The Minimization of Transplant Scars: Looking at Possible Options

[tluser]

Hello everyone,

 

It's been quite a while since I've posted here (not that I posted very much at all). But I've recently been looking into hair transplants more, now that I can visibly see my temporal regions start to thin more. I've already decided on my transplant surgeon and method (FUE) for the future, should I decide to get one. Still, the only thing that really gives me any hesitation is the subsequent scarring.

 

We know how much of a role punch sizes and the doctor's skill play a role in both strip scars and "white dot" scarring. But I've been looking into the ways that we as transplant patients could possibly minimize the scars beyond those two variables. The search led me to all the options you already know about: ACell, Dr. Wesley's proposed Piloscopy, etc.. These are not topics that I will be visiting in this post. I will however be talking about the options below.

 

It has also led me to revisit the topic of LLLT (Low Level Laser Therapy), which I know is a controversial topic that has just as well been ruled out as bogus in the HT community. More on that later. Continuing down the trail of lasers, I came across information about treating Psoriasis and Vitiligo (the disease and skin condition that afflicted Michael Jackson). Both conditions have treatments that use something called an Excimer Laser to reintroduce pigment into hypopigmented areas. Another exciting treatment for Vitiligo uses a layer of your own skin cells that are removed, centrifuged in a concoction of some sort, and transplanted to areas where Vitiligo exists. This is called Non Cultured M-K.

 

I believe these may hold great potential for minimizing the transplant scars that affect all HT patients. However, I am no scientist, nor do I know the specifics of these technologies or techniques to determine whether they will truly help scar-repair/minimization. That is where you all come in. Let's discuss.

 

LLLT

It is a common belief in the HT community that LLLT does nothing for regrowth of old hair that has been lost, or has miniaturized. I am not here to contest that. No magic lasers or powder can get back the hair that has already been lost. However, it is well documented that the application of LLLT on open-wounds speeds the healing process and assists in the creation of fibrous tissues that more effectively closes those wounds and minimizes the appearance of scars than leaving them without. The exact process is not understood, but a quick Google search will yield several studies in medical journals. Here are some of those:

 

Low-Level Laser Therapy Facilitates Superficial Wound Healing in Humans: A Triple-Blind, Sham-Controlled Study

 

Effects of a low level laser on the acceleration of wound healing in rabbits

 

If HT patients would subject themselves to LLLT immediately following surgery for several sessions until healing is completed (or possibly even beyond completion of healing), it seems that there would a few benefits: 1) faster healing, 2) reduced size of wounds, 3) reduced appearance of scars.

 

Excimer Lasers

Dermatologists have reported success in repigmentation of areas affected by hypopigmentation through use of excimer lasers. The application is much the same as traditional LLLT therapy, except for the treatment being on wounds that have already healed (of course). Below is a study conducted on three patients, with pictures included:

 

Rapid Response of Facial Vitiligo to 308nm Excimer Laser and Topical Calcipotriene

 

For those with visible scars - either a strip or white dots - would it be possible to undergo a few excimer laser treatments to bring back natural color to scarred areas? My only concern is if the excimer laser would actually have the adverse affect of removing hair. I'm not sure what wavelengths or power output is needed for a laser to cross into that territory of removing hair.

 

Non Cultured M-K

Finally, there is Non Cultured M-K. This truly seems like the most reasonable option that would yield results - at least in the common sense nature of the application. With this procedure, you literally remove your own skin from another part of the body and graft it into areas where pigmentation is needed. The skin is broken up into smaller pieces, centrifuged in a trypsin solution, spread on the area where it is needed, and covered with a collagen dressing that would be removed after one week.

 

Here is a study with pictures included. The images in Figure 1 are confusing, as it seems the patient had actually lost more pigment before gaining it back, but this may be a mistake in the order the images are listed. Figure 2 shows a much better result.

 

Non-cultured melanocyte/keratinocyte transplantation for the treatment of stable vitiligo on the face: report of two cases

 

With a combination of these options, or just single approaches using these options, I believe scarring could possibly be drastically minimized. Does anyone see any plausability in this, or holes in the theory?

 

EDIT: If this is in the wrong section of the forum, or if it would better be served or read in another part - please, moderators, feel free to move it.

Edited October 26, 2014 by tluser