Recent attempt by Dr. Robert Jones to perform axillary hair transplant on one of his patients has triggered quite a debate in the hair transplant forum. The following is Dr. Woods and Dr. Campbell's opinions on this topic. 

The following is a further explanation of our position on axillary hair transplantation. We have been asked about it for several years and it was discussed in our Feb 2003 New York Seminar

The groin/pubic perineal, and armpit are crease areas where the skin reflects upon itself. These are the skin “wet zones”. It needs to be this way otherwise dry skin would constantly rub against dry skin causing severe discomfort, abrasion, rash, and infection. In these “wet zones”, nature has devised a complex system of unique and specialized glands attached to the follicular units. Secretions lubricate and protect the skin, but the full function of the apocrine gland system to this day is not fully understood. In hot weather and exercise etc. moisture would accumulate and, because air circulation and drainage is limited in these “crease” areas there would be “water logging” of the skin.

Tinea, yeast, fungal and bacterial infections would become a major factor. But, incredibly it is not usually a problem. However, In our clinical experience, problems do occur primarily when there is interference in the nature of the “wet zone”.
People who excessively shave, wax , overuse antiperspirants or have surgical procedures in these areas are at increased risk of these infections and boils.

Apocrine glands are unique to these areas. They are a tubular structure extending from the deep subcutaneous layer and are intimately connected around the follicle. The “milky” secretions drain into the follicle near the epidermis. We believe their existence to be crucial to the normal function of these special “wet areas”.

In 1998, we looked at the issue and made a benefit–risk analysis. Attempting to remove armpit hair would result in very high transection rates. That means a lot of holes but very few hair. It would be very easy to wipe out entirely ALL armpit hair in one session. This would achieve one, maybe two hundred hair. Maybe less. Then of course there is the issue of odor coming out of the patient's scalp. To overcome this one would need to get rid of the apocrine glands. Our early experimental work involved the high power dissection of follicles. What we found out then and what we know now is that it is almost impossible to remove the sebaceous gland entirely and attempts to do so render the follicle terminally damaged. We drew the conclusion that apocrine gland removal would most likely have similar problems. This means the yield could be even less

Anyone who has had chest hair transplants knows that a temporary but common side effect is ingrown hair. If a boil occurs, it is no major problem. Just squeeze it, and it should drain. However, a boil in the armpit is much more tender, and infection can spread much more easily into the lymph nodes. Sweating makes things worse and cannot be avoided. We believe side effects and complications would be worse.

Whether you believe in GOD or evolution, neither makes “silly mistakes” and went to a great deal of trouble giving us specialized glands or hormones that we don’t need, or for no reason. Eventually, we find out.

So, rather than resorting to “wet zone” harvesting , our position is to treat each and every body (and head) hair as precious and irreplaceable. Every hair that is transected is gone forever and those who have been scarred and disfigured CANNOT afford unnecessary wastage. The doctor must go by the rule “if in doubt, DON’T!!”

As far as beard hair is concerned, we recently spent several days removing beard hair transplanted to a patients head. It looked, and felt like barbed wire and made this man's life a misery. Again, BEWARE.

It is our belief that the hair transplant industry despite creating so many “experts” has caused more disfigurement, more suffering, agony, humiliation , negligence, blatantly stupid mistakes and deception than any other discipline in the history of medicine. And we want no part of it. 

THE DECLARATION OF PATIENT RIGHTS STAYS . There will be no compromise.

Dr Woods and Dr Campbell