• Hair transplants in women
• Hair transplants in women references

Hair transplants in women

Through this web site I get asked by women quite regularly whether it is possible for them to get a hair transplant. The answer is yes within certain limits. Advertising from hair transplant clinics is almost exclusively pitched at men. This is probably because androgenetic alopecia is much more common in men than women. Despite the lack of advertising directly to women, under some circumstances women can be suitable for a hair transplant.

In general, for a woman to be a candidate for a hair transplant, the type of hair loss needs to be one or more of; androgenetic alopecia, scarring alopecia (only after it has “burnt out”), traction alopecia, alopecia due to cosmetic surgery gone wrong, trauma from an accident, or a need to cosmetically correct an issue such as a lack of eyebrow hair growth. In these forms of alopecia the hair loss is more or less permanent, but the hair loss is not expected to expand beyond a defined area of skin that the surgeon can actually see or predict as with progressive androgenetic alopecia. These forms of alopecia can be treated by removing the affected area and/or by transplanting the affected area. In short, the same types of alopecia treated using hair transplants in men can also be treated in the approximately the same way in women. Similarly as for men, the same limitations of suitability for hair transplantation apply to women. The primary limiting issue is whether the female candidate for a hair transplant has a good donor area from which to take the hair follicles. Read the other pages of this web site section for more details – most of the pages apply equally to both men and women who are considering a hair transplant. However there are perhaps a few issues specific to women that need a brief statement.

For most women affected by androgenetic alopecia, a mild diffuse hair loss develops. While the extent of the hair loss can be quite limited, the expectations of our modern society are for women to have nothing less than a full head of hair. This is an impossible ideal for many women to obtain given that around 50% of the female population will be affected by some form of hair loss during their lives with up to 40% of that figure accounted for by androgenetic alopecia. Yet the expectation of full head of hair in women prevails. The psychosocial impact of hair loss for women is significant and proven in a number of studies (Cash, 1999; Cash, 1993). Ideally the attitudes of society would change to admit the reality that hair loss affects the majority of the population. However, this seems unlikely anytime soon and for a woman with androgenetic alopecia the quickest method to relieve the pressure of society and its views on body image is a hair transplant.

The extreme body images values that our society holds for women and their scalp hair can create a significant problem for the hair transplant surgeon. Many women seeking a hair transplant are expecting to regain nothing less than a normal scalp hair density, but in many instances, this is not possible. Hair transplants just redistribute the hair follicles you already have, transplantation does not create new hair follicles. So while hair density can be improved on the top of the scalp, how close you get to a normal scalp hair density depends on the extent of the alopecia and the donor hair area. A large area of alopecia to be covered, or a limited hair follicle donor area, will mean that a normal scalp hair density is not possible. Because many women enter the hair transplant clinic with such high expectations, a surgeon may spend a significant amount of time counselling, reassuring, and explaining the limitations of hair transplantation to a prospective female patient.

Women with the classic androgenetic alopecia presentation with diffuse hair loss may find they are not suitable candidates for hair transplantation. While the diffuse hair loss of androgenetic alopecia is most often primarily on the top of the scalp, it can be quite extensive for some such that the back of the scalp, the donor area, is also partially affected. The smaller the donor area at the back of the scalp, the fewer hair follicles available for transplantation to the top and front of the scalp. This is also an issue for some men, but it is a more common problem in women with a diffuse hair loss presentation. When the donor area is limited, a hair transplant can be conducted if there is some compromise on the anticipated result. For example, transplanted hair follicles can be concentrated towards the front of the scalp and the hair grown long to be brushed over the thinner vertex. Whilst there are limits to what a hair transplant can do, a transplant can yield a natural result with a density that is cosmetically acceptable.

Women do have some advantages over men when it comes to hair transplantation. As androgenetic alopecia is usually a diffuse hair loss, it is relatively easy to fill in over the scalp with transplanted hair follicles to give a nice even density of very natural looking hair – because it is partially natural hair! Most women with androgenetic alopecia maintain their hair line (although a few do have hair line recession). This is a significant advantage compared to men who generally have a hair line recession with androgenetic alopecia development. The hair line is the most visible and most noticeable part of the scalp hair. It is also the most difficult part to reconstruct with a hair transplant. Some expertise is required on the part of the surgeon to get a hair line to look natural. It is much easier to transplant follicles behind a hair line to fill in and increase density than it is to create the hair line from scratch.

Hair transplants in women references

• Epstein JS. The treatment of female pattern hair loss and other applications of surgical hair restoration in women. Facial Plast Surg Clin North Am. 2004 May;12(2):241-7. PMID: 15135134
• Unger WP, Unger RH. Hair transplanting: an important but often forgotten treatment for female pattern hair loss. J Am Acad Dermatol. 2003 Nov;49(5):853-60. PMID: 14576664
• Epstein JS. Hair transplantation in women: treating female pattern baldness and repairing distortion and scarring from prior cosmetic surgery. Arch Facial Plast Surg. 2003 Jan-Feb;5(1):121-6. PMID: 12533155
• Chartier MB, Hoss DM, Grant-Kels JM. Approach to the adult female patient with diffuse nonscarring alopecia. J Am Acad Dermatol. 2002 Dec;47(6):809-18; quiz 818-20. PMID: 12451364
• Cash TF. The psychosocial consequences of androgenetic alopecia: a review of the research literature. Br J Dermatol. 1999 Sep;141(3):398-405. PMID: 10583042
• Avram MR. Hair transplantation in women. Semin Cutan Med Surg. 1999 Jun;18(2):172-6. PMID: 10385285
• Halsner UE, Lucas MW. New aspects in hair transplantation for females. Dermatol Surg. 1995 Jul;21(7):605-10. PMID: 7606371
• Cash TF, Price VH, Savin RC. Psychological effects of androgenetic alopecia on women: comparisons with balding men and with female control subjects. J Am Acad Dermatol. 1993 Oct;29(4):568-75. PMID: 8408792
• Cotterill PC, Unger WP. Hair transplantation in females. J Dermatol Surg Oncol. 1992 Jun;18(6):477-81. PMID: 1592999
• Unger WP. Hair transplantation in females. In: Hair transplantation, 2nd Ed. Unger WP, Nordstrom REA (Eds). Marcel Dekker, New York, 1988, 295-300.