Hair Transplant with Psoriasis – Is It Possible?

Psoriasis is a chronic autoimmune condition that affects the skin, including the scalp, leading to redness, flaking, and irritation. Many individuals with scalp psoriasis experience hair thinning or loss and may consider a hair transplant. However, undergoing a hair transplant with psoriasis presents unique challenges. This article explores whether a hair transplant is a viable option for psoriasis patients, the associated risks, procedural considerations, and post-operative care.

Can You Get a Hair Transplant If You Have Psoriasis?

A hair transplant is possible for individuals with psoriasis, but eligibility depends on the severity and control of the condition. Psoriasis can cause scalp inflammation and scaling, which may impact the healing process and graft survival.

Candidacy Checklist for Hair Transplant:

1. Psoriasis is in remission or well-controlled.
2. Scalp inflammation is minimal before the procedure.
3. A dermatologist approves the transplant based on medical history.
4. The patient is not experiencing an active flare-up at the time of surgery.

Risks and Challenges of Hair Transplant for Psoriasis Patients

Hair transplants involve small incisions in the scalp, which can trigger the Koebner phenomenon, where new psoriasis lesions appear at sites of skin trauma. This response can make post-operative healing more complex and affect the overall success of the procedure. Other risks include:

Infection Risk

Psoriasis weakens the skin barrier, making it more susceptible to bacterial or fungal infections post-surgery. Since the scalp is already prone to inflammation and scaling, any breach in the skin, such as those caused by transplantation incisions, increases infection risks. Proper antiseptic care, including the use of antimicrobial shampoos and prescribed medications, is essential to prevent complications. Patients should also avoid touching or scratching the scalp post-surgery to reduce bacterial exposure.

Delayed Healing

Psoriasis slows down the skin regeneration process, meaning the healing period may take longer compared to individuals without the condition. Since the immune system is already hyperactive, wound closure can be delayed, leading to prolonged scabbing and an increased risk of secondary infections. Patients must adhere to their dermatologist’s post-operative care instructions, including the use of mild, medicated shampoos and anti-inflammatory medications, to ensure optimal healing.

Graft Survival Issues

Inflammation caused by psoriasis can disrupt the establishment of transplanted hair follicles, leading to a lower survival rate of the grafts. When the immune system identifies the transplanted follicles as foreign, it may trigger an inflammatory response, leading to rejection or poor follicle integration. Close monitoring by the surgeon and dermatologist is necessary. Anti-inflammatory medications and gentle scalp care can significantly improve graft survival.

Flare-Ups and Increased Scaling

The procedure itself can act as a physical trigger for psoriasis, causing an increase in symptoms such as redness, itching, and scaling. This can make it difficult for the new grafts to stabilize and grow. Patients may require targeted post-surgical psoriasis management, including topical treatments, to reduce these effects. Avoiding common triggers such as stress, harsh shampoos, and excessive sun exposure can also help maintain a stable scalp condition post-transplant.

Scarring and Poor Aesthetic Outcome

Since psoriasis-prone skin is more reactive, the risk of excessive scarring or an uneven result is higher. Patients with a history of hypertrophic or keloid scarring should discuss potential risks with their surgeon before proceeding with the transplant. Working with a surgeon experienced in psoriasis-related hair transplants can help mitigate this risk through precise graft placement and post-operative scar management treatments.

How to Minimize These Risks

• Pre-Surgical Psoriasis Management: Stabilizing the condition before surgery through dermatologist-approved treatments significantly reduces complications.
• Anti-Inflammatory Post-Care: Using medicated shampoos, topical treatments, and oral anti-inflammatory medications can help control symptoms post-transplant.
• Customized Surgical Techniques: A skilled surgeon will modify the procedure to minimize trauma and avoid psoriasis-prone areas for better graft survival.

Proper pre-surgical care, post-operative management, and choosing an experienced clinic specializing in psoriasis cases are crucial to ensuring a successful hair transplant outcome.

You might also be helpful to know: Hair Transplant with Long Hair: Is It Possible? Procedure, Pros & Cons

Pre-Transplant Preparations for Psoriasis Patients

Undergoing a hair transplant with psoriasis requires careful preparation, ideally starting at least 6–8 weeks before surgery, to minimize complications and ensure optimal graft survival. Psoriasis is an autoimmune disorder that triggers excessive skin cell production, leading to inflammation, scaling, and delayed wound healing. To reduce risks, patients must follow a structured pre-operative regimen under the supervision of both a dermatologist and hair transplant specialist to stabilize their condition and prepare the scalp for surgery.

1. Consult a Dermatologist and Hair Transplant Surgeon

Before scheduling the procedure, an in-depth medical evaluation is essential. A dual consultation with a dermatologist and a hair transplant expert will determine the stability of your psoriasis, assess scalp health, and identify any contraindications. A biopsy may be necessary if there are concerns about excessive inflammation or scarring tendencies.

2. Stabilize Psoriasis Before Surgery

• Topical Treatments: Dermatologist-prescribed corticosteroids, vitamin D analogs, or calcineurin inhibitors can help reduce active inflammation.
• Systemic Medications: If scalp psoriasis is severe, oral immunosuppressants or biologic injections (e.g., methotrexate, cyclosporine, adalimumab) may be necessary to bring symptoms under control.
• Phototherapy: Narrowband UVB therapy is another effective method for reducing scalp inflammation before the procedure.
• Discontinue Irritants: Avoid harsh hair treatments, dyes, or aggressive shampoos in the weeks leading up to surgery to prevent triggering a flare-up.

3. Use Gentle Hair Care Products

• Medicated Shampoos: Patients should transition to mild, medicated shampoos at least four weeks before surgery. Options include:
  • Coal Tar Shampoo (reduces scaling and inflammation)
  • Salicylic Acid Shampoo (helps remove dead skin cells without excessive irritation)
  • Ketoconazole Shampoo (reduces fungal overgrowth that can exacerbate inflammation)
• Moisturizing Scalp Treatments: To prevent excessive dryness and flaking, hypoallergenic, fragrance-free scalp oils or creams (such as coconut oil or aloe vera) may be used under dermatologist supervision.

4. Modify Diet and Lifestyle to Support Healing

• Anti-Inflammatory Nutrition: Patients should focus on foods rich in omega-3 fatty acids (fatty fish, flaxseeds), antioxidants (berries, leafy greens), and turmeric to help modulate immune responses and reduce flare-ups.
• Increase Hydration: Adequate water intake helps maintain skin elasticity and enhances healing.
• Avoid Processed Foods and Alcohol: Sugar, processed meats, dairy, and alcohol can act as psoriasis triggers and should be minimized before surgery.
• Supplementation: Vitamin D, zinc, and probiotics may be recommended by a specialist to support immune function and skin health.

5. Avoid Triggers That Can Exacerbate Psoriasis

• Stress Reduction Techniques: High stress levels can trigger psoriasis flare-ups, so it is advisable to practice meditation, yoga, or deep-breathing exercises.
• Environmental Precautions: Avoid excessive sun exposure, harsh weather conditions, and dry indoor heating, all of which can irritate the scalp.
• Quit Smoking and Limit Alcohol Intake: Both can significantly worsen psoriasis symptoms and slow post-operative healing.
• Discontinue Certain Medications (With Medical Guidance): Nonsteroidal anti-inflammatory drugs (NSAIDs), beta-blockers, and lithium have been associated with worsening psoriasis and should be reviewed with a healthcare provider before surgery.

This detailed preparation phase plays a critical role in minimizing the risk of complications and ensuring a successful hair restoration outcome for psoriasis patients.

You might also want to know: Stem Cell Hair Transplant – A Revolutionary Approach to Hair Restoration

Hair Transplant Procedure for Patients with Psoriasis

Performing a hair transplant on psoriasis-affected scalps requires precision, customized techniques, and careful pre-surgical planning to minimize trauma and prevent flare-ups. Surgeons must adapt their approach to ensure optimal graft survival while reducing the risk of post-operative complications. The following considerations help ensure a safe, effective procedure for psoriasis patients seeking hair restoration.

FUE vs. FUT: Which Is Better?

• FUE (Follicular Unit Extraction): This method is preferred for psoriasis patients because it is minimally invasive and involves extracting individual follicles rather than removing a strip of scalp tissue. Since psoriasis-prone skin is sensitive to trauma, FUE reduces the likelihood of triggering new lesions due to the Koebner phenomenon. However, since the procedure involves many small punctures, the surgeon must ensure proper spacing and avoid excessively irritated areas.
• FUT (Follicular Unit Transplantation): FUT involves removing a strip of scalp from the donor area, which results in a linear scar. This technique is generally not recommended for psoriasis patients unless their scalp is highly stable, as the larger incision can lead to prolonged inflammation and a higher risk of flare-ups.

Read more about the differences of FUE vs FUT Hair Transplant.

Special Considerations During Surgery

While the exact hair transplant technique is no different for psoriasis patients than for others, there are certain precautions the surgeon should take to minimize risks and ensure optimal results.

Pre-Surgical Scalp Mapping

Before surgery, the surgeon will map the scalp to identify areas with active psoriasis plaques. These areas may need additional pre-treatment with corticosteroids or UV therapy to ensure they are stable enough for transplantation.

Minimal Trauma Techniques

• Smaller Punches: Using smaller diameter punches (0.7mm-0.8mm) in FUE reduces tissue trauma and irritation.
• Gentle Handling: Follicles should be handled carefully to avoid excessive pressure that could trigger an inflammatory response.
• Staggered Extraction Approach: To prevent excessive trauma to the donor area, the extraction should be spread out over a larger region rather than concentrated in one area.

Avoiding Psoriasis-Prone Areas

If a section of the scalp has persistent psoriasis, the surgeon may choose to avoid transplanting hair there or recommend additional pre-surgical treatments to stabilize the area.

Special care is taken to ensure the donor area is free of lesions before graft extraction, as inflamed donor tissue may result in poor graft survival.

Reducing Post-Operative Flare-Ups

• Use of Anti-Inflammatory Medications: The patient may receive a low-dose oral corticosteroid or topical treatments immediately after surgery to suppress potential flare-ups.
• Optimized Post-Op Washing Routine: Instead of standard post-op washing, psoriasis patients may require gentle scalp cleansing with medicated shampoos to prevent plaque buildup without disturbing grafts.
• Longer Recovery Time Consideration: Due to slower healing in psoriasis patients, follow-up visits may be more frequent, with additional care instructions tailored to reducing irritation and inflammation.

Check this out: Hair transplant service in Dubai

Post-Transplant Recovery & Managing Psoriasis Flare-Ups

Psoriasis complicates post-transplant healing due to increased skin sensitivity, prolonged inflammation, and the risk of triggering new lesions. The scalp requires extra care to prevent excessive irritation, infection, or graft failure. Patients must follow a carefully structured recovery protocol to ensure optimal healing and graft survival.

Hair Transplant Recovery Timeline for Psoriasis Patients

Here is the recovery timeline for Psoriasis patients along with practical aftercare tips.

First 24-48 Hours: Critical Healing Period

• Expect mild to moderate swelling, redness, and tenderness in the treated area.
• Keep the scalp completely dry to avoid disrupting grafts.
• Avoid touching, scratching, or massaging the scalp as psoriasis-prone skin is highly reactive to trauma.
• Sleep with the head elevated to minimize swelling.

First Week: Preventing Irritation and Flare-Ups

• Avoid excessive washing or aggressive rubbing of the scalp.
• Use only a prescribed gentle saline solution to lightly cleanse the scalp without disrupting the grafts.
• Expect some scabbing; do not pick at scabs to prevent infection and trauma-induced psoriasis flare-ups.
• Minimize sun exposure as UV radiation can aggravate inflammation and trigger new lesions.
• Monitor for signs of infection, such as excessive redness, pus, or increasing pain.

Second Week: Scab Shedding and Controlled Cleansing

• Scabs will begin to fall off naturally; do not force them to detach as this can damage newly transplanted follicles.
• Start using a mild, dermatologist-recommended shampoo, preferably with anti-inflammatory ingredients like coal tar or salicylic acid.
• Apply topical treatments as prescribed to reduce itching and inflammation.
• Resume light activity but avoid strenuous exercise, as sweating can trigger psoriasis flare-ups.

First Month: Early Hair Growth and Flare-Up Risk

• Some patients may experience “shock loss”, where transplanted hair temporarily falls out before regrowth starts.
• Mild itching and flaking may occur, so continue using gentle scalp moisturizers under dermatological supervision.
• Patients with persistent psoriasis may need low-dose corticosteroid creams to control inflammation.
• Follow-up appointments are essential to assess healing and adjust treatment plans.

Preventing Flare-Ups After Surgery

Psoriasis patient should take special care to prevent flare-ups after a hair transplant.

Use Medicated Shampoos Safely

• Introduce coal tar, salicylic acid, or ketoconazole-based shampoos gradually to avoid irritation.
• Limit shampooing to 2-3 times per week to prevent excessive dryness and scaling.
• Use lukewarm water instead of hot water, as extreme temperatures can worsen inflammation.

Apply Prescribed Topical Treatments with Caution

• Avoid alcohol-based treatments, as they can excessively dry out the scalp.
• If using corticosteroid creams, apply only on non-grafted areas to prevent unwanted effects on new follicles.
• Consider calming, non-medicated treatments like aloe vera or coconut oil for additional scalp relief.

Follow a Healthy Lifestyle to Support Healing

• Maintain a diet rich in anti-inflammatory foods, such as omega-3 fatty acids (salmon, flaxseeds) and vitamin D.
• Stay hydrated to keep the scalp healthy and promote proper cell regeneration.
• Avoid alcohol, smoking, and processed foods, which can worsen psoriasis symptoms.
• Reduce stress through meditation, light exercise, or professional counseling, as stress is a major psoriasis trigger.

Long-Term Considerations for Psoriasis Patients Post-Transplant

• Monitor for Recurring Psoriasis Lesions: Regular dermatologist check-ups are necessary to prevent flare-ups near transplanted areas.
• Scalp Hydration & Maintenance: A gentle moisturizing regimen is crucial to prevent excessive dryness that leads to scaling.
• Consider PRP Therapy: Platelet-Rich Plasma injections may help improve graft survival and scalp health post-transplant.

By following a structured, psoriasis-conscious recovery plan, patients can improve their chances of a successful hair transplant while minimizing discomfort and complications.

Alternatives to Hair Transplant for Psoriasis Patients

For psoriasis patients who are not ideal candidates for a hair transplant, several non-surgical and minimally invasive treatments can help improve hair density and scalp health while minimizing the risk of flare-ups.

PRP Therapy (Platelet-Rich Plasma)

PRP therapy involves drawing a small amount of the patient’s blood, processing it to concentrate the platelets, and injecting the plasma into the scalp.

• Effectiveness: Studies show that PRP can stimulate hair follicles, improve hair thickness, and reduce inflammation in patients with scalp conditions like psoriasis.
• Considerations for Psoriasis Patients: PRP has anti-inflammatory properties, which may help reduce psoriasis-related scalp irritation. However, repeated needle injections can trigger the Koebner phenomenon, so careful administration by an experienced professional is crucial.

Find out more about PRP for Hair.

Mesotherapy for Hair Regrowth

Mesotherapy involves micro-injections of vitamins, amino acids, minerals, and growth factors into the scalp to nourish hair follicles.

• Effectiveness: This treatment has been found to improve hair density, blood circulation, and follicle strength.
• Considerations for Psoriasis Patients: Since it involves multiple injections, mesotherapy carries a risk of triggering psoriasis lesions at injection sites. To minimize this, dermatologists may combine mesotherapy with anti-inflammatory serums specifically tailored for psoriasis-prone scalps.

Find out more about Mesotherapy for Hair.

Hair Filler Injections

Hair filler injections use biomimetic peptides and hyaluronic acid to strengthen hair roots and encourage growth.

• Effectiveness: These fillers have been shown to extend the hair growth phase (anagen) and improve hair thickness over several months.
• Considerations for Psoriasis Patients: Hair filler injections may be less irritating than PRP or mesotherapy because they do not rely on multiple punctures. The hydrating properties of hyaluronic acid may also help soothe dry, flaky scalp conditions.

Find out more about Hair Filler Injections.

Medical Treatments

• Minoxidil: This FDA-approved topical treatment can stimulate hair regrowth but may cause scalp irritation in psoriasis patients.
  Steroid Creams: Used under medical supervision, low-strength corticosteroids may help reduce inflammation while promoting hair retention.
• Low-Level Laser Therapy (LLLT): A non-invasive method that improves blood circulation and stimulates hair follicles. It is a good option for psoriasis patients since it does not involve scalp penetration.

Choosing the Right Clinic for a Hair Transplant with Psoriasis

Selecting an experienced clinic is crucial for psoriasis patients undergoing a hair transplant.

Why Choose Padra Clinic?

• Specialized in treating patients with scalp conditions.
• Experienced dermatologists and hair transplant surgeons.
• Personalized treatment plans to ensure transplant success.
• Advanced techniques to minimize scalp trauma and promote healing.

At Padra Clinic, we offer safe and customized hair transplant solutions for psoriasis patients. Book a consultation today to explore your options!

Conclusion

A hair transplant is possible for psoriasis patients, but it requires careful planning, expert technique, and specialized post-operative care to ensure success. Managing psoriasis before and after the procedure is crucial to prevent complications like inflammation, delayed healing, and graft failure. By working with an experienced clinic like Padra Clinic, patients can achieve optimal results while minimizing risks. If you’re considering a hair transplant with psoriasis, consult a specialist today to develop a personalized treatment plan that ensures both scalp health and long-term hair restoration success.