Technical Considerations for Follicular Unit Extraction in African-American Hair

The document discusses the technical considerations for performing Follicular Unit Extraction (FUE) on African-American men, who often have tightly curled hair, making the procedure more challenging due to a higher risk of transecting the hair follicles. The authors report on a 36-year-old African-American man with Norwood type IV male pattern hair loss who underwent FUE. They found that using a punch tool with a diameter greater than the diameter of the hair curl and ensuring the angle of the tool was parallel to the curl as it entered the skin were crucial to minimizing transection rates. They also recommend using minimal depth incision and starting with manual punch tools for better control and cost-effectiveness. The authors conclude that with these technical considerations, FUE can be successfully performed on African-American individuals with minimal transection, offering a viable option for those who cannot undergo strip surgery due to the risk of visible scarring and for those with central scarring alopecias.