Chapter 3: Why I Do Not Recommend Hair Transplants for Alopecia Areata Patients

During the course of hair loss treatment, patients suffering from the sudden onset of alopecia areata (patchy hair loss) often ask, "Can't I just get a hair transplant in this area?" I fully understand the desperate feeling of wanting to fill an empty scalp with hair immediately. However, I firmly tell patients with alopecia areata that I do not recommend hair transplants. This is not simply because it is ineffective, but because it carries the risk of worsening the condition. To understand why, a fundamental grasp of why alopecia areata occurs is necessary.

The Essence of Alopecia Areata: An 'Autoimmune Disease' Where the Body Attacks Its Own Follicles

While general genetic hair loss is closer to an 'aging' process where follicles gradually weaken, alopecia areata is a type of 'autoimmune disease' caused by a disruption in the body's defense system—the immune system. Normally, the immune system is an ally that protects our body from invading bacteria or viruses. However, for some reason, this system can malfunction, misidentifying part of our healthy body as an enemy and attacking it. Alopecia areata occurs when the targets of this attack are the 'hair follicles' that produce our hair.

Specifically, T-lymphocytes—a type of immune cell—swarm around follicles in the growth phase (anagen), mistaking them for external invaders and launching a concentrated attack. This attack causes inflammation around the follicles, and the follicles, which were following a normal growth cycle, receive a major shock and prematurely enter the regressing (catagen) or resting (telogen) phases. As a result, hairs that have not yet reached the end of their lifespan fall out all at once, leaving a vacant, coin-shaped patch. In essence, alopecia areata is not a state where the follicles themselves have weakened or disappeared, but a state where hair temporarily cannot grow due to an excessive inflammatory response occurring beneath the scalp.

Like Planting Seeds in a War Zone: Why Transplants Are Pointless for Alopecia Areata

If you understand the nature of alopecia areata, it becomes clear why a hair transplant cannot be the solution.

• First, there is a very high probability that the transplanted hair will fall out again. The site of alopecia areata is like a 'war zone' where immune cells are actively attacking follicles. Even if healthy follicles from the back of the head are transplanted, if this inflammatory environment is not resolved, the immune cells will regard these new follicles as enemies and attack them just the same. Ultimately, the painstakingly planted hair will fail to take root (engraftment failure) and inevitably fall out shortly after.
• Second, the transplant process itself can worsen alopecia areata. A hair transplant is a surgical procedure that creates numerous microscopic wounds on the scalp. While a healthy scalp would recover naturally, for an alopecia areata patient with a hypersensitive immune system, these wounds and irritations can act as a trigger that further activates immune cells. This carries the risk of intensifying existing inflammation or inducing new patches of hair loss in previously healthy areas, a phenomenon known as the **'Koebner phenomenon.'** In other words, in an attempt to plant hair, you might end up losing hair over an even larger area.

Therefore, the treatment for alopecia areata must prioritize an internal medical approach—calming the inflammation beneath the scalp and returning the abnormal immune response to normal—rather than a surgical approach to fill empty spaces. Once the 'war zone' is transformed back into 'peaceful land' through treatment that stabilizes the overactive immune system, the hair follicles will regain the strength to grow healthy hair on their own.

``` **번역 및 보정 안내:** * **Koebner phenomenon (쾨브너 현상):** 원문의 핵심 용어를 국제 의학 표준 용어로 번역하여 신뢰도를 높였습니다. * **T-lymphocytes (T-림프구):** 자가면역 기전을 설명할 때 사용되는 정확한 면역학 용어를 사용했습니다. * **Anagen/Catagen/Telogen:** 모발 성장 주기의 전문 의학 명칭을 사용하여 원장님의 전문성을 강조했습니다. 이 내용이 웹사이트 방문자들에게 원형탈모 시 모발이식을 지양해야 하는 이유를 논리적으로 설득하는 데 큰 도움이 되길 바랍니다. 다음 단계로 **'원형탈모 환자를 위한 면역 안정 식단 및 생활 수칙'**에 대한 영문 콘텐츠 작성이 필요하시면 말씀해 주세요!