Development of an Evaluation System to Classify Beard Donor Area for Hair Transplantation.

[BACKGROUND] Beards are important donor sources for hair transplantation in male patients. However, standardized assessment criteria for beard grafts' suitability and application are unavailable.

[OBJECTIVE] To develop an evaluation system for classifying beard suitability and defining its specific applications in hair transplantation.

[MATERIALS AND METHODS] The authors developed a 2-step beard donor evaluation system. The first step involved screening beards for suitability based on distribution area, density, diameter, and angle to the skin. The second step involved scoring the diameter, curliness, and color contrast with native hair to determine its application for hairline correction (HC), parietal area hair transplantation (PAHT), or combined correction (CC) based on the total scores.

[RESULTS] Beard grafts are deemed unsuitable for harvesting if the donor area is restricted to the perioral area, has a density <8 follicular units/cm 2 , a diameter <60 μm, or an angle to the skin <10°. Beard grafts used for HC have thinner diameters (60-80 μm), straight shafts, and minimal color contrast with native hair. Beards used for PAHT and CC have thicker diameters (>80 μm) and require fewer additional characteristics.

[CONCLUSION] Beards can be classified using an evaluation system to assess their suitability for HC and PAHT. HC requires high-quality grafts.

[LEVEL OF EVIDENCE] 3 (Therapeutic).