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Q: Dr. Bernstein, can you please comment on leg and body hair transplants? — J.R., Ridgewood, NJ

A: I’ve tried the technique in the past but have been dissatisfied with the results. Scalp hair, unlike the rest of the body, has multiple hairs rising out of each follicle. With leg and body hair, you have only one hair per follicle, not follicular units of multiple hairs. Leg hair is also very fine. It might thicken up a little bit after it is transplanted, but not enough to be clinically useful. In men you want full thickness hair, so fine hair can make it look like it is miniaturizing, as it does when you’re losing it.

Body hair has been successful in softening hairlines, but most people have enough scalp hair to due this, since it often requires very little if properly placed. Another issue is that because leg hair emerges from the skin on a very acute angle, more wounding of the skin occurs as each hair is individually extracted and this leaves marks.

Body hair, from the chest or back, does hold better potential for success than leg hair, particularly if it is plentiful, but it still is extracted one hair at a time and can leave significant scarring when done in large numbers.

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After trading anecdotes with fellow hair loss physicians about how finasteride can reduce body hair in some patients, Sharon A. Keene, M.D. took the next logical step and asked whether finasteride might have a negative effect on patients who have body hair transplant (BHT) procedures.

In a review of scientific literature on whether finasteride effects body hair growth, Dr. Keene finds that current research is inconclusive.

Finasteride, the drug in the hair loss medication Propecia, works by blocking the 5-alpha-reductase type 2 enzyme (5-AR Type 2) which is needed by the body to covert testosterone to DHT. DHT causes common baldness, by making hair follicles shrink and eventually die.

In looking at DHT’s effect on body hair growth, current research strongly suggests that it does play a key role. Males born with a deficiency of 5-AR Type 2, and thus no DHT, have reduced, or absent, body hair growth (and no loss of scalp hair).

It would seem logical then, that when finasteride is used to re-grow hair on the scalp, it would also inhibit the growth of hair on the body. However, the genetic variation among people is too great to determine exactly how much of an influence it plays.

With this uncertainty of DHT’s effects on body hair, it is impossible to say, without further study, if finasteride would have the same effect on body hairs which are transplanted to the scalp. In Dr. Keene’s conclusion, she suggests:

A patient on finasteride for at least a year who undergoes BHT is probably safe to continue it, as remaining body hairs are apparently not sensitive to the effects of this drug.

You can read the full discussion and review of current research in the January/February 2011 issue of Hair Transplant Forum International, the official newsletter of the International Society of Hair Restoration Surgery (ISHRS).

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Q: I heard that it is possible to transplant body hair to the scalp. Does it leave any scarring? — V.P., Cherry Hill, NJ

A: Unfortunately, it does leave scarring. And since the hair is generally of poor quality, it is usually not worth the trade-off. Below is the typical scarring seen in a BHT procedure. Click the image for a larger version:

Body Hair Transplant - Scarring

Scarring with body hair transplant
(note circular white scars on the person’s chest)

Read more about Body Hair Transplants

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Q: I have heard of body hair transplants as an option being considered by some patients. Do you think that could be an option for me as my donor area isn’t able to provide the hair that I need? — N.S., Winnetka, I.L.

A: With body hair transplants, the hair quality is poor and there can be a significant amount of scarring where the hair is harvested, so we are not recommending it at this time.

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