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Copyright (c) 2025 Ney Arencibia Perez, Maria Jose Guerrero Roldán
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The undersigned hereby assign all rights, included but not limited to copyright, for this manuscript to CMB Association upon its submission for consideration to publication on Cellular and Molecular Biology. The rights assigned include, but are not limited to, the sole and exclusive rights to license, sell, subsequently assign, derive, distribute, display and reproduce this manuscript, in whole or in part, in any format, electronic or otherwise, including those in existence at the time this agreement was signed. The authors hereby warrant that they have not granted or assigned, and shall not grant or assign, the aforementioned rights to any other person, firm, organization, or other entity. All rights are automatically restored to authors if this manuscript is not accepted for publication.Donor site healing in follicular unit extraction hair transplantation: current evidence, cellular mechanisms, and future research directions
Corresponding Author(s) : Ney Arencibia Pérez
Cellular and Molecular Biology,
Vol. 71 No. 8: Issue 8
Abstract
Follicular unit extraction (FUE) has become a leading technique in hair transplantation, yet optimal management of the donor area remains a clinical challenge. This systematic review analyzes intraoperative and postoperative interventions applied to the donor area in FUE hair transplantation, with a focus on both clinical outcomes and the cellular and molecular mechanisms involved in tissue repair, inflammatory response, and regenerative processes. A comprehensive literature search was conducted in PubMed and EMBASE (January 2000–June 2025), identifying clinical studies that evaluated donor area treatments and reported outcomes related to healing, inflammation, infection, and patient satisfaction. Four studies met the inclusion criteria, encompassing corticosteroid infiltration, platelet-rich plasma (PRP), timing of postoperative care, and hair follicle-derived microtissue (HFMT) application. Evidence suggests that intraoperative corticosteroid use significantly reduces postoperative edema, likely by modulating local inflammatory pathways and vascular permeability. Early postoperative wound care is associated with decreased folliculitis incidence, highlighting the importance of timely intervention in preventing microbial colonization and dysregulated immune responses. While PRP and HFMT show potential for enhancing cellular proliferation and accelerating wound closure, current data are limited by heterogeneity in study design and lack of standardized molecular endpoints. The review identifies a critical gap in mechanistic studies exploring the cellular dynamics of donor area healing, including the roles of keratinocytes, fibroblasts, and immune cells. Future research integrating molecular biomarkers and advanced imaging is needed to elucidate the pathways driving optimal tissue regeneration. These insights may inform evidence-based protocols that not only improve clinical outcomes but also advance our understanding of scalp wound biology in the context of FUE.
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