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In this article, recommended hair transplant surgeon Dr. Parsa Mohebi shares his expert advice regarding stress and hair loss.

Many of my hair loss patients who come for their first consultation associate their hair loss to the beginning of a stressful event or season in their lives. Several of these individuals explain they began to notice thinning hair when they moved to a different city or country, went through a divorce, or had difficulties at work or in their personal lives. The situation always revolved around some type of emotional trauma or sudden change of life’s routine pattern. Usually, they have been right in their assessment that these types of events have the potential to accelerate hair loss.

Looking at the situation more critically, hair loss would not have occurred to these same individuals if they were not genetically predisposed to balding. For example, someone at the age of 20 or older, may have the hair loss gene which will cause male or female baldness. From the age 20 and older, if they are involved in a major surgical procedure, a traumatic event, or stressful situation, it can accelerate the hair loss process. So the loss expected to be seen in 10 years could come around much earlier.

Trauma, stress, other medical conditions, or major surgeries may cause hair loss in individuals not prone to lose hair, in the form of hair shedding.  This is due to a signal their scalp hair received to push them to the resting phase, or telogen phase.  However, the condition is merely temporary, and the missing hair will grow back after the passing of the stressful circumstance, or treatment of the medical condition.

I am a female with a high forehead which looks very masculine. It has a receding look on both sides. one side recedes more than the other. (I am not balding). I look like I have two horns on my head. I have a heart shaped face which is very small so I don’t like to just have a fringe which halves my already small face. I often tie back my hair for convenience but it looks ugly, uneven and makes my head looks like a light bulb. I can’t afford a hairline lowering procedure but I have heard of scalp tattooing, I have drawn a hairline with a thin brown texture to fill in the gaps and it makes such a difference. I can’t seem to find any photos of female hairline correction on the Internet using cosmetic tattooing techniques. I realize that they can’t lower it too much using tattooing but, since my hairline is uneven and “gappy” at least they could dampen the severity of it. Could you please advise me on this and find some examples of female hairline tattooing for a case like mine?

Quality, unbiased scalp micropigmentation photos are very rare, even for male patients. I’ve not seen any work done on females.

While I’m no expert on scalp tattooing, I don’t believe that it would be appropriate in this instance. SMP is best suited for men who wish to completely shave their heads in order to simulate a “buzz” cut or, for both men and women with thinning hair, it can also be utilized as a permanent hair loss concealer.

Although many assume hair loss and dissatisfaction with high or uneven hairlines is a male issue, many female patients suffer from these conditions as well. In fact, according to recent research, up to 20% of women may suffer from a disproportionately high or uneven hairline.

Of the various hair restoration procedures available to female hair loss sufferers, one continually met with enthusiasm is hairline lowering.

During the hairline lowering procedure, an incision is made near the anterior hairline, the hair-bearing scalp is loosened from underlying tissue and bone, the scalp is moved “forward” (lower on the forehead), the excess portion of non hair-bearing forehead skin is removed, and the new hairline is sutured into place. The result of the procedure is a lower, most proportional hairline and a smaller appearing forehead.

Although it seems like nearly all women with disproportionate hairlines would want to undergo the hairline lowering procedure, recommended hair transplant surgeon and female hair restoration expert Dr. Sheldon Kabaker recently explained why patients chose to undergo this surgical treatment:

… some of my cases just want the option of a lower hairline. It is a small minority of women whose hairlines are a bit high who care greatly enough about this to have surgery. Most hair stylists simply cut bangs for these women. Those women with very high, masculine hairlines are the majority of my hairline loweriing patients.

Is there a 2% Rogaine Foam for Women or can I use regular strength Men’s Rogaine Foam?

Unfortunately, there is currently no 2% Rogaine Foam for women. However, you may wish to try the 5% foam. 5% minoxidil is not only safe for use by women but many hair loss experts recommend it for their balding female patients as it is proven to be more effective than the 2% solution.

It is important to note that the higher dose also carries a greater risk of side effects such as increased facial hair growth and scalp irritation.

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David (TakingThePlunge) Forum Co-Moderator and Editorial Assistant for the Hair Restoration Forum and Social Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q & A Blog.

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Technorati Tags: Rogaine, minoxidil, hair loss, balding

Although most assume hair loss is a condition exclusive to men, studies indicate that women actually comprise over 40% of the balding population. In most cases, female hair loss (female alopecia) is a devastating condition, causing emotional and psychological distress in a significant population of women. Due to the stress and stigma associated with this condition, various hair restoration and dermatological experts continually seek new ways to treat female hair loss.

One of these researchers, Dr. Bahman Guyuron – a plastic surgeon at Case Western Reserve University, recently conducted a study analyzing lifestyle factors and resulting hair loss in both male and female patients. Dr. Guyuron recruited over 200 identical twins (both male and female) and surveyed each subject’s lifestyle, living habits, and stress factors.

Interestingly enough, the survey results demonstrated a difference in factors causing hair loss in male and female patients. In male study subjects suffering hair loss, Dr. Guyuron found the strongest correlation between genetic predisposition (familial hair loss) and balding. Other elements, such as smoking, excessive sun exposure, alcohol consumption, and exercise, also play a lesser role in male hair loss.

However, the most significant component of female hair loss, according to the study, is the loss of a male spouse. In other words, Dr. Guyuron found that divorced or widowed subjects were more likely to suffer from female hair loss. Additionally, when comparing identical female twin subjects, one divorced or widowed and the other single or married, the correlation between loss of male spouse and female baldness was still observed.

This question, from a member of our Hair Loss Social Community and Discussion Forums, was answered by TheHairUpThere – a consultant for Coalition hair transplant surgeons Dr. True and Dr. Dorin:

I’m a female hair loss sufferer looking to lower my hairline and I’m wondering which method, follicular unit transplantation (FUT) or follicular unit extraction (FUE) would be better for the procedure? What are the pros and cons of both methods?

You can do either procedure, both will grow the same way, but FUE does have a smaller yield about 10-20% but that number can be lower if you have good quality skin and grafts.

The FUE scars are very small white dots, and you won’t notice them unless you plan on shaving your head, which I’ll assume you don’t. The scar from the FUT is a thin linear scar that can go from ear to ear, but again you will not notice this scar unless you shave your head, most men can get away with shaving to a level #3 on a razor with it being undetectable.

FUE and FUT are both very natural looking as the transplanting process is exactly the same it is only the extraction part that is different. Most people choose FUT over FUE because of the cost difference, but women have to think about the extraction process because with FUE you have to shave the donor area, and for large treatments you will have to shave the entire back of the head from ear to ear so most women tend to shy away from FUE for those reasons.

This question comes from a member of our Hair Loss Social Community and Discussion Forums:

I’m in my twenties and recently noticed my hair started thinning. After doing some personal research, it seems like Propecia (finasteride) is a proven hair restoration medication used frequently by hair loss sufferers. However, I’m wondering if female patients can use Propecia (finasteride) to fight hair loss?

Propecia (finasteride) is NOT for female use.

I think you should make an appointment with a hair restoration expert and see what they recommend for your female hair loss. There are some good female hair restoration products available, such as Rogaine for Women, but because it may present unknown carcinogenic risks in females and is damaging to fetuses in pregnant women, Propecia should not be utilized by female patients.

Here is Merck Pharmaceutical’s official statement:

PROPECIA is for the treatment of male pattern hair loss in  MEN ONLY and  should NOT be used by women or children.

Women who are or may potentially be pregnant must not use PROPECIA and should not handle crushed or broken PROPECIA tablets because the active ingredient may cause abnormalities of a male baby’s sex organs. If a woman who is pregnant comes into contact with the active ingredient in PROPECIA, a doctor should be consulted.  PROPECIA tablets are coated and will prevent contact with the active ingredient during normal handling, provided that the tablets are not broken or crushed.
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Blake – aka Future_HT_Doc

A new study, published in the Archives of Dermatology, suggests that certain hair styles may cause a specific type of hair loss in African-American women.

Along it’s been associated with female hair loss in African-American females for quite some time, central centrifugal cicatricial alopecia, or “scarring hair loss” – a condition where excess hair pulling results in follicular inflammation, scarring, and eventual loss, was thought to occur from using hot-comb straightener and, until now, was never fully investigated.

However, Cleveland Clinic Dermatologist Dr. Angela Kyei recently decided to take a deeper look at scarring hair loss and determine whether or not a correlation existed between certain hair styles (namely tight braiding and hair weaves) and central centrifugal cicatricial alopecia in African-American females.

The study investigated over 326 women and found 28% suffering from some type of hair loss; 60% of that 28% suffering from serious balding, and discovered that more than half of these 60% of women had either tight hair braids, hair extensions, or hair weaves. According to Dr. Kyei, this study does not prove that these hair styles directly cause scarring hair loss, but does demonstrate an interesting correlation and requires further research.

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Blake – aka Future_HT_Doc

Editorial Assistant and Forum Co-Moderator for the Hair Transplant Network, the Hair Loss Learning Center, the Hair Loss Q&A Blog, and the Hair Restoration Forum

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Many people who think of “hair loss” typically conjure an image of the dreaded “horseshoe” pattern of genetic balding that many men develop. However, while balding is typically seen as a male affliction, it also affects an estimated 30 million women in the United States alone and may also be caused by a variety of non-genetic factors.

There are many types of hair loss; the most common of which in both men and women is androgenic alopecia.  This progressive balding condition is a result of genetics and the hormone DHT (dihydrotestosterone) which binds with the receptor sites of vulnerable hair follicles causing them to miniaturize and fall out over time. Currently, the most effective medical hair loss treatment for men with genetic balding is a combination of Propecia (finasteride) and Rogaine (minoxidil). Propecia has been shown to slow the conversion of testosterone to DHT and can be helpful in slowing, stopping or in some cases, reversing hair loss when it is used early enough. The mechanisms behind Rogaine’s effect on hair loss are not fully understood but it is thought to increase blood supply to the hair follicles through dilation of the blood vessels. It is important to note that Propecia is not approved for use by females and should not be taken or even handled by women of child-bearing age.   For those who can’t or don’t want to use Propecia, there are credible alternative treatments for hair loss worth exploring.   You are encouraged to visit our online discounted hair loss product shop for a list of products we recommend.

Trichotillomania, or obsessive “hair pulling,” is a a compulsive disorder which, according to some hair loss experts, may affect up to 3.4% of females at some point in life. Because this condition is serious and should not go undiagnosed or untreated, recommended hair transplant surgeon Dr. Parsa Mohebi decided to share his expert opinion on Trichotillomania:

Compulsive hair pulling or Trichotillomania, is a type of hair loss which results  from the  obsessive pulling, plucking or twisting of the hair until it comes out. The reason behind this compulsive behavior is not exactly clear.   Trichotillomania is four times more likely to affect women than men. This condition affects about 1.5% of men or 3.4% of women (o.6% incidence in a lifetime) and in some cases has been linked to stress and/or anxiety.

Trichotillomania usually appears before the age of seventeen and may not be noticed by the sufferer until they are seen by a dermatologist or hair transplant surgeon. It can affect anywhere that hair grows, including eyebrows, eyelashes, body hair and last but not least, the scalp. Circular bald patches  are seen in the affected areas and are characteristically uneven and incomplete, and in some cases lesions can be found from scratching of the skin.

Trichotillomania is a clinical diagnosis and usually lab work is not required to confirm its diagnosis. On occasion a skin biopsy may be requested to rule out other possible causes of patchy hair loss such as; fungal infection, Alopecia areata, or Cicatricial alopecia.