Q: I am an African-American woman who had a unsuccessful hair transplant. Should I have another one? – S ~ Boston, MA

A: A common cause of a failed hair transplant in African Americans is the surgeon missing a diagnosis of primary scarring alopecia. In this case the scalp is literally attacking the transplanted hair and a repeat hair transplant would also not expected to be successful. This condition is recognized by scaling and redness around the follicles and diagnosed by biopsy. The condition is treated medically rather than by surgery. However, if the cause of the failed transplant was poor surgical technique, then a repeat procedure would be warranted as long at the remaining donor supply was adequate. In all cases, a repeat procedure should not be contemplated unless the cause of the failure can be identified and corrected.