Hair Growth in Intraoral Skin Grafts from Thigh Donor Sites
Primary Treatment Recommendation
Laser hair removal using ruby laser is the most effective treatment for unwanted terminal hair growth from full-thickness skin grafts, with sustained reduction in hair numbers on follow-up 1.
Understanding the Problem
Hair growth in intraoral grafts occurs because hair-bearing skin from the thigh retains its follicular characteristics when transplanted to the mouth 1. This is a recognized complication when hair-bearing donor sites are used for oral reconstruction 2.
Treatment Options
First-Line: Laser Hair Removal
- Normal mode ruby laser has demonstrated successful treatment of terminal hair growth from full-thickness skin grafts with sustained hair reduction 1
- This approach directly targets the hair follicles that were transplanted with the graft tissue 1
- Treatment provides long-term improvement rather than temporary solutions 1
Alternative Consideration: Surgical Revision
- If the graft area is limited and laser treatment fails, surgical excision with regrafting using non-hair-bearing tissue (such as buccal mucosa from the opposite cheek) could be considered 2
- Buccal mucosa grafts are preferred for intraoral reconstruction specifically because they do not produce hair growth 2
Prevention Context (For Future Reference)
The ideal approach is prevention by selecting appropriate donor sites initially 2:
- Buccal mucosa is the preferred graft material for intraoral reconstruction because it lacks hair follicles 2
- Split-thickness skin grafts (rather than full-thickness) from hair-bearing areas significantly reduce the risk of intraurethral/intraoral hair growth, as demonstrated in urethral reconstruction where split-thickness grafts avoided hair growth complications during extended follow-up 3
- Non-genital, non-hair-bearing tissue should be prioritized for oral cavity reconstruction 2
Clinical Pearls
- Hair growth from grafts indicates that full-thickness skin with intact hair follicles was used 1, 4
- The hair follicles retain their growth characteristics regardless of the transplant location 5
- Laser treatment targets the follicles without requiring graft removal or additional surgery 1
- Multiple laser sessions may be needed for optimal results, as is standard for laser hair removal 1