The University Record, April 11, 1994

Researcher discovers cuticular damage in transplanted hair

Men with male-pattern baldness who have hair transplantation surgery often find the results are not quite what they expect: Their new hair may be wavy and lusterless. This is especially startling to those with naturally straight, shiny hair.

While the appearance of the new hair usually returns to normal within about a year, until recently scientists were unable to explain the cause behind the temporarily curly, dull look of transplanted hair.

But Bruce R. Nelson, assistant professor of dermatology at the Medical Center, has taken the first step toward understanding these changes by studying transplanted hair under an electron microscope. These high-powered instruments can magnify and photograph the tiniest objects up to 400,000 times their actual size.

“Basically, the transplanted hair is going through a kind of shock,” says Nelson, who compared hair samples from patients before and after transplant surgery. “The surface of the hair before transplantation shows orderly, overlapping cuticular cells that retain oils from the scalp and reflect light. But once a hair follicle has been removed and prepared for transplantation, it’s a different story.”

The electron microscope reveals a chaotic jumble of cuticular cells in the transplanted hair—evidence of damage to the surface of the hair shaft. Such damage would make it more difficult for the hair to retain oils and reflect light, leading to a dull appearance, Nelson says. “Straight hair that undergoes that sort of cuticular damage would also be more likely to curl. We see the same effect in someone who has had a permanent wave.”

The good news is that the condition is temporary and hair begins growing normally once the follicle has taken root in its new location. Most people can overcome the lusterless appearance by using additional hair conditioner, Nelson says.

Many of Nelson’s patients have had previous hair transplants and now want to make some modifications. He specializes in incisional slit-grafting, a time-consuming but effective method in which single hairs are transplanted, usually from the back of the scalp, to form a new hairline.

“Having hair transplantation surgery is a lifetime commitment. As a surgeon, I need to anticipate how that person will look five, 10 or 20 years from now and shape his or her appearance accordingly. It’s a combination of medicine and art,” says Nelson, one of the few hair transplant specialists in Michigan who combines clinical practice with research.