FUE and FUT considerations

Both FUE and FUT carry keloid risk, though FUT linear scars may be more problematic in predisposed patients.

Technique differences are explained here:
FUT vs FUE

Importance of preoperative screening

A detailed history of previous scars is essential before recommending surgery.

Test incisions and patch testing

In uncertain cases, small test incisions may be considered to assess healing response.

Why keloid risk is a contraindication

Elective hair transplant surgery should be avoided in patients with high keloid risk due to irreversible cosmetic damage.

Can keloids be prevented?

True keloids cannot be reliably prevented once a patient is predisposed. Avoidance is the safest strategy.

Medical and procedural interventions

Steroid injections, pressure therapy, or laser treatments may reduce keloid size but rarely eliminate them completely.

Psychological and cosmetic impact

Keloids can cause distress, discomfort, and dissatisfaction, particularly when visible.

Ethical responsibility of clinics

Clinics must refuse surgery when keloid risk outweighs potential benefits.

Informed consent and documentation

Clear documentation of scar risks is essential in high-risk individuals.

Long-term planning implications

Patients with keloid tendency should explore non-surgical options.

Long-term planning considerations are discussed here:
When Hair Transplant Is Not Recommended

Clinical impact of proper screening

Identifying keloid risk protects patients from irreversible harm and preserves trust.

References

1. Dermatologic Surgery – Keloids and Hypertrophic Scars
   
2. NIH – Pathophysiology of Keloid Formation
   
3. American Academy of Dermatology – Keloids Overview
   

Medical Disclaimer:
This article is provided for informational and educational purposes only and does not constitute medical advice.
It is not intended to replace a face-to-face consultation, diagnosis, or treatment by a qualified physician.
Individual treatment decisions should always be made in consultation with a licensed medical professional.