Scalp Reduction Surgery: How it Works and Alternatives

Today, a variety of treatments are available to treat male pattern baldness, from convenient medications like finasteride and minoxidil to highly effective surgical treatments such as hair transplant surgery. 

However, many of these treatments weren’t available until the last 20 years. Before this, men with hair loss relied on a variety of other options to improve the appearance of their hair. 

Scalp reduction surgery is one of these treatments. It’s a cosmetic procedure that, although once popular as a treatment for male pattern baldness, is rarely used today due to the large range of more effective treatment options available.

Below, we’ve explained what scalp reduction surgery is and how it works. We’ve also listed a range of newer, more effective treatments that are typically used instead of scalp reduction surgery to treat and prevent male pattern baldness.

What is Scalp Reduction Surgery?

Scalp reduction surgery is a cosmetic procedure that involves moving areas of the scalp with thick, healthy hair to cover areas that have lost hair. It’s also referred to as alopecia reduction (AR) and galeoplasty, 

During the 1980s and ‘90s, scalp reduction surgery was used as a treatment for hair loss in men and in women. Since the late 1990s, scalp reduction has largely been phased out as a hair loss treatment in favour of more effective, less invasive procedures such as hair transplant surgery. 

Unlike a hair transplant, which involves moving hair follicles from one part of the scalp to an area affected by hair loss, scalp reduction surgery involves removing baldness-affected skin from the scalp, then covering the area using the remaining hair-covered areas of skin.

Performed correctly, scalp reduction surgery can create the illusion of a fuller head of hair by reducing the total amount of skin that’s affected by hair loss. 

How Does Scalp Reduction Surgery Work? 

In a scalp reduction surgery procedure, a surgeon will remove sections of skin from the scalp that are affected by hair loss. A surgical flap of skin is created using areas of the skin that are unaffected by hair loss. This flap is then stretched over the balding area and sewn in place.

As the skin heals from the surgery, the end result is a head of hair that appears fuller. Scalp reduction surgery can be used to cover a bald spot on the crown of the head, or to give the appearance of a lower, less receded hairline.

This type of cosmetic procedure is lengthy, complicated and invasive. It typically takes patients several weeks to recover from the surgery. As it’s such an invasive procedure, scalp reduction surgery often leaves significant scars that are covered using the patient’s new hairline. 

Although rare, scalp reduction surgery can lead to complications. The most common issues are infection and bleeding around the skin flaps used during the surgery. Many men who underwent scalp reduction surgery in the ‘80s and ‘90s have some degree of lasting numbness in the scalp. 

Although it was popular in the 1980s, scalp reduction surgery is rarely performed today. Modern procedures, such as hair transplant surgery, which involves harvesting and relocating individual hair follicles, are more effective at restoring hair and less likely to result in complications.

Alternatives to Scalp Reduction Surgery

Scalp reduction surgery was a popular option for balding men in the 1980s, before treatments like finasteride, minoxidil and hair transplant surgery were available. Today, it’s rarely used due to its numerous disadvantages. Instead, the following options are used to treat baldness:

  • Finasteride. Introduced in 1997, finasteride prevents hair loss by blocking the hormone DHT, which miniaturises and damages hair follicles. Used daily, finasteride can stop hair loss and even help you regrow some or all of the hair you’ve lost.

    Our guide to DHT and hair loss explains more about how DHT causes hair loss, as well as how medication like finasteride can help you stop losing hair.
  • Minoxidil. Introduced in 1988, minoxidil is a topical medication that promotes growth in your hair follicles. Studies show that it’s effective at promoting hair growth in men who’ve lost hair to male pattern baldness.

    Our guide to how minoxidil works explains how minoxidil stops hair loss and encourages healthy hair growth in more detail, as well as how you can use it to prevent your hair loss from worsening.

  • Hair transplant surgery. For advanced hair loss, hair transplant surgery is a modern, safe alternative to scalp reduction. Instead of stretching skin to cover a bald spot, hair transplant surgery involves relocating hair follicles to area affected by baldness.

  • Other hair loss products. While hair loss products like ketoconazole shampoo, biotin and many others don’t directly prevent hair loss, there’s some scientific evidence that they can contribute to healthy hair growth and maintenance. 

Is Scalp Reduction Surgery Worth It?

Although scalp reduction surgery was once a popular treatment for male pattern baldness, it’s no longer offered by most cosmetic surgeons. Instead, safer, less invasive treatments such as hair transplant surgery are typically used to treat moderate to advanced baldness in men.

For mild to moderate hair loss, non-surgical treatments such as finasteride and minoxidil can often restore significant amounts of hair, all while blocking the androgen hormones that cause male pattern baldness in the first place. 

Learn More About Keeping Your Hair

Considering scalp reduction surgery? Our guide to the treatments for baldness that are currently available explains how you can protect your hair and restore some or all of your hairline without the need for costly, painful surgical procedures. 


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The views expressed in this article intend to highlight alternative studies and induce conversation. They are the views of the author and do not necessarily represent the views of hims, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.