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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

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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.

Despite the best efforts of patient-driven hair loss communities such as the Hair RestorationForum and Social Network, misinformation, myths, and outright lies about the causes of and treatments for hair loss abound on the Internet. Some of these fabrications are, in fact, elaborate ploys to market and peddle ineffective hair loss cures to unwary balding men and women. To set the record straight regarding the cause of androgenic alopecia, let’s bust some more popular hair loss myths:

• Wearing a hat causes hair loss: Hats, especially the venerable baseball cap, have been scorned by balding men and women for ages as the root of the hair loss problem.   But have no fear; there’s no need to forgo the chapeau! Wearing a hat will not cause nor will it exacerbate thinning hair.

• Brushing with a boar bristle brush stimulates hair regrowth: Many hair loss myths surround the act of brushing hair. Hair brushing is both heralded as a hair growth stimulant and derided as a hair loss accelerator. But, many believe in the magical hair growth powers of boar bristles. In truth, boar bristle brushes do help spread sebum across the length of the hair shaft. This helps to naturally moisturize, protect and add shine to the hair. They may also stimulate blood flow and speed hair growth to some degree but for the 2/3 of men and women experiencing genetic hair loss, brushing with one of these will simply not regrow hair.   Conversely, brushing your hair will not cause it to fall out either.

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

I’m a female hair loss sufferer looking for effective options to fight my thinning hair. It seems like many of today’s hair restoration treatments are aimed towards males, and I want to make sure I’m using safe and effective therapies. How can I fight my female hair loss?

Although a majority of individuals suffering from hair loss are male, it’s important to understand that the problem is not restricted to men alone. Not only do females experience hair loss, but female thinning is a unique issue and needs to be treated differently than male hair loss. Fortunately, current hair restoration therapies, namely surgical hair transplantation and preventive medications, can be altered and applied to female patients.

For example, preventive medications, such as minoxidil/Rogaine, are available to female hair loss sufferers. Because most female hair loss is manifested as widespread miniaturization and not patterned baldness, a specialized type of minoxidil is designed especially for women. Additionally, it’s important to remember that finasteride/Propecia should not be utilized by women.

Hair transplant surgery is also a restorative option available to female hair loss patients. Like preventive measures, the method of transplantation is slightly altered in women, with follicular unit transplantation (FUT) usually being performed over follicular unit extraction (FUE) and hairlines normally created “lower” and “flatter” around the face.

Many people think of balding as strictly a male affliction. However, the estimated 30 million balding women in the United States comprise roughly 40% of American hair loss sufferers. This female segment of the balding population is increasingly seeking answers and treatments for the multitude of conditions leading to female hair loss.

The main culprit behind female balding is genetics. In fact, 96% of all female balding is due to androgenetic alopecia. Unlike male pattern baldness which can manifest itself in any number of patterns, female pattern baldness is often diffuse in nature (occurring over the entire area of the scalp) as represented by the Ludwig Scale.

Aside from genetic balding, non-genetic factors such as pregnancy, crash dieting, traumatic stress, low iron levels, medical conditions, etc. can lead to a condition known as telogen effluvium. This condition includes the rapid shedding of healthy hair when the body senses that it needs to divert its energies elsewhere.   Telogen effluvium is often reversible after successfully treating the stressor causing the condition. However, just as it typically takes three to four months for the hair to shed, it may take three to four months for the hair to regrow after successful treatment.

Other factors influencing female hair loss are menopause, medications such as birth control pills, trauma and illness. Trauma may arise from burns, scarring or traction alopecia. This condition arises when damage is done to the hair follicle by continual pulling and tight tension for very long periods and is common among women who wear tightly braided hairstyles or weaves. In fact, photographs recently emerged on the Internet indicating that supermodel Naomi Campbell may be a victim of traction alopecia. There is no medical treatment for this condition. However, if diagnosed early, traction alopecia is reversible.

Recently, the Publishers of the Hair Transplant Network  attended the 2010 18th annual ISHRS scientific meeting held in Boston from October 20 th through the 24th.

Each year hair restoration physician from around the world gather for several days to attend lectures, meetings, workshops and discussions focused on hair loss treatments. It’s practically impossible to cover all of the important topics discussed at the meeting. Thus, this report will feature the highlights that may be of most interest to hair loss sufferers and those wanting to restore their hair. A few of these topics have been discussed and debated by patients for years online using our hair loss forum, while other topics provide information on innovative techniques and treatments that may potentially revolutionize the hair restoration profession in the future. However, despite some exciting anecdotal evidence provided in various presentations, it’s important to remain cautiously optimistic while much needed research continues and investigation is underway. Some of these topics include the benefits, limitations, and refinements in follicular unit extraction (FUE), its tools and techniques; treating and minimizing the risks of scar stretching via follicular unit hair transplantation (FUT); Platelet Rich Plasma (PRP)  as a storage solution for grafts; Bioengineering of the hair follicle (hair multiplication) including exciting preliminary findings using the highly talked about formula ACell; the advantages and disadvantages of dense packing; studies on the causes and treatments for female hair loss and more.

The attention to detail at these meetings is highly impressive and hair transplant surgeons who regularly attend deserve to be commended for their dedication to continuing education.