There are various causes of hair loss or baldness. It could arise as a result of a systemic and/or localized illness or disorder. While researches are going on to find a medical cure, other localized forms of alopecia (devoid of or absence of hair) may be treated surgically, as in this case of post burn scaring and alopecia (shown below). Small areas of alopecia can be excised & closed off directly, using the nearby, normal hair-bearing skin. However, for larger areas, the following 2 techniques may be used:
1. Serial Excisions - partial excision, just enough to close of without tension, followed by 1 or 2 more excisions at a later time; eventually removing the lesion totally and replacing the area with normal, surrounding skin.
2. Tissue Expansion - inserting a special, inflatable material under the normal adjacent skin, and gradually filling it with fluid to increase the size, thus expanding the normal skin to a size that can completely replace/cover the defect area, before excising the lesion. There are 2 stages to this procedure; the first part is to insert the tissue expander & the second part is to excise the lesion, remove the tissue expander & reposition the normal expanded skin to cover the defect.
*BELOW IS A CASE OF POST BURN ALOPECIA, THAT WAS EXCISED, FOLLOWED BY DIRECT CLOSURE (APPROXIMATING THE NORMAL HAIR-BEARING SKIN)
Our techniques for scarless (scar is obscured or less prominent) surgery and scarless skin closure will be published in the New PIH e-Med Journal in November 2017, including these photographs (techniques displayed/explained here).