Scalp psoriasis is a common inflammatory skin condition that patients frequently ask about in relation to hair transplant suitability. The relationship between psoriasis and surgical candidacy depends significantly on the current state of the condition and how well it is controlled.
Active scalp psoriasis — with visible plaques, scaling, and inflammation — is a contraindication to hair transplant surgery in the affected area. The inflammatory process associated with active psoriasis creates a hostile environment for newly implanted grafts, reduces graft survival rates, and significantly increases the risk of Koebner phenomenon — the tendency of psoriasis to develop new lesions at sites of skin trauma. Surgical wounds in active psoriasis frequently trigger new psoriatic lesions.
Psoriasis in well-controlled remission — with no active plaques on the scalp for at least three to six months — changes the picture considerably. With confirmation from a dermatologist that the condition is stable and controlled, and with an agreed maintenance strategy to preserve remission through and after the procedure, hair transplant surgery is a viable option for many patients with well-controlled psoriasis.
The perioperative plan for a patient with psoriasis should include: continuing any effective systemic psoriasis treatment through the procedure period (unless there is a specific surgical contraindication to a particular agent), close dermatological monitoring post-operatively, and a readiness to treat any new psoriatic activity promptly should it appear.
A joint consultation between the hair transplant surgeon and the patient’s dermatologist before committing to surgery is strongly recommended for any patient with a history of scalp psoriasis.
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