My Hair UK Sheffield Clinic

The Role of the Scalp Microbiome in Hair Health and Transplant Outcomes from My Hair UK, Sheffield

The link between scalp microbiota and hair follicle function has gained serious attention over the past decade, though it's still under-recognised in mainstream transplant discussions. As doctors at My Hair UK hair transplant clinic in Sheffield, we routinely assess scalp condition before recommending surgery, but a deeper appreciation of microbial ecology can help patients better understand why seemingly minor factors might affect hair transplant success, recovery, and long-term outcomes. It also helps to explain why two individuals with similar graft counts might experience very different results.

The scalp microbiome refers to the diverse communities of bacteria, fungi and viruses that inhabit the scalp surface. While often thought of in the context of skin diseases like seborrhoeic dermatitis or psoriasis, the microbiome plays a regulatory role in barrier function, sebum balance, inflammatory response, and immune signalling. Studies have shown that disruptions in microbial diversity, particularly a dominance of Cutibacterium acnes or Malassezia species, may be associated with hair thinning and inflammatory scalp conditions, both of which could compromise hair graft survival.

Post-transplant inflammation is a natural stage of healing, but if the microbiome is imbalanced before surgery, it may heighten the inflammatory cascade or predispose to folliculitis during early recovery. We frequently see cases where patients unknowingly live with chronic low-grade microbial scalp irritation. These individuals often report itchiness or excessive scaling pre-surgery, both signs worth noting. Left unmanaged, the altered local immune environment could reduce graft take rate, especially in procedures exceeding 2000 grafts where trauma to the scalp surface is more extensive. At My Hair UK Sheffield, we take these factors seriously and educate patients about scalp care prior to surgery.

Emerging literature now explores whether restoring microbial balance can improve the scalp’s receptiveness to surgery and support faster revascularisation of the grafts. Certain probiotics, topical antimicrobials, and prebiotic scalp formulations are being trialled to enhance follicular density and reduce inflammation, though high-quality RCTs are still needed. A recent paper published in Frontiers in Cellular and Infection Microbiology discussed how the skin microbiome influences cutaneous immunity and might be modifiable in clinical settings. This opens a pathway to potentially include microbiome modulation in pre-operative routines for elective hair restoration.

Clinically, we’ve observed better healing and fewer post-op complications in patients with healthy scalps that show no signs of dysbiosis. Patients with recurrent dandruff, oily seborrhoea, or unexplained shedding may benefit from a short course of targeted antifungal shampoo or zinc-based preparations before booking a transplant. These are inexpensive interventions but can substantially reduce microbial load. This applies especially in larger graft sessions like 2500–3000 grafts, which at My Hair UK would typically cost between £4,099 and £4,499 depending on exact needs. Investing in pre-op scalp health not only improves comfort post-surgery but may support long-term density.

From a broader health standpoint, it's important to determine if scalp dysbiosis is an isolated issue or part of a systemic imbalance. Chronic stress, high-glycaemic diets, and poorly managed dermatological conditions can all influence skin flora. Before undergoing surgery, we advise that you visit your local GP for a routine health check. Basic screening for thyroid function, iron status, vitamin D levels, and autoimmune markers is useful in identifying reversible causes of hair loss that may undermine transplant outcomes if left unaddressed.

If you live in Sheffield, here are three NHS practices we commonly recommend for pre-consultation health checks:

Selborne Road Medical Centre – 1 Selborne Rd, Sheffield S10 5ND

Upperthorpe Medical Centre – 30 Addy St, Sheffield S6 3FT

Regent Street Clinic Sheffield – 90 Rockingham St, Sheffield City Centre, Sheffield S1 4EB

Make sure to mention any history of scalp itching, flaking, or recent antibiotic use, as this helps guide appropriate referrals if dermatological input is needed. In some cases, a trichoscopy performed by a dermatologist or trichologist may also help clarify causes of poor hair retention before surgery is offered.

At My Hair UK Sheffield, all hair transplant procedures are performed using Follicular Unit Extraction (FUE) — a method that extracts individual grafts with high precision and places them carefully into recipient areas to achieve a natural result. Pricing ranges from £2,899 for up to 1000 grafts, to £4,899 for up to 3500 grafts. We include a full pre-operative assessment, where scalp health is examined in detail.

We are committed to ensuring that you are medically fit, dermatologically stable, and fully informed before your transplant. Understanding your scalp microbiome is one small but important part of that process.