Dermatologic Microsutures Using Human Hair

A Useful Technique in Cutaneous Stitching

Mohammed Al azrak, MBBCh, MSc, FEBOPRAS, FACS; Rei Ogawa, MD, PhD, FACS


ePlasty. 2017;17(e24) 

In This Article

Abstract and Introduction


Background: Facial wounds are challenging for dermatologic surgeons, particularly traumatic facial wounds, because they can yield disfiguring scars. To obtain good results, narrow needles and sutures are needed. Hair filaments have a very small diameter (0.06–0.1 mm) and could serve as suture threads for facial wounds.

Objective: To determine the aesthetic outcomes by using autologous hair to suture facial wounds.

Patients and Methods: This case series study examined the aesthetic outcomes of all consecutive female patients with traumatic facial wounds who underwent autologous hair-based stitching in 2009–2016. Autologous hair ampoules were generated from an insulin needle. Micro instruments were used for wound stitching.

Results: In total, 54 females (mean age, 10.8; range, 3–45) years had 56 traumatic wounds. Mean wound length was 3.6 (range, 1–12) cm. Injury depth varied from cutaneous-only to muscle involvement. Suturing yielded good edge coaptation, nice healing, and excellent aesthetic outcomes; the scars were often scarcely visible. Suture marks were not detected. Cutaneous reactions did not occur.

Conclusion: Autologous hair can serve as a thread for closing facial wounds. It is low cost and thus suitable in settings characterized by facility and equipment limitations. It is also suitable for the battlefield.


The repair of traumatic facial cutaneous wounds carries a considerable risk of disfiguring scarring. Regardless of their age, females are significantly more affected by facial scarring than males because of social norms that value female attractiveness.[1] Thus, when repairing traumatic facial wounds in females, it is necessary to make an effort to conserve their aesthetic appearance.

To obtain good aesthetic outcomes after wound repair, it is necessary to employ a variety of surgical techniques.[2] Several local and technical factors have a considerable impact on the aesthetic outcome after repair of traumatic cutaneous wounds. One of the most important factors is the nature of the thread used for stitching, particularly its inability to provoke unwanted immune reactions by the body.[3,4] In this case series, we used the scalp hair of the patients as a thread for stitching their traumatic facial wounds. In our experience, autologous hair did not elicit noticeable cutaneous reactions and yielded acceptable scars.