If it's truly burnt out, a hair transplant could be a good option. If it's not truly burnt out, a transplant might not be a good option. A repeat biopsy could be helpful in some cases to assess whether CCCA is the current diagnosis and whether it's indeed active. I'm certainly of the opinion that patients with scarring alopecia who have some anti-inflammatory treatments on board during their transplant often have better long term success. This may mean some periodic use of a topical steroid and sometimes doxycycline. The key here is that we need to make sure your scarring alopecia is quiet. If you think there is any chance you look different than what you looked like back in 2020, then it might not be truly burnt out. Oral minoxidil together with topical fluocinolone acetonide oil and/or clobetasol could be helpful. All in all, it's really important to optimize the medical side of treatment here. Patients who do so are often the most pleased in the long run. If you and your doctors truly think your scarring alopecia is quiet and you look the same as you did at the start of the COVID pandemic, then you might be ready for surgery.