Hair Restoration, Hair Transplant, Hair Loss Treatment Clinic

When a strong family history for female hair loss is not present it is unlikely that a woman is suffering from typical female patterned hair loss. A physician would then pursue evaluation and diagnostics to learn the cause for the hair loss the patient is experiencing.

Various types of medications are known for having hair loss as one of their side effects. This is why it is important that the patient’s history of medications be carefully evaluated. However, we do not see many women who lose hair solely after the use of medications.

Step 2: Macro and Micro-evaluation
A hair transplant surgeon should thoroughly examine the scalp of the patient to determine if any abnormal pattern is present. A woman with a receding hairline or significant thinning in front with preserved hair on top and back should be evaluated for causes of male patterned hair loss such as elevated testosterone levels.

Microscopic evaluation of the scalp and hair (Miniaturization study)is an important part of every hair loss evaluation.

It is known that hair shafts become very fine before they are lost. In fact fineness of more than twenty percent of hair shafts cannot be explained by simple recycling of normal hair and other causes should be considered. The next step is the mapping of scalp hair miniaturization for all patients during their physical evaluation. We then compare the numbers after months of treating patients with medication as a guideline to evaluate the success of our treatment.

Patients who are not qualified for medical therapy, miniaturization could be used to predict the future of their hair loss. This helps a hair transplant surgeon to know which areas to restore foreseeing future rate of loss in different areas.

Step 3: Lab Work
Conducting lab work might be necessary for many women with hair loss. This includes simple tests such as a CBC to more specific ones such as an Iron panel including serum iron levels, TIBC and ferritin levels. Since hormonal imbalances can be the reason for hair loss thinning in many women some hormonal evaluations should be included in our evaluations too. The primary hormonal levels to check are: total and free testosterone, DHEA-sulfate, Prolactin, T3, T4 and TSH. There might be a need to check other specific tests such as ANA if there is any evidence of autoimmune disorders that may cause hair loss.

In more atypical patterns of hair loss or in hair loss conditions without any family history, the doctor may need to obtain a scalp biopsy to rule out other and rarer skin conditions that may lead to a woman’s hair loss. Those conditions include autoimmune conditions of the scalp that cause hair loss such as Alopecia Areata (AA) or Alopecia Cicatricial among others. Confirming the diagnosis of those conditions helps a physician to know what types of treatments could and could not be used.

Step 4: Diagnosis
Treatment of women hair loss is directly related to diagnosis of their hair loss condition. If we diagnose any medical condition that causes hair loss in women, we can treat that condition and in many instances by doing so we will alleviate the hair loss by resolving the underlying cause. In cases that we do not find any other medical condition causing hair loss which is majority of the cases, we treat female hair loss based on our findings in our microscopic evaluation.

Step 5: Treatment
Diffuse hair loss is the most common type of hair loss in women in which patients have significant thinning or miniaturization of hair throughout scalp. If these women still have high levels of miniaturization (fineness of scalp hair), they are good candidates for medical treatment with minoxidil(Rogaine). If the baldness is matured and there is less that 20% miniaturization in the scalp hair these women may not respond as well to the medical treatment.

Local hair loss or asymmetrical hair loss with loss of one area (usually the front) and preserving the donor hair on the permanent zone makes these women great candidates for hair transplantation. Women’s hair replacement through hair transplant surgery can be very successful; providing the patients are selected properly and after following the other three steps described above.

It is important to set the expectations appropriately and to make sure the patient has a good understanding of the final outcome. Level of satisfaction for women with female patterned hair loss might be quite different than men with male patterned baldness. These patients should be aware that in some cases more than one hair transplantation is necessary for the best cosmetic result.

Table 1: Association of each diagnosis of female patterned hair loss with its treatment options

Any hair specialist should be familiar with the basics of cosmetics that could be used to enhance the appearance of hair in women with female patterned hair loss. There are many myths about shampoos, conditioners, hair colors etc. about their positive or negative effects on hair growth. A specialist who is dealing with female hair loss should be reasonably knowledgeable about those and other products.

Coloring hair differently might be the only change that a women need to prevent looking thin on top. Discussing about other cosmetic changes such as microfibers (Toppik) and scalp coloring agents should be part of a women hair loss visit if indicated. Finally training about the style of hair should be included in the initial consultation process.

Conclusion: It is important to realize that the approach to women who suffer from hair loss should be completely different than men who suffer from typical male patterned baldness. It is important to evaluate their hair loss thoroughly and come up with the right diagnosis. Medical treatments might be used to maintain their hair in most cases rather than treatment of their hair loss condition. It is important to select the women who are candidates for a hair transplant surgery meticulously. More than anything it is crucial to set the expectations right. It is important for women who undergo hair transplantation to realize that hair transplant cannot give them the full head of head they once had.

Producing the original density or something close to it might be more challenging in women with extensive hair loss; having mentioned the limitations of hair transplantation in women. Hair restoration surgery could be a life changing experience for women whose candidacy is determined after appropriate evaluation. The combination of medical treatment, hair transplantation and cosmetic changes can help create the appearance of maximum fullness in many women who suffer from female hair loss.