Hair Transplantation – Women

  • Best Results10-12 months+
  • Treatment RecoveryVariable
  • Procedure Time2-6 hours
  • Skin SpecialistDermatologist
  • Duration of ResultsYears+
  • AnaestheticBlocks, sedation
  • Back to Work3-7 days
  • Cost$$$-$$$$$

Hair Transplantation - Women

Over a third of women will experience significant hair loss over the age of 50. Most cases can be treated with medical management including the use of minoxidil & antiandrogen tablets. Good regrowth can be expected with microneedling & PRP. FUE hair transplantation can be considered for stable refractory cases with good donor site density. Candidate selection is important. 

FactsFacts On Hair Transplants for Women

  • PRP, microneedling & lasers can be adjunctive therapy
  • Females are more likely to have diffuse or global hair loss
  • Diffuse patterns are not great candidates for hair transplantation
  • Post transplant telogen (limited hair loss) is more common in women
  • Female pattern hair loss patients are best treated with medical therapy including minoxidil, spironolactone, cyproterone acetate & hormone modulators
  • Careful selection of suitable candidates is paramount

What is the logic behind hair transplantation?

Hair transplantation means shifting the location of your hair follicles from a more densely populated area to an area of thinning, or in some cases absolute hair loss. Transplantation just repurposes the existing hair follicles. Medical science is not at the stage of ‘growing’ new hair.

The most common area we harvest hair from is the back of the head, known as the occipital area. Gone are the days of hair plugs, as now we use follicular units. Each unit contains hair shafts (between 1 to 4), the sebaceous or oil gland, the hair muscle known as the arrector pili as well as the blood & nerves that supply the unit.

What is FUE hair transplantation?

FUE or follicular unit extraction is a minimally invasive surgical procedure that transfers hair follicles from a high-density donor area, to a poor density recipient area- typically the front of the scalp.

The majority of hair transplants in women employ this method. Strip or unshaven FUE is the most common sub-method as this enables women to keep their hair long & hide the recovery areas.

FUE involves manually harvesting one, two & three group hairs within a ‘follicular unit.’ Each unit contains terminal hairs, an oil gland (sebaceous gland), the arrector pili muscle, as well as tissue containing the neurovascular sheath. These units are then repurposed to areas of low hair density using either micro incisions or a follicular unit hair implantation device (Choi or modified Choi implanter).

Why is hair transplantation much more difficult in women than in men?

It is because hair loss in men follows certain patterns called the Norwood pattern of hair loss. This means blokes have hair loss that favors the front, temples & vertex of the scalp. Hence the donor area at the back is largely spared from the balding process.

Women on the other hand experience hair loss from many areas, known as diffuse hair loss(type 2). This is classified as the Ludwig scale of hair loss. This means that the occipital area donor site has less density to work with. The other important point is that for males, we are able to construct a high hairline that looks natural. Not a great look for women- hence the importance of hair styling to hide less dense areas.

How do I know if I am a good candidate for FUE transplantation?

Here is a checklist.

  1. Is the diagnosis certain? FUE is not indicated for conditions such as telogen effluvium, chronic TE, hair loss due to medications, nutritional deficiencies or rare inflammatory conditions. A diagnosis from a medical dermatologist is the first step.
  2. Are you on optimal medical therapy? This includes minoxidil, cyproterone acetate or off label finasteride. You do require medical therapy to maintain your hair growth.
  3. Is the pattern of hair loss conducive to hair transplantation? Only some forms of androgenic alopecia in females are amenable to FUE. Women with diffuse hair loss including Ludwig Type 2 (global thinning) are poor candidates for FUE, as are patients with predominantly single follicular units.
  4. Have you tried less invasive procedures that are cost effective? Microneedling & PRP can give good results in most cases.
  5. Are you willing to be guided by your hairdresser as to what hairstyle is best for coverage?

Davin’s Viewpoint on FUE for women

As with all sexes, prevention of follicular miniaturization is paramount. Far, far easier to halt early progression than to deal with thinning, especially globally.

Your first point of contact is a medical dermatologist. They can confirm or exclude other causes of hair loss including telogen effluvium, chronic TE, drug induced hair loss, metabolic/endocrine cases, & rare conditions such as diffuse alopecia areata, loose anagen syndrome etc. In many cases there are two concurrent hair loss conditions, the most common being telogen effluvium (or CTE) & androgenic alopecia. Treatment can be complex, & in many cases FUE hair transplantation is not the answer.

Note: I am a procedural dermatologist. For hair loss conditions that are medical please see my colleagues at Clinic Cutis.

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