{"entity":{"id":"hair-camouflage-and-restoration","kind":"technology","name":"Camouflage and restoration: fibres, micropigmentation, transplantation","aka":[],"tldr":"When density has not come back, the options are to hide the gap or to move hair into it. Keratin fibres and scalp micropigmentation are cheap, immediate and reversible; hair transplantation and surgical reconstruction have been reported in cancer survivors only in small numbers, and no trial compares any of them.","summary":"This record covers what is left after minoxidil: concealment and surgery. Keratin or cotton hair-building fibres cling to existing hairs electrostatically and make a thin area read as dense in ordinary light; they wash out, cost little and carry no medical risk beyond the obvious one of a wet day. Scalp micropigmentation tattoos pigment into the scalp to imitate shaved stubble or to reduce the contrast between scalp and hair; it is semi-permanent, needs a practitioner who has been told the medical history, and fades over years. Partial hairpieces, toppers and integration pieces sit between fibres and a full wig and suit a patch of loss, which is the usual pattern after radiotherapy.\n\nSurgical hair restoration in people treated for cancer is reported, but thinly. In the largest published series of persistent radiation-induced alopecia, 71 patients, two responded to hair transplantation and one to plastic surgical reconstruction; those are case numbers, not an evidence base. Transplantation moves follicles from the back of the scalp, which is spared in pattern hair loss but not necessarily spared by chemotherapy or by a radiation field, so whether donor hair will survive is a question for a surgeon who understands what the treatment did. Nothing here has a randomised trial behind it in any population with cancer, which is why the grade is insufficient: not that these do not work, but that nobody has measured them in this setting.","status":"established","asOf":"2026-10-02","wikipedia":"https://en.wikipedia.org/wiki/Hair_transplantation","links":[{"label":"Phillips et al., assessment and treatment outcomes of persistent radiation-induced alopecia in patients with cancer (JAMA Dermatology 2020)","url":"https://doi.org/10.1001/jamadermatol.2020.2127"},{"label":"Freites-Martinez et al., hair disorders in cancer survivors (Journal of the American Academy of Dermatology 2019)","url":"https://doi.org/10.1016/j.jaad.2018.03.056"},{"label":"American Cancer Society: hair loss","url":"https://www.cancer.org/cancer/managing-cancer/side-effects/hair-skin-nails/hair-loss.html"}],"tags":["complementary","supportive-care","hair-loss","evidence:insufficient"],"related":[],"cancers":[],"sections":["rejuvenation","supportive-care"],"technologies":["wigs-cranial-prosthesis","minoxidil-chemotherapy-alopecia","scalp-care-cancer-treatment"],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["alopecia-persistent-chemotherapy","alopecia-radiotherapy-persistent"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"principle":"Concealment changes what light does at the scalp, by adding fibre to existing shafts or pigment to bare skin. Restoration moves follicles from an area that still grows into one that does not, and depends on the donor area having been spared.","strengths":["Fibres and micropigmentation are immediate and do not interact with treatment","Partial pieces suit the patchy loss radiotherapy causes","Reported success in a small number of survivors after surgery"],"limitations":["No controlled study in people treated for cancer","Transplantation assumes the donor area was spared, which chemotherapy and wide radiation fields may not have done","Micropigmentation and tattooing break the skin, so timing has to wait for blood counts","Cost is personal and rarely reimbursed"]},"route":"/technologies/hair-camouflage-and-restoration/","neighbours":{"section":[{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"minoxidil-chemotherapy-alopecia","kind":"technology","name":"Minoxidil for persistent chemotherapy- and endocrine-therapy hair loss","route":"/technologies/minoxidil-chemotherapy-alopecia/"},{"id":"hair-platelet-rich-plasma","kind":"technology","name":"Platelet-rich plasma for hair after cancer treatment","route":"/technologies/hair-platelet-rich-plasma/"},{"id":"scalp-care-cancer-treatment","kind":"technology","name":"Scalp care during and after cancer treatment","route":"/technologies/scalp-care-cancer-treatment/"},{"id":"wigs-cranial-prosthesis","kind":"technology","name":"Wigs, cranial prostheses and head coverings","route":"/technologies/wigs-cranial-prosthesis/"}],"term":[{"id":"alopecia-persistent-chemotherapy","kind":"term","name":"Persistent chemotherapy-induced alopecia","route":"/terms/alopecia-persistent-chemotherapy/"},{"id":"alopecia-radiotherapy-persistent","kind":"term","name":"Persistent radiation-induced alopecia","route":"/terms/alopecia-radiotherapy-persistent/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}