Synthetic Hair Implantation and Squamous Cell Carcinoma of the Scalp

In the letter to the editor, Manjul Agrawal criticizes a case report by Chiarelli et al. that suggested a correlation between synthetic hair implantation and the development of squamous cell carcinoma (SCC) of the scalp. Agrawal argues that the case report lacks critical information such as the type and quality of synthetic fibers used, the implantation protocol, and whether a physician or technician performed the procedure. Agrawal also disputes the authors' negative remarks about the qualifications of health professionals performing these procedures without providing supporting statistics. Furthermore, Agrawal points out that SCC of the scalp is not uncommon, particularly in elderly men with androgenetic alopecia and actinic damage, and that the case report failed to consider other well-known risk factors for cutaneous SCC. Agrawal concludes that it is unreasonable and biased to attribute the cause of SCC to artificial hair based on a single case report and suggests that the association could merely be coincidental.