There are different skin disorders that appear as brown spots. Most seborrhoeic keratoses (Fig 6) can be easily destroyed with electrosurgery or carbon dioxide laser. Solar lentigines and freckles (Fig 7) respond well to pigment lasers with minimal risk of scarring.
Fig.6 Seborrheic keratosis
Fig.7 Solar lentigines/freckles
Small areas of non-inflammed bald scalp that have remained unchanged for many years can be excised and the hair-bearing sides stitched together.
Hair transplantation is a treatment option for male pattern baldness (Fig 8). Hair-bearing scalp skin (grafts) are removed from the back of the scalp (donor site) and implanted into the bald areas (recipient site) where hair growth is desired. Male pattern baldness worsens with advancing age and the severity of baldness is unpredictable. Thus, hair transplantation must be individualised taking into consideration the person's family history of baldness, age, severity of baldness and hair texture. It may not be suitable for some persons with male pattern baldness.
Fig.8 Male pattern baldness
Synthetic hair implants are polyester fibres, which are embedded in the scalp to simulate human hair. The procedure of implanting the artificial "hair" is safe and quick and there is no limit to the number of implants available. However, this expensive procedure necessitates specialised aftercare and the implants fracture after one to two years. Some people develop inflammation of the scalp after hair implantation (Fig 9).
Fig.9 Foreign body reaction to hair implants
The decision to undergo cosmetic surgery and the type of procedure to undergo is highly personal. Decision to undergo such procedures should be an informed choice.
Fig.10 Scarring from attempts by beautician to remove eyebrow tattoo.