This Norwood 4 patient had a strip hair transplant procedure performed at a well-known clinic before choosing CIT (Cole Isolation Technique) to improve naturalness on the front and fill balding areas. The area on the top of the scalp initially had hair growth from the strip procedure but later became completely bald. The loss of hair in this area was correlated with the combination of the topical application of Minoxidil and Retin A. The patient noted that the area gradually became irritated and red with the development of a crust. Scarring alopecia can produce skin changes and hair loss similar to this, but one often is not able to get additional grafts to grow in the area of scarred skin. These combinations of Minoxidil and Retin A can be quite irritating to the skin. There is no strong evidence that Retin A adds any additional benefit to the Minoxidil. This patient later discontinued using the combination of Minoxidil with Retin A and later peeled the scab off. The area was left without hair and the skin had the appearance of scar tissue. Another contributing factor for this patient's need of CIT hair transplant method was the lower donor density due to strip surgery from the past. Beginning in 2005, Our surgical staff successfully transplanted 2000 CIT grafts to treat this patient’s hair loss. The treatment plan consisted of three smaller CIT sessions to achieve ideal coverage on the receded areas. This patient noted growth within just two months after his first procedure, which in not uncommon as all hairs do not grow at the same rate. The results after 28 months can be seen below as well as images of a satisfied patient.