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Pubic
hair escutcheon transplants
A total lack of hair growth in the pubic area in adults is a
rare entity usually associated with a genetic anomaly
in the affected individual. There
are
many genetic
conditions that have an absence of body hair, including pubic hair,
as one of the symptoms – too
many to mention here. Most of these conditions are very rare and
of the many physical and mental retardation symptoms involved,
a lack of pubic hair is often the least of the affected individual's
concerns.
However, there are other non-genetic causes of pubic hair hypotrichosis
(a lack of pubic hair growth) or pubic hair alopecia (hair loss
through disease). Some individuals
grow a normal pubic hair density at puberty, but
may find
alopecia develops later in adulthood. The most common causes
of pubic hair loss include alopecia areata and telogen effluvium
(see elsewhere on this web site for details). In these cases
where and active process is involved in the hair loss, hair transplantation
to the
pubic area would not be successful. The transplanted hair will
also be affected by the underlying process that is causing the
hair loss. In the case of alopecia areata and telogen effluvium
affecting the pubic hair, the best approach is to treat the alopecia
areata or telogen effluvium. If treatment is successful, the affected
pubic hair follicles should regrow. For
those over 65 years of age there may be a general thinning of pubic
hair. Hair growth slows down in the elderly and this may become
apparent
as a diffuse hair loss most noticeable on the scalp, but underarm
hair
and pubic hair may also be lost. Hair transplantation might be successful
in this situation, but it is very rare for such a procedure to
be conducted.
A disruption of hormone production prepuberty, particularly pituitary
insufficiency, may result in a lack of pubic hair growth through
puberty and well into adulthood. A hysterectomy or bilateral oopherectomy
may be done prepuberty due to abnormal bleeding and this can also
result in a lack of pubic hair growth in adulthood. In these cases
it may be possible to graft hair from the scalp to the pubic region,
though hormone supplementation is typically the preferred treatment
approach.
There are situations where pubic hair transplantation is possible
and successful. Most often, hair transplantation to
the pubic area is needed to repair a burns injury or because
the individual has inherited genes that infer a relative lack of
pubic
hair growth.
In East Asian countries, it is a common practice for prostitutes
shave their pubic hair. Because of this, many Asian
men and women
traditionally associate a lack of pubic hair with lack
of "moral values". As a result, the cultural pressure
to have a thick crop
of pubic
hair
is high in some Asian countries. Unfortunately, many ethnic groups
in East Asia have a genetic constitution that codes for a relative
lack of body hair growth
as compared to Caucasians and they have
only limited pubic terminal hair. Whilst both men and women
in these ethnic groups have a lack of pubic hair growth,
the social pressure is mostly focused on women. Some women
suffer psychologic distress and have a low self-esteem
due to a lack of pubic hair growth.
This "condition" may cause them shame and decrease
their chances of attaining a happy and successful marriage due
to the potential
husbands’ suspicious ideas. For Japanese women it can also
be an issue in public baths and hot springs where nude bathing
is acceptable, but "morally questionable" patrons are
barred. Correction of this "problem" can
be achieved either by hair transplantation or sometimes by grafting
larger sections of skin containing hair to the
region of the pubis.
There are two approaches to transplanting hair to the pubic region,
either by grafting mini and micrografts consisting of 1-4 hair
follicles each, or grafting a flap of scalp skin. Each approach
has advantages and drawbacks. With mini and micrografts, to transplant
the
entire pubic
area usually takes more than one grafting sessions with intervals
of about 2 months in between each session. With the time needed
to let the hair regrow after grafting, it can take a year before
the end result can be seen. However, if the procedure is done carefully,
the result can look reasonably natural with an appropriate hair
density. Grafting a large flap of hair bearing skin to the pubic
area is a much quicker process, but the result is more likely to
look unnatural. Pubic hair is much more sparsely distributed than
scalp hair, so a scalp hair graft can look unnaturally dense. This
can
be remedied
partially by using tissue expansion under the scalp skin to be
transplanted before surgery to stretch out and reduce the density
of the skin to be grafted. Alternatively, epilation by electrolysis
can be used a couple of months after grafting to decrease the hair
density
and contour the hair bearing area to a more acceptable shape. The
more common approach is the mini-micrografting technique. It takes
longer, but the result is more natural.
The transplanted scalp skin hair follicles retain their scalp
skin hair growth characteristics, although at least one report
has suggested that the recipient transplanted skin areas' properties
may modify the transplanted hair follicles to a degree. However,
it is common for scalp hair transplanted to the pubic area to look
less kinked than natural pubic hair. Some kinking is apparent because
the contact/friction with underwear probably creates some physical
damage to the hair. The transplanted hair also grows more quickly
than natural pubic hair and grows for a longer time period in each
hair growth cycle. As a result, regular trimming of the transplanted
hair is required.
Pubic
hair escutcheon transplants references
-
Gandelman M, Epstein JS. Hair transplantation to the eyebrow,
eyelashes, and other parts of the body. Facial Plast Surg Clin
North Am. 2004 May;12(2):253-61. PMID: 15135136
- Chen HC, Mardini
S, Santamaria E. Long-term follow-up and unusual findings
after microvascular transfer of hair-bearing
skin for pubic hair restoration. Ann Plast Surg. 2003 Dec;51(6):627-9.
PMID: 14646664
- Hwang S, Kim JC, Ryu HS, Cha YC, Lee SJ,
Na GY, Kim do W. Does the recipient site influence the hair
growth characteristics
in hair transplantation? Dermatol Surg. 2002 Sep;28(9):795-8;
discussion 798-9. PMID: 12269871
- Tanaka A, Hatoko M, Shiba A, Kuwahara M, Tada H, Okazaki T,
Muramatsu T.
An experience of pubic hair reconstruction using free temporoparietal fasciocutaneous
flap with needle epilation.
Plast Reconstr Surg. 1999 Jul;104(1):187-9.
PMID: 10597694
- Hong CK, Choi HG.
Hair restoration surgery in patients with hypotrichosis of the pubis: the reason
and ideas for design.
Dermatol Surg. 1999 Jun;25(6):475-9.
PMID: 10469095
- Dacou-Voutetakis C, Kakourou T. Treatment of atrichia pubis
in adolescent girls with pituitary dwarfism.
J Pediatr. 1996 Feb;128(2):284-5.
PMID: 8636832
- Choi YC, Kim JC. Single hair
transplantation using the Choi hair transplanter. J Dermatol
Surg Oncol. 1992 Nov;18(11):945-8.
PMID: 1430550
- Bagchi N, Komanicky P.
Loss of pubic and axillary hair following treatment with glucocorticoids.
Am J Med Sci. 1989 Apr;297(4):263-4.
PMID: 2705467
- Astore IP, Pecoraro V, Pecoraro EG.
The normal trichogram of pubic hair.
Br J Dermatol. 1979 Oct;101(4):441-5.
PMID: 508610
- Tamura H: Pubic hair transplantation. Jpn J
Dermatol 1943; 53: 76.
- Pinkus, F. Die Gruppenstellung der Haare. In Jadassohn's Handbuch
der Haut-und Gesicht-Krankheit, 1/1. Berlin: Springer Verlag,
1927. P. 239-68
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