Patients presenting with scars on the scalp are often encountered by hair transplant surgeons. Scars resulting from trauma, previous surgery, burns or infections have a significant impact on the scalp anatomy and its blood supply, making regrowing of hair naturally in that area being restricted. Hence, hair restoration on scars are particularly demanding for cosmetic reasons. This abstract outlines an overview in addressing hair transplant on scarred scalp. Prior to hair transplant, the assessment of scars is essential to determine the extent and characteristics of scar tissues which includes its vascularity, pliability and potential of further scarring. Trichoscopy is a useful tool to aid in assessing the scarred area and identifying optimal donor sites for grafts harvesting. Surgical technique that has minimal trauma to scalp tissues such as follicular unit extraction (FUE) is the preferred method of harvesting grafts as it allows grafts to be harvested selectively while preserving the surrounding healthy follicles. Tumescence and local anaesthetic without adrenaline over scarred areas are employed to prevent further vascular compromise. The location, area, thickness and laxity of scar needed to take into consideration while making slit on the recipient site to maximise grafts survival and optimise the camouflage effect on scars. Some adjuvant treatments such as topical minoxidil spray, intralesional steroid injection prior hair transplant surgery and platelet rich plasma injection intraoperative and postoperative are beneficial to improve outcome of hair transplant on scar tissues. In conclusion, the diagnosis and management of scars on the scalp require a combination of medical and surgical expertise. Hair transplant on scarred scalp poses various challenges and meticulous planning from preoperative, intraoperative to postoperative are needed to improve the successful rate and to achieve aesthetically pleasing results that enhances the quality of life for individuals seeking hair restoration. In addition, patient education prior to procedure is crucial to meet the expectations on the outcome of hair restoration on scarred area. 

Dr. Inderjit Kaur is one of the pioneers who got the credential and privilege to perform aesthetic medicine by the Ministry Of Health Malaysia. She is a Fellowship in Dermatologic Laser Surgery in Mahidol University (Thailand), Board Certified Member of American Academy of Aesthetic Medicine (AAAM) and Member of American Board of Anti-Aging & Regenerative Medicine USA (ABAARM). Dr Inderjit Kaur has more than 30 years of experience in aesthetic medicine and her highly driven passion in hair restoration has made her the first and only female doctor in Malaysia to be a Fellow of International Society of Hair Restoration Surgery (ISHRS). Being the Diplomate of the American Board Of Hair Restoration Surgery (ABHRS), life member of Asian Association Hair Restoration Surgeons (AAHRS) and FUE Europe Society, she has been actively participating in conferences globally and publications for training and learning purposes.