posted by ISHRS on August 1, 2005
Hair transplantation is universally accepted as a treatment for hair loss. While it was developed and first offered as a hair-loss treatment for men, women have increasingly found hair transplantation a viable option to correct the cosmetic deficit of thinning hair. Advances in hair transplantation techniques and better understanding of the biology of female hair loss contributed to the evolution of hair transplantation for women.
When should a woman consider hair transplantation?
Many women today are proactive about seeking hair transplantation. They are unwilling to accept hair loss as an unavoidable fact of life. Scalp hair is a major component of the image women project to the world and they do not wish to have hair loss detract from that image. Almost worse than hair loss in some cases is hair miniaturization-the fine-caliber, wispy hair that grows out a follicle when the follicle is no longer able to produce hair of normal size. Miniaturized hair is hard to style and difficult to conceal. It begins to appear in the course of female pattern hair loss, the female form of the most common type of hair loss in men.
So, the answer to the question-"When should a woman consider hair transplantation?"-is "When hair transplantation is the right hair loss treatment for this woman at this time."
When It's Time for Hair Transplantation
Hair loss is not "an inevitable sign of getting older". It has been reported in studies that about 80% of women experience some degree of hair loss before menopause. Much of this hair loss has a hereditary basis-female pattern hair loss. A woman who has a family history of hair loss in women may be especially aware of the possibility that she may also begin to lose hair as she matures. And, she would be correct; a family history of hair loss in women is an indication that a woman may be genetically predisposed to lose hair. For more information, see About hair loss.
A woman's hair loss is not always genetically predisposed and is not always permanent. Hair loss during pregnancy has a hormonal basis associated with pregnancy, and hair growth is usually restored in a normal pattern after pregnancy. Some hair loss may be due to a condition such as alopecia areata that is a disease process rather than genetically predisposed pattern hair loss, or to a condition such as hypothyroidism that requires treatment before hair restoration can be undertaken.
Women may experiment with various herbal and over-the-counter remedies for hair loss. Only one over-the-counter hair restoration medication-minoxidil-has a track record of success and is approved by the Food and Drug Administration for use in women. It is frequently recommended by physician hair restoration specialists for use in a planned program of hair restoration after the cause of hair loss has been diagnosed. Other products that may be tried include (1) protein fibers that bond with hair to give the appearance of greater fullness, and (2) a masking agent that disguises bare scalp to make it blend better in color with existing hair. If her own experimentation with hair loss remedies proves unsatisfactory, as is often the case, a woman with even mild to moderate hair loss may consider herself a candidate for hair transplantation.
Whether hair transplantation is a viable option for a woman with mild to moderate hair loss is a question to be answered by close consultation between the woman and the physician hair restoration specialist. Into that determination will go the patient's medical history, hair loss history, family medical and hair loss history, physical examination, scalp examination and laboratory tests as indicated by other examination results.
Also into that determination goes the question: What does the patient want hair transplantation to accomplish? On the basis of all objective information from test results, what is a realistic expectation for the short-term and long-term cosmetic outcome of hair transplantation?
Planning for long-term cosmetic outcome may have to consider the woman's hair loss history and family hair loss history. A one-time "fix" may not provide an acceptable outcome over a period of years if progressive hair loss diminishes the result over time. A family history of female hair loss may be indicative of the probable course of the patient's hair loss. Assessment of the patient's supply and quality of potential donor hair (the hair that will be surgically removed and grafted into a recipient area of hair loss) indicates how much donor hair will be available for transplantation over time. A projection of progressive hair loss is an indication that a one-time "fix" will not provide an acceptable long-term cosmetic outcome.
The woman may also ask the question: "If my hair loss is not too severe and I can cover it up with hair styling for a while longer, should I be seeking hair transplantation?"
The answer to that question can only be subjective on the part of the patient, with objective input from the physician hair restoration specialist. The physician hair restoration specialist may, for example, agree that hair transplantation is not an immediate need; the woman's mild degree of hair loss may be treated adequately with topical minoxidil and the question of hair transplantation delayed to a later time. If hair loss seems likely to be rapidly progressive, the physician may recommend early hair transplantation.
An important difference between male and female hair loss is that women rarely "go bald", but often have thinning of hair over a large area of the scalp. Spreading grafts over such a large area may not provide a significant cosmetic improvement. It may be more important, for cosmetic improvement, to place grafts into a key area such as the hairline. Transplanting key areas can be planned with hair styling in mind-for example, so that transplanted hair can be styled to layer over other areas to improve hair density. Transplantation and planned hair styling is often a more important consideration in hair transplantation for women than it is for men.
Hair transplantation is a surgical procedure associated with some degree of discomfort and a small risk for complications. The financial cost of hair transplantation can be a substantial consideration. It is a procedure that should be undertaken with due deliberation.
Hair transplantation is also a procedure with a very high rate of success in meeting the expectations of patients.
For a woman who is unwilling to accept thinning hair as inevitable, hair transplantation may be the hair restoration treatment of choice when all the facts are in hand.
