Good hair transplant candidates are typically over 25, have stable hair loss, possess adequate donor density, and maintain realistic expectations about outcomes. A qualified surgeon evaluates these factors during consultation, but understanding them yourself helps you avoid wasting time and money on consultations with clinics that will either turn you away or, worse, operate on you when they should not.
This article is for informational purposes only and does not constitute medical advice.
Candidacy Assessment Criteria
| Factor | Good Candidate | Poor Candidate |
|---|---|---|
| Age | 25-65 | Under 21 |
| Hair loss stability | Minimal change in 12+ months | Rapidly progressing |
| Donor density | 60+ FU/cm² | Below 40 FU/cm² |
| Hair caliber | Medium to coarse | Very fine |
| Norwood stage | 3-5 (defined pattern) | 1-2 (too early) or 7 (insufficient donor) |
| General health | No uncontrolled conditions | Uncontrolled diabetes, autoimmune disorders |
| Scalp condition | Healthy, no active inflammation | Active psoriasis, dermatitis, infection |
| Expectations | Understands limitations | Expects full teenage hairline at Norwood 6 |
Age and Timing
Age is the most debated candidacy factor. Operating too early (before 25) creates a specific risk: the transplanted hairline looks natural today but becomes isolated as native hair behind it continues to thin. This produces an unnatural "island" of hair at the front with a visible gap behind it.
Most experienced surgeons follow a conservative approach. They prefer to wait until hair loss has stabilized or at least established a clear pattern. A 22-year-old with aggressive Norwood 3 progression is a riskier patient than a 35-year-old with stable Norwood 4 because the younger patient's loss trajectory is still uncertain.
The exception is patients under 25 who combine transplantation with long-term finasteride use. Finasteride can stabilize loss in the non-transplanted areas, reducing the risk of future pattern mismatch. However, this commits the patient to years of medication use, which not everyone is willing to do.
Donor Area Assessment
Your donor area is the biological bank account that funds your transplant. If the balance is too low, the procedure cannot deliver meaningful results.
| Donor Density | Assessment | Graft Potential |
|---|---|---|
| 80+ FU/cm² | Excellent donor | 5,000-6,000+ lifetime FUE grafts |
| 60-80 FU/cm² | Good donor | 4,000-5,000 lifetime FUE grafts |
| 40-60 FU/cm² | Limited donor | 2,000-3,500 lifetime FUE grafts |
| Below 40 FU/cm² | Poor donor | May not be a candidate for FUE |
Donor density is measured using a densitometer or trichoscopy device during consultation. The surgeon examines the safe donor zone (the permanent horseshoe area at the back and sides of the head) and calculates how many grafts can be extracted without creating visible thinning in the donor region.
Hair Characteristics
Not all hair provides equal coverage. Coarse, curly hair covers more scalp area per strand than fine, straight hair. Patients of African descent often have naturally curly hair that provides excellent perceived density even at lower graft counts. Patients with fine, straight, light-colored hair typically need more grafts for the same visual result.
Hair-to-skin color contrast also affects candidacy assessment. Dark hair against light skin creates high contrast that makes thin areas more obvious and requires higher density to look full. Light hair against light skin or dark hair against dark skin is more forgiving.
Disqualifying Conditions
Temporary Disqualifiers
These conditions prevent surgery now but can be resolved:
- Active scalp infections or inflammation. Treat first, then reassess in 3-6 months.
- Uncontrolled blood pressure. Must be managed with medication before surgery.
- Nutrient deficiencies (iron, vitamin D, biotin). Correct and allow 3 months for improvement.
- Recent steroid use. Stop and allow washout period as directed by your physician.
Permanent or Long-Term Disqualifiers
- Alopecia areata (active). Autoimmune attack on follicles can destroy transplanted grafts. Patients with alopecia areata in remission for 2+ years may be candidates under close dermatological supervision.
- Diffuse unpatterned alopecia (DUPA). Thinning throughout the entire scalp, including the donor zone. Since the donor hair is also compromised, transplanted grafts may eventually thin as well.
- Severe donor depletion. Previous over-harvesting or naturally low donor density that cannot support meaningful transplantation.
The Role of Medication in Candidacy
Finasteride (1mg daily) and minoxidil (topical, 5%) can convert borderline candidates into good candidates by stabilizing loss and maintaining native hair density. Surgeons often recommend starting one or both medications 6-12 months before considering surgery.
If medication stabilizes your loss pattern and preserves existing hair, the transplant only needs to cover current gaps rather than anticipating future loss. This reduces graft requirements and improves long-term outcomes.
Questions to Ask During Your Candidacy Assessment
A thorough surgeon will answer these without prompting. If they do not address them, ask directly:
- Based on my donor density, how many lifetime grafts are available to me?
- Is my hair loss stable enough for surgery, or should I wait?
- Do you recommend medication alongside the transplant?
- What Norwood stage do you assess me at, and what stage should I plan for long-term?
- Are there any health conditions in my history that affect my candidacy?
For a complete breakdown of the Norwood classification system, see the Norwood scale guide. To understand how different extraction techniques affect donor area management, review the FUE vs FUT comparison.
Wondering if you are a candidate? Upload a photo at myhairline.ai/analyze for a free AI assessment of your hair loss stage and preliminary candidacy evaluation.
FAQ
Am I a good candidate for a hair transplant?
You are likely a good candidate if you are over 25, have stable hair loss (minimal progression in the past 12 months), have adequate donor density (over 60 follicular units per cm² in the donor zone), are in good general health, and have realistic expectations. The best candidates are Norwood 3-5 with strong donor areas. A qualified surgeon must perform an in-person assessment to confirm.
At what age should you get a hair transplant?
Most surgeons recommend waiting until age 25-30. Hair loss patterns are too unpredictable before 25, and transplanting too early means future loss can create an unnatural gap between transplanted and native hair. Exceptions exist for patients with very stable, clearly defined loss patterns. A surgeon who agrees to operate on an 18-year-old without discussing long-term risk is a red flag.
Can women get hair transplants?
Yes, but female candidacy is more complex. Women with androgenetic alopecia typically experience diffuse thinning rather than defined bald areas, which makes transplantation less effective because there is no clear boundary between donor and recipient zones. Women with traction alopecia, scarring from surgery, or hairline recession are often better candidates. A dermatologist specializing in female hair loss should evaluate before proceeding.
What disqualifies you from getting a hair transplant?
Common disqualifying factors include insufficient donor density (below 40 FU/cm²), active scalp conditions (psoriasis, dermatitis, infections), uncontrolled diabetes or autoimmune disorders, blood clotting disorders, active alopecia areata, unrealistic expectations, and age under 21. Some conditions are temporary disqualifiers that can be resolved with treatment before proceeding.