Preparing the scalp before a hair transplant

Transplanted grafts need a healthy blood supply and a calm scalp to survive. In conditions that inflame or scar the scalp, such as lichen planus affecting the hair follicles, grafts are at higher risk of failing. Preparing the scalp before surgery aims to reduce inflammation and improve blood flow first.

Why does the condition of the scalp matter?

After a hair transplant, each graft depends on new blood vessels growing into it from the surrounding skin. Scar tissue has fewer vessels, and active inflammation can attack the transplanted follicles just as it attacked the original ones. That is why scarring alopecias are usually treated until they have been quiet for some time before a transplant is considered.

What is regenerative scalp preparation?

Regenerative preparation uses the patient's own tissue to improve the scalp before surgery:

• Stromal vascular fraction (SVF) is a mix of cells obtained from a small sample of the patient's fat, including cells that support new blood vessels.
• Platelet-rich fibrin (PRF) is prepared from the patient's blood, like PRP, but forms a fibrin matrix that releases growth factors over a longer period.

What has been reported?

A 2026 case report from Professor Nilforoushzadeh's team describes a 26-year-old woman with lichen planus of the scalp. She received SVF six weeks before her transplant and PRF four weeks before it, to improve the blood supply and reduce inflammation. After one year of follow-up, graft survival was good and the scalp had improved, without major complications.

A single case cannot show that the approach works for everyone; it shows that it is feasible and worth studying further. For people with scarring hair loss, the main message is broader: the scalp should be assessed and treated before surgery, not only the hair. The hair restoration guide explains how the different treatments fit together.