Women’s Hair Transplant

by Y on November 7, 2007

Women's Hair TransplantDoes anyone know anything about hair transplants…I’m really considering it. I have an appointment on Nov 8… Has anyone here had a hair transplant? What do I need to qualify for one?
Thanks,
gypsy

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Dear Gypsy,

It is my opinion that most women who suffer with typical female pattern hair loss are not candidates for hair transplantation. The reason being, usually women’s hair loss exhibits itself in a diffuse thinning all over the scalp leaving no stable donor hair. In order to understand what I am referring to it is important to first understand how a hair transplant is performed. Since I’m not trying to reinvent the wheel here, with permission I am republishing the hair transplant information provided by The American Hair Loss Association

Understanding Hair Transplants (from the American Hair Loss Association)

At this point a hair transplant can only be performed by harvesting DHT resistant hair from the back of your own scalp, and then transplanting it into the balding areas. Typically, men experiencing male pattern baldness will remain with a permanent wreath of hair surrounding the sides and the back of their head, this is where hair is harvested from for transplantation. This hair is genetically programmed to continue to grow even in the worse cases of male pattern baldness.

The exception is men suffering with diffuse hair loss. These men suffer with a similar form of hair loss as women; the hair loss is distributed throughout the entire scalp leaving the sides and the back very sparse. If this hair were to be transplanted, there would be no guarantee that the hair would continue to grow in the recipient area due to the fact that this hair seems to be inherently unstable and just as susceptible to DHT as the hair lost on the top of the scalp. For this reason the vast majority of women suffering from hair loss should never have a hair transplant.

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Since hair transplantation is a good option for nearly 90 percent of the balding men in the country, women think that they will make a good hair transplant candidate as well, but this is usually not the case. Very few women have the type of hair loss that would make them good candidates, and that’s because most women have what’s called diffuse hair loss. That means that women have an overall thinning in all areas of the head, including the sides and back, these are the areas that act as donor sites in men. It is from these sites that the hair is removed for hair transplantation to other areas of the head. In men, the donor sites are called stable sites, which means that the hair and follicles in those areas are not affected by the DHT that shrinks follicles elsewhere on the head in those with androgenetic alopecia, or what’s commonly called male pattern baldness. In female pattern baldness, however, these donor areas are usually unstable. They are thinning, just like the other areas of the head. The donor areas in women are affected by follicle-killing DHT. That means that if you remove hair and accompanying follicles from these donor areas in women and transplant them to other areas, it’s just going to fall out. Any doctor who would attempt to transplant hair from an unstable donor site is unethical and just trying to take economic advantage of the patient.

Another difference between male and female pattern baldness is the frontal hairline. Unlike men, women experiencing hair loss still tend to keep their frontal hairline. They don’t have to worry about needing a hair transplant to frame their face and are instead more concerned about the loss of volume from the top and back. Hair transplants, though, don’t do much to increase volume. It just moves hair from one place to another.

Are You a Good Candidate?

According to experts a very small percentage of women are actually candidates for hair transplant surgery, approximately 2 – 5% will benefit from this type of procedure. The only women who are potential candidates for surgical hair restoration are:

  • Women who have suffered hair loss due to mechanical or traction Alopecia (non hormonal)
  • Women who have had previous cosmetic or plastic surgery and are concerned about hair loss around the incision sites.
  • Women who have a distinct pattern of baldness, similar to that of male pattern baldness. This includes, hairline recession, vertex thinning, and a donor area that is not affected by androgenetic Alopecia.
  • Women who suffer hair loss due to trauma, including burn victims, scarring from accidents and chemical burns.
  • Women with alopecia marginalis, a condition that looks very similar to traction alopecia.

Due to the lack of stability in women suffering with female pattern baldness, women generally make very poor candidates for hair transplant surgery. However, if your hair loss is caused by any of the above mentioned, then you may benefit from this procedure.

Gypsy, who are you having your consultation with tomorrow? There are so many unethical hair transplant doctors that may be willing to perform a hair transplant on a woman that isn’t a candidate so you have to be very very careful! I also tell women that if they are insistent on having a consultation for hair transplant surgery that they choose a doctor who is a member of The International Alliance of Hair Restoration Surgeons (IAHRS) those doctors have been screened and are not only good hair restoration surgeons, but also ethical as well, so I think they would provide an honest assessment to a woman who was trying to figure out if she was a candidate. Please keep us updated.

~Y

{ 18 comments… read them below or add one }

jeni November 8, 2007 at 4:20 am

I have thought a lot about hair transplants (because my ex-boyfriend wanted to get them, so we would talk about them all the time). It has never dawned on me that they wouldn’t be a reasonable solution for a lot of women. I see a lot of women with Androgenetic Alopecia, where their hair is just noticeably thinning on the top, so I have always assumed transplants would be a good option, especially since less hair would need to be used than a man that is considerably more bald on the top part of his head.

If my hair gets a lot worse, I have always thought I would get hair transplants, since it’s only the top of my head where the hair is see-through. But if my hair got extremely thin all over, then I guess I would realize I didn’t have enough donor hair.

I’m not sure what form of hair loss the women in the Bosley and Hair Club commercials have.

Depending on what they say tomorrow (and what type of hair loss you have), I would seek out a few different hair transplant places to get a range of opinions.

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admin November 8, 2007 at 8:41 am

Hi Jeni – If your hair loss is only on the top and all of your other hair remains untouched by hair loss, then perhaps you would be a candidate for a hair transplant. I don’t know, you’d have to talk to a ethical, reputable, knowledgeable hair restoration surgeon about that. My hair loss has always been diffuse, I lose it from ALL over my head, its thin everywhere not just not top. That is usually what I see in women on the street as well who are suffering with hair loss and usually consistent with what is considered female pattern hair loss.

Whatever you do, do not go to Bosley, infomercials are very deceptive. I have read so many horrible patient stories from people who got hair transplant there. Look at this site: http://www.bosleymedicalviolations.com/

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Gypsy November 9, 2007 at 10:20 am

hi
thanks for your advice… i went for my appointemet yesterday.. all he said was i had alopicia, the hair on side and top are thinning but back looks stable….he wants to run more test but wiating for copies of blood work test to come back from my other doc..i still havent commited to this surgery, i think i will go in agian and ask more question..any question anyone wnat me to ask?????

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admin November 9, 2007 at 10:23 am

Gypsy – What hair transplant doctor did you have a consultation with yesterday?

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Diane November 9, 2007 at 10:45 pm

I also went for a transplant consultation, but was told (and I appreciate the candor) that I would not be eligible for a transplant, as my remaining hair was too thin. I have the female pattern baldnes. I’m the one who thought up getting the my white scalp partially covered with tattooing….it really does help.

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GYPSY November 10, 2007 at 9:46 am

hello admin

i went to see DR BARR in ontario canada,he hasnt said yes to the transplant yet! he wnats to run more test before he can conferm that i might be a canidate..
i have alot of hair on the t=back of my head, but not so much on sides and top..
as any one tried propecia yet?????its suppose to reverse the minaturization and help with the dht! im on spiradalcton but that doesnt seem to be working..! anyway im jsut looking into my options i might try propecia first before i take the dive to hair transplant!!! anyone have any info??????
gypsy

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admin November 11, 2007 at 12:41 pm

Hi Gypsy – How long have you been losing your hair? I ask because when I first started losing my hair it was mainly noticeable from the top then it spread to the sides and over the years it spread all over to the back as well. I have A LOT of thinness in the back and sides of my hair today that I didn’t exist early on in my hair loss for the first few years. That is why it is so tricky for a woman to get a hair transplant. Had I gotten a transplant years ago that hair that was cut out of the back of my head and moved to the top or sides, would have mostly likely just fallen out because it wasn’t resistant to hair loss and I would be left with the a scar on the back of my head that may be visible the thinner my hair got. There is also something called “shock loss” that can occur from a hair transplant and could result in losing even more hair. These are all things to consider.

Propecia is usually prescribed to men, but some doctors prescribe it to woman as well, although it has not been approved for the treatment of female pattern hair loss and the long term effects in women have not been studied either. I actually took propecia myself for treatment of my hair loss early on and it absolutely did not help me. It made my skin very oily and greasy and I broke out with a lot of pimples which is very unusual for me because I rarely ever get pimples and never had acne. I ended up getting off it and my skin returned to normal. That was my experience with it.

There was a study done titled “Finasteride treatment of Female Pattern Hair Loss” here is the link to the abstract:

Matilde Iorizzo, MD; Colombina Vincenzi, MD; Stylianos Voudouris, MD; Bianca Maria Piraccini, MD, PhD; Antonella Tosti, MD

Arch Dermatol. 2006;142:298-302.

Objective To evaluate the efficacy of oral finasteride therapy associated with an oral contraceptive containing drospirenone and ethinyl estradiol in premenopausal women with female pattern hair loss.

Setting Outpatient consultation for hair disorders at the Department of Dermatology, University of Bologna.

Patients and Intervention Thirty-seven women with female pattern hair loss were treated with oral finasteride, 2.5 mg/d, while taking an oral contraceptive containing drospirenone and ethinyl estradiol. Treatment efficacy was evaluated using global photography and the hair density score from videodermoscopy. A self-administered questionnaire was used to assess patient evaluation of treatment effectiveness.

Results At 12-month follow-up, 23 of the 37 patients were rated as improved using global photography (12 were slightly improved, 8 were moderately improved, and 3 were greatly improved). No improvement was recorded in 13 patients. One patient experienced worsening of the condition. There was a statistically significant (P = .002) increase in the hair density score in 12 patients. No adverse reactions to the drug were reported.

Conclusions Sixty-two percent of the patients demonstrated some improvement of their hair loss with the use of finasteride, 2.5 mg/d, while taking the oral contraceptive. It is unclear whether the success was due to a higher dosage of finasteride (2.5 mg instead of 1 mg) or to its association with the oral contraceptive containing drospirenone, which has an antiandrogenic effect. Further studies are necessary to understand which patterns of female pattern hair loss respond better to this treatment.

Author Affiliations: Department of Dermatology, University of Bologna, Bologna, Italy.
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Eva Frederick June 3, 2008 at 4:52 am

According to this I might not be a candidate for surgery. I still have hair and looks normal but at the rate that is falling I figure I have 2 years of a normal appearence.
I am fighting it as much as I can taking herbal medicine and the Lasercomb.
I will not go for any other chemicals due to breast cancer history in my family.
I was considering transplants, I also have questions like
Is it posible to receive hair from a donor, I mean they transplant livers and hearts why not hairs?
Is it possible to clone your good hairs and put them on your head and keep a sort of stach of hairs? They clone sheeps compare to that hairs seem very simple.
Is gene therapy doing any work on the matter?
Hopefully someone has the information about this there must be a scientist out there trying to find the cure for this incurable desease.

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rosebud October 20, 2008 at 8:24 pm

Hello Ladies

I am new to this world and I am enjoying reading all of this wondereful information that you are putting out. I was told on Friday that the hair follicles that were located in th center back of my scalp are gone possibaly from chemical scaring. The doctor also told me that I might be a candidate for hair transplant. Is anyone else familiar with this condition

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Dr Sara January 14, 2009 at 2:44 pm

Hi All!

I am a hair transplant surgeon, one of the few female doctors out there who does this exclusively, and I have to say I respectfully disagree with “Y.” About half of my patients are females with a range of surgically treatable hair loss conditions including “burned out” alopecia areata, female pattern loss confined to the top with good donor areas, traction alopecia (from excessive braiding/weaves/tight hairstyles), scars from burns or radiation treatments, and others.

The advice in the 9 comments after the initial post is pretty accurate and strikes a more “hopeful but cautious” tone that I agree with. Sure, not everyone is a candidate for surgery, but meeting with a reputable hair transplant surgeon who has a lot of experience with females should be the first step instead of dismissing it out of hand. I’ll repeat these comments on my blog and keep this entry short. Just realize that this initial entry is an opinion based on some of the older techniques and that these attitudes are changing.

Warm Regards,
Dr. Sara
http://www.californiahairsurgeon.com

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Becky February 18, 2021 at 11:38 am

Hello Dr. Sara,

What can you tell me about the XoFlo, regenerative medicine or Exosomes treatment. My local dermatologist is performing these procedures and I am very interested in doing it. Still researching but interested in your opinion. I do have high iron levels right now, not sure why. I also have early stages of lichen planopilaris. I am 65 years old and no weary of the hair loss “depression!”

Thanks so much,
Becky

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lorraine corcoran September 27, 2009 at 1:21 pm

Hello
Im devastitated. My 21 yr old daughter sudying musical thatr has ben told she has female pattn baldness. No one has done a scalp test they have just looked at her hair. No one in either family had baldness. I travelled from Ireland to London to c her and bring her to a doctor and returned the same day with no hope! Im still nt convinced this is the problem. If we could get her a transplant we would do it – her hair at the back seem soo thick although she maintains it has become thinner. Your advise would be appreciated.

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Gloria January 6, 2010 at 11:06 am

Hi everyone,

Here’s my story with reguard to hair transplants in women. Since my teen years (I’m 47 now), I began loosing my hair– thinning on the top of my crown. Lucky for me I had very thick course hair which minimized the actual thinning process for many years. About 6 years ago, I decided to get a hair transplant from a fab surgeon in Saratoga Springs, NY eventhough I had access to surgeons in NYC. I was very happy until about a year ago when I began experiencing a lot of loss all over my head (diffuse loss), including my crown. My head of hair now is very very thin on top and the sides and back are much thinner than one year ago. I know I’m no longer a candidate for another transplant (if I were, I’d be back in a flash) and I have no idea what to do. I do NOT want to take pharmaceuticals like finasteride and I’ve ‘been there, done that’ with rogaine. Low light laser therapy looked really good until I read these posts. Am I destined to grab attention now because people can notice more easily that my scalp is showing through? I hate that feeling and become very self-conscious. On one hand, I want to go ‘au natural’ and on the other I want hair whether it be from extension, wigs or toppers. So right now I’m at a crossroads trying to figure out what to do about my androgenic alopecia. I’ve had all my biology checked, and there’s no deficiencies that would indicate my dilemna. Mine is truely hereditary, so now what?

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Sande February 7, 2021 at 9:39 pm

I just see this post and realize some time has past but wonder if you found a solution. My hair very thick in back and it is primarily front center hairline and temple areas that are affected, that have worsened in last couple years. I also in my late 60s haha some would say why bother but it really does disturb me. I have seen two doctors who feel i will benefit but i am worried about shock loss. At any rate with the restrictions now i cannot travel so wont do anything for at least 6 months.

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Jodi December 30, 2011 at 3:56 am

I am not sure if anyone could help me or give me any advise about what I have been experiencing with my hair, but any advise from someone reading this would be awesome. I have been considering a hair transplant because my hair has been thinning in my temple area. It has become basically like peach fuzz in that area, its like two ugly bald spots. The rest of my hair in the back seems to be coming in normal. It has been slowly doing this for the past ten years. My hair has been slowly thinning, but that particular area bothers me. Would I be a good candidate for a hair transplant or am I wasting my time? My hair is not doing the female pattern baldness pattern is more like just receding in the temple area and it keeps coming out and getting thinner and thinner in that area. Any advise???

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kaeha December 28, 2015 at 11:46 am

i am 12 and when i was 2 my mum spilt hot oil on my head. i was in hospital for months. Now i have a huge burn on top of my head and have no hair there, i can just cover it up. sometimes people cam see it and stare at me. i have lost all my self confidence and i get upset all the time. I heard from my mum that i could get get hair transplants but am i old enough? And im a girl.

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Kd March 13, 2018 at 6:07 am

This is in response to Kaeha’s comment/question,

When I read your comment, I knew how you some of how you feel, although I was a good bit older when I lost all the hair on top and on the sides of my head, leaving a big scar that people stared at. You see, I had a brain tumor and had my scalp cut open, my skull sawed open, so the surgeons could get to my brain to remove the tumor. When they closed it back up, they used staples inside and out. It left a scar from my right temple up through the middle of the top of my head arcing back down behind my ear. It looked like the seam on a baseball. My hair grew back to about a half inch before I had radiation. Oh I forgot to mention, my hair was long, way past my waist, and so thick and coarse I had it thinned at least once a year, before they shaved it for surgery.
Anyway, the radiation – 6 weeks , 5 days a week, was very intense. It killed the follicles on the right side and the top. All my hair fell out, not from chemo, but radiation. It came back on the left and in the back as thick as before. But the top and right side never did. That was 22 years ago. I’ve tried wigs, custom made hair pieces, hats, you name it. I’ve tried Rogaine, Biotin supplements, Saw Palmetto supplements, and non of that worked. Well I got some peach fuzz with Rogaine. But gave all that up and for about 20 years have been rocking a combover! My side part seems to get lower and lower, and I’ll probably have to go back to wigs and hats someday. But I survived. I got to see my little boy grow up and have kids. I know you’re just a little girl, but if people stare at you, try hard not to let it hurt your confidence. Don’t let them get you down. Like my surgeon tells me. God has a special purpose for you.

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Megan August 7, 2018 at 6:32 pm

Do you still go to Dr. Greco for PRP?

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