Efficacy of single-hair follicular unit transplantation in the treatment of vitiligo in hair-bearing areas

Objective To evaluate the efficacy of single-hair follicular unit transplantation in the treatment of vitiligo in hair-bearing areas, and to estimate the performance of dermoscopy in efficacy evaluation. Methods Eighty-nine patients with vitiligo in hair-bearing areas were divided into two groups: a treatment group (38 patients with 46 vitiligo lesions) receiving single-hair follicular unit transplantation, a control group (51 patients with 67 vitiligo lesions) treated with topical drugs. Follow up visits were scheduled every 4 weeks for 24 weeks. The growth of epidermal melanocytes and degree of repigmentation were evaluated by both dermoscopy and naked eyes at every visit. Results A better outcome was achieved in the treatment group compared with the control group. Of the 46 vitiligo lesions receiving transplantation, 12 achieved complete repigmentation of white hairs and skin around transplanted hair follicles, with a marked response rate of 54.3% . Perifollicular repigmentation was seen by dermoscopy as early as 4 weeks after the transplantation, and gradually expanded and coalesced thereafter. The average time required for the appearance of repigmentation was 9.8 weeks by dermoscopy, markedly shorter than that by naked eyes (14.5 weeks). After transplantation, microcirculation in vitiligo lesions was improved obviously, skin was softened, and skin texture became clear, but no correlation was observed with the appearance of perifollicular pigmentation islands. No complications such as scarring or infection occurred at incision sites after the operation. Conclusion Single-hair follicular unit transplantation is safe, simple to operate, and effective for the treatment of vitiligo in hair-bearing areas. Key words: Vitiligo; Hair; Hair follicle; Transplantation; Dermoscopy