A common question Dr John Watts hears from viewers is simple but urgent: "I have baldness -- how do I grow my hair back?" In this FAQ session, the Hyderabad-based dermatologist, trichologist and hair transplant surgeon lays out the options depending on how advanced the baldness is, and also answers a separate question about whether transplanted donor hair keeps growing once it is moved to a new spot on the scalp.
Treatment Options Based on Your Stage of Baldness
Responding to a viewer named Tirupati, Dr Watts explained that a hair transplant is the most logically viable way to grow natural hair on bald spots, but it isn't the only option, and the right approach depends on how far the baldness has progressed.
"If your baldness is at an early stage, you can continue taking hair medication for your existing hair and use hair fibre wherever you have a bald spot," Dr Watts advised. For baldness that is mid-range, he recommends a combination approach -- a hair transplant along with continued hair medication for the existing hair.
When a Hair Transplant May Not Give Dense Results
For advanced-stage baldness, a hair transplant is still possible, but Dr Watts was candid that it may not deliver the density patients hope for. "It may not provide the desired hair graft density. Based on donor hair availability, the front hair may be a little dense and back not too dense," he explained. The results depend heavily on how much healthy donor hair is available at the back and sides of the scalp.
Alternatives When Donor Hair Is Limited
If a person cannot undergo a hair transplant because of insufficient donor hair, Dr Watts said a wig or hair patch is one option. Another is scalp micro-pigmentation (SMP), a technique that creates the appearance of hair follicles using pigment. "This technique is suitable for those who are scared of the hair transplant procedure and do not wish to use a wig," he said. The trade-off is that SMP requires keeping the head shaved and the sides trimmed. "The look of new hair-like growth appears natural with SMP," Dr Watts added.
Do Transplanted Hair Grafts Keep Growing?
In a separate question, a viewer named Shiva asked whether donor hair grafts continue to grow once they're transplanted. Dr Watts confirmed that they do. Donor grafts are usually extracted from the back of the scalp, or from body hair such as the beard, chest or pubic region. "You can stay rest assured as the transplanted hair grows naturally. You can cut and comb them as you wish," he said.
What Happens to the Donor Area?
The spots where donor hair is extracted will never grow hair again, but Dr Watts explained that the extraction pattern is deliberately randomised so the donor area doesn't look empty or noticeably thinner. He also described the follicular unit extraction process: "We extract hair not as a single strand but as a follicular unit with several hair strands clung to the sebaceous gland and dermal papilla along with their muscle called Arrector Pili."
"The hair gaps are not visible as we extract donor hair from the back of the scalp in a 1:4 ratio and 1:3 from the beard. The other growing hair covers these gaps successfully. Hence, there is nothing to worry about," Dr Watts explained. He added that when donor hair is taken from the beard, some small dots may be visible on darker skin tones, though this is less noticeable on fairer skin.
This article is for educational purposes only and is not a substitute for professional medical advice. Consult a qualified dermatologist for diagnosis and treatment.
Instant Appointment Slot Booking
Frequently asked questions
Can hair grow back naturally after baldness?
For early-stage baldness, hair medication combined with hair fibre can help manage existing hair and bald spots; more advanced baldness typically requires a hair transplant, SMP, or a hair patch.
What is scalp micro-pigmentation (SMP)?
A technique that creates the look of hair follicles using pigment, suitable for people who don't want a hair transplant or a wig, though it requires keeping the head shaved.
Does transplanted donor hair continue to grow after a hair transplant?
Yes, transplanted hair grows naturally and can be cut and combed like normal hair.
Does the donor area go bald after hair is extracted?
No, donor hair is extracted in a randomised pattern, roughly a 1:4 ratio on the scalp and 1:3 on the beard, so the remaining hair covers any gaps.
Why might a hair transplant not give dense results in advanced baldness?
The results depend on donor hair availability -- in advanced baldness there may not be enough donor hair to achieve even density across the scalp.
