Staphylococcus lugdunensis and Trichophyton tonsurans infection in synthetic hair implants

Abstract

Synthetic hair implants are considered in alopecia when the patient requests an immediate result with minor surgery and with a poor donor area. However, the procedure has historically been marred by poor quality fiber and performance resulting in serious complications. Nevertheless, companies continue to market the procedure with the claim that previous problems have been sorted out. We report a case of inflammation in synthetic hair implants, in which microbiological studies revealed infection with Staphylococcus lugdunensis and Trichophyton tonsurans. The procedure was performed by a hair stylist. The patient experienced symptoms at the site of the implants. Nevertheless, he had the artificial implants repeated. Despite persistent symptoms of peri-implantitis, medical assistance was not sought. It is the view of the International Society of Hair Restoration Surgery that artificial hair fiber implants represent a surgical procedure and as such should be confined to experienced and licensed medical doctors in a reputable medical clinic. As with any surgical procedure, complications may occur which should be handled under a physician's care. Usually, problems result from lack of asepsis during the procedure, lack of patient hygiene, excessive quantity and density of implanted fibers in one session, incorrect choice of implant area, and poor aftercare. In cases, where implant-related problems cannot be resolved within 15 days of antibiotic and anti-inflammatory treatment, an extended microbiological work-up is warranted, and it may be necessary to remove the fibers that may harbor microbial biofilms.