Hair Transplant on Scar Tissue: A Complete Guide to Techniques, Results & Recovery

Hair loss due to injury, surgery, or burns can leave behind stubborn scars where hair refuses to grow back. Fortunately, modern advances in hair restoration make it possible to perform hair transplants even into scar tissue. But while the procedure is achievable, it comes with added complexity compared to traditional transplants. This guide explores the science, techniques, success rates, and what patients can expect from hair transplants on scars.

Is Hair Transplant on Scar Tissue Possible?

Absolutely! While it might sound unlikely at first, hair can grow in scarred skin with the right techniques. Thanks to medical advances, what was once thought impossible is now routinely done in skilled hands.

Here’s what the research shows:

• A 2024 clinical trial found that using a fractional CO₂ laser before FUE (Follicular Unit Extraction) improved results in eyebrow scars.
• A 2021 study reported up to 85% hair graft survival in burn scars when pre-treated with fat injections and laser.

So what makes success more likely?

• The type and maturity of your scar
• Whether the skin was pre-conditioned with regenerative treatments
• The technique your surgeon uses

In other words: yes, it’s possible. And with the right approach, the results can be both natural-looking and confidence-boosting—even in tough cases.

What’s the Success Rate for Hair Transplant into Scar Tissue?

Success rates for hair transplantation into scar tissue can be surprisingly good—when the procedure is done right. While results aren't identical to those seen in healthy skin, the gap has narrowed thanks to advances in pre-conditioning and surgical technique.

Let’s break it down:

• Burn scars: Studies report 75–90% graft survival when fractional CO₂ laser and nanofat injections are used before surgery. These methods help remodel the scar, making it more like healthy skin. (Ağaoğlu et al., 2021)
• Linear surgical scars: When high-density FUE is applied correctly, especially in scars that are at least one year old, survival rates average around 66%. Good cosmetic coverage is typically achieved when final hair density exceeds 20 FU/cm². (Okochi et al., 2022)
• Eyebrow scars: A 2024 randomized controlled trial found 82% survival in laser-pretreated scars versus 74% in untreated ones. Laser not only improved survival but also reduced irregular hair direction and regrowth issues. (Xue et al., 2024)

What does this mean for you?

Even in areas where blood flow is compromised and the skin is less forgiving, outcomes can be excellent—with proper planning, technique, and healing support.

The Importance of Pre-Conditioning Scar Tissue

One of the biggest game-changers in transplanting hair into scar tissue is pre-conditioning. Unlike healthy skin, scarred areas aren’t naturally equipped to support new hair growth. That’s where regenerative therapies come in—they help re-engineer the scar to behave more like normal skin. Here are the proven techniques that work:

• Fractional CO₂ Laser: Laser therapies for hair deliver controlled micro-injuries to the skin, which kickstart healing and trigger the release of growth factors. The laser creates tiny channels that also help subsequent treatments—like PRP or fat grafting—penetrate more effectively. In the aforementioned 2024 study by Xue et al., eyebrow scars pre-treated with fractional CO₂ laser showed a significant improvement in both graft survival and aesthetic quality.
• Nanofat (Microfat) Grafting: This involves harvesting fat from the patient (usually the abdomen), processing it into a fine emulsion, and injecting it into the scarred area. The fat is rich in a mix of regenerative cells that improves dermal thickness and boosts the growth of new blood vessels. In the aforementioned 2021 study by Ağaoğlu et al., nanofat-treated burn scars showed up to 85% follicle survival after FUE transplantation.
• Platelet-Rich Plasma (PRP): PRP is made by concentrating a patient’s own blood platelets, which are full of growth factors. When injected into scar tissue before (or even after) surgery, PRP can stimulate vascular growth and tissue remodeling. It also accelerates healing and supports graft retention during the vulnerable early phase of regrowth.
• Mesotherapy: Hair mesotherapy treatment involves micro-injections of vitamins, peptides, and growth factors directly into the scalp. When applied to scarred areas, it enhances circulation, improves cellular hydration, and can support pre- and post-transplant recovery. It's especially useful when combined with other therapies to boost local response in low-vascularity zones.

The Bottom Line?

Pre-conditioning isn’t optional—it’s often the deciding factor between a mediocre and a highly successful transplant in scarred areas. These therapies don’t just improve outcomes—they help make the procedure possible in cases that would otherwise be too high-risk or low-yield.

The Bottom Line?

Pre-conditioning isn’t optional—it’s often the deciding factor between a mediocre and a highly successful transplant in scarred areas. These therapies don’t just improve outcomes—they help make the procedure possible in cases that would otherwise be too high-risk or low-yield.

Hair Transplant Success on Different Types of Scars

The success of a hair transplant depends heavily on the type of scar being treated. Each scar type comes with its own structure, challenges, and ideal treatment plan. Below is a more detailed breakdown. Simply click or tap on the type of scar you wish to know more about.

Understanding the type of scar you have is the first step in planning a successful hair transplant. An experienced surgeon will assess your skin’s condition and determine whether additional therapies are needed before grafting.

Complexities of Transplanting Hair into Scar Tissue

Transplanting hair into scar tissue isn't quite the same as working with healthy skin. Scar tissue presents a set of unique challenges that demand thoughtful planning, precise technique, and, often, a bit more patience.

1. Poor Blood Supply

Scar tissue has limited circulation, which means less oxygen and fewer nutrients for new hair follicles. This can lead to lower graft survival. Surgeons use treatments like platelet-rich plasma (PRP) or fractional CO₂ laser therapy before surgery to stimulate blood vessel growth and boost oxygen delivery to the area.

2. Dense, Stiff Skin

Scarred skin is often tough and inelastic due to thick collagen. This makes it harder to insert grafts cleanly, which can stress the follicles. Fractional lasers and nanofat injections are used before surgery to soften the scar tissue and improve flexibility. Softer skin allows for smoother graft placement and better healing.

3. Unpredictable Graft Behavior

Hair grafts in scarred areas may grow at awkward angles or come out curly, especially if placed too shallow or if dense collagen distorts the follicle path. Surgeons compensate by using finer, single-hair grafts and customizing the angle and depth of each incision. Laser pre-treatment can also reduce skin tension that causes misdirected growth.

4. Technical Adjustments Needed

Standard techniques don’t always work on scarred areas. Surgeons need to adjust the tools, angles, and density to match the scar's condition. Smaller punches (0.7–0.9 mm) help minimize trauma, while shallow implantation angles reduce stress on the grafts. Often, the first session is used to prepare the area for better results in a second pass.

5. Need for Adjunct Therapies

Because scar tissue is less hospitable to new follicles, it often needs a “reset” before it’s ready to receive grafts. Treatments like PRP, fractional CO₂ lasers, and nanofat injections remodel the tissue, improve blood flow, and create a more favorable environment for graft survival.

Best Techniques for Hair Transplant on Scar

Scarred skin isn't just tougher to work with—it's also less predictable. That's why using the right transplant technique is essential. It’s not about one-size-fits-all; it’s about tailoring the method to the scar’s unique characteristics.

FUE (Follicular Unit Extraction)

FUE involves harvesting individual follicles from the donor area using a small punch. For scar cases, it's the gold standard. Why?

• It avoids creating new linear scars (as FUT might).
• Surgeons can selectively harvest healthy, robust grafts.
• It allows more flexibility in placing hairs at customized angles to blend into irregular scar contours.

According a 2015 review, FUE is particularly advantageous for blending into and around linear surgical scars with minimal additional trauma.

Smaller Punches (0.7–0.9 mm)

In scarred areas, where skin can be tight and fibrotic, smaller tools make a big difference. These finer punches:

• Minimize trauma during insertion
• Reduce skin resistance
• Lower the chance of the “stilt-pole” effect, where grafts sit too high and appear unnatural

This is especially useful for areas with stiff collagen or low elasticity, like old burn or trauma scars.

Aftercare Following Hair Transplant into Scar Tissue

Post-surgical care for hair transplants in scar tissue requires special protocols. Scarred skin behaves differently than healthy skin—it’s more prone to complications.  Proper aftercare isn’t just supportive—it’s strategic. It helps compensate for the biological limitations of scar tissue and ensures your grafts have the best chance to survive and thrive.

Hydration and elasticity support

Scar tissue dries and tightens faster than normal skin. Moisturizing with non-irritating, surgeon-approved ointments helps prevent cracking and supports pliability—key for healing.

Minimize mechanical stress

Unlike elastic scalp tissue, scars don’t stretch well. Avoid tight headwear, rough bedding, or exaggerated facial movement (for facial scars) for at least two weeks. Grafts in scarred areas are more vulnerable to displacement.

Manage inflammation

Scars can flare up post-surgery. Anti-inflammatory care may include cool saline compresses or topical steroids, depending on the scar type and surgeon’s protocol.

Topical and injectable therapies

In some cases, surgeons prescribe post-op PRP, minoxidil, or other growth stimulators to support early vascularization and graft anchoring. These are especially useful in low-perfusion scar zones.

Frequent monitoring

Healing in scarred tissue is less predictable. Expect more frequent post-op visits to assess graft retention, watch for infection, and intervene early if complications arise.

Delayed shedding

Grafts in scar tissue may shed later and regrow more slowly. This is normal. Surgeons often stagger sessions for this reason, assessing each area’s response before proceeding further.

Risks and Complications of Hair Transplant on Scar

Hair transplantation into scar tissue is safe and effective in experienced hands—but it comes with unique risks that differ from standard procedures. These risks are closely tied to the biology of scarred skin and require specialized planning.

1. Lower Graft Survival: Scar tissue often lacks the microvascular network needed to nourish new follicles. This reduced blood flow can lead to graft failure if not addressed properly.
2. Higher Infection Risk: Scar tissue is less vascular and often has a lower immune response. This creates a higher susceptibility to post-operative infection, especially in burn or surgical scars.
3. Abnormal Hair Growth Pattern: Grafts in scarred tissue may grow in unintended directions or develop a curly texture. This happens because dense collagen can distort the direction of follicle growth.
4. Scar Reactivation or Hypertrophy: Surgical trauma can sometimes reactivate dormant scar tissue, leading to thickening or keloid formation.

Understanding and addressing these risks is what separates a routine transplant from a successful scar restoration. With proper planning, these challenges can be managed—and often overcome.

Who Is a Good Candidate for Scar Hair Transplantation?

Not everyone with a scar is an ideal candidate for a hair transplant—but many are, especially with the right preparation and expectations. Here’s what makes someone a strong candidate:

• Mature scars: The best candidates have scars that are fully healed and stable—typically at least 9 to 12 months old. These scars are less likely to change shape or texture after surgery.
• Flat and soft tissue: Scar tissue that is flat, soft, and pliable is easier to work with than thick, raised, or keloid-prone tissue. Softer scars allow better graft placement and healing.
• Healthy donor area: A sufficient amount of strong, healthy hair in the donor zone (usually the back of the scalp or beard area) is essential to achieving good density.
• Localized vascularity: Even within a scar, certain areas may have enough blood flow to support graft survival. Surgeons can assess this during examination or with imaging tools.
• Realistic expectations: Great candidates understand that outcomes in scarred tissue may not be identical to native scalp. Results take time and may require more than one session.

Why Choose Padra Clinic for Scar Hair Restoration

Padra Clinic combines advanced surgical technique with regenerative therapies such as laser preconditioning and PRP to offer high success rates for scar hair transplants. With locations across Toronto, Dubai, Doha, Riyadh, and Kuwait City, our specialists have managed a wide range of scar-related hair loss cases with high patient satisfaction.

Book a personalized consultation with Padra Clinic, free of charge, to learn if you’re a candidate for hair transplant on scar tissue. Experience world-class care with scientifically supported techniques!

Conclusion

Hair transplant on scar tissue is no longer a fringe or experimental procedure—it’s a realistic, well-supported solution for restoring hair after injuries, surgeries, or burns. With the right combination of preparation, surgical technique, and follow-up care, patients can achieve strong, natural-looking results even in areas once considered untreatable.

This success doesn’t come from a single method—it’s the product of understanding scar biology, using regenerative therapies to improve the recipient site, and applying tailored surgical techniques like FUE or DHI. While the journey might involve more planning and more than one session, the outcome can be transformative.

If you’re dealing with hair loss from a scar, know that there are expert-backed solutions available. Padra Clinic brings together science, skill, and personal care to help patients regain not just hair—but confidence.