Female Hair Transplants: All You Need To Know

Many women experience hair loss and wonder if a hair transplant could be a solution for them. While there are some similarities between male hair loss and female hair loss, there are some vital differences. These differences mean that although male pattern baldness accounts for over 95% of hair loss in males making a hair transplant a viable option for the majority, only 2 to 5% of females with hair loss are suitable candidates for a hair transplant.

How is male hair loss different than female hair loss?

Both men and women can have androgenetic (androgenic) alopecia, a genetic predisposition for hair loss, often called “male pattern baldness” or “female pattern baldness.” This type of hair loss in both males and females is mostly due to a combination of genetics, age, and hormones. However, females produce a few additional hormones and enzymes that make it more difficult to diagnose the exact cause of the hair loss and leads to the hair loss presenting differently.

Male pattern baldness presents clinically, meaning a specialist can usually tell by looking and asking a few questions about a male’s family and medical history to determine if androgenic alopecia is the cause of the hair loss.

For most men, the hairs usually thin and fall out from the front and top of the head, including a receding hairline, but the hair on the back and sides will remain stable and of a similar density. The degree can vary (as demonstrated in the Norwood scale - a visual representation showing the typical stages and extent of baldness in men) but this is the usual “pattern” that is seen in male pattern baldness. That is because the hair follicles on the back and sides are resistant to the DHT hormone which is thought to cause hair loss (the exact reason why is still unknown).

This mechanism is important because this is what makes hair transplants in males more successful. When these DHT-resistant follicles are moved from the back and sides of the head, or the “donor” area, to the affected areas on the top and front during a hair transplant, they keep that resistance to DHT and the hair will not fall out of this transplanted follicle. However, when most females start to lose hair, it tends to be diffuse, meaning the hair thins all over the head and not just on the top of the scalp. When a woman has diffuse hair loss, often there is not enough hair left in the back of the head to transplant to the front without leaving the hair in back with much less density. Her “donor” area is not “strong” enough. Also, the diffuse hair loss could indicate that the hair in the back of her head is not resistant to DHT so it would only fall out again if a hair transplant is done.

What types of hair loss do females usually have?

Although it is less common, women can also have hereditary, patterned hair loss similar to male pattern baldness where the hair loss is localised at the front and top of the scalp with little or no thinning of the hair at the back and sides of the head. Women with patterned hair loss will also usually will keep more of the front hairline with the thinning happening behind it or in sections along the hairline, whereas most males’ front hairlines will continue to recede. Having this type of hair loss can make you a good candidate for hair transplant surgery if the hair on the back and sides is stable since you typically retain enough hair in your donor area to transplant. The Ludwig Classification breaks down the stages of this type of hair loss in females:

Hair loss scales

Even though most female hair loss is hereditary, in a majority of women it presents as thinning hair all over the scalp rather than the tell-tale pattern than many males will have. Also, females’ hair can be susceptible to underlying, systemic health conditions and hair loss often shows up as a symptom or side effect of one of these conditions. For both of these reasons, it’s difficult to determine if hair loss is androgenic by simply looking at the hair so further diagnostic tests are often advised.

The causes for hair loss in females are varied and many. The types of hair loss can be broken down into diffuse, patterned and localised. Under localised hair loss, there are further designations of scarring and non-scarring. Just some of the conditions and factors that can cause hair loss include:

Diffuse hair loss

  • autoimmune diseases - i.e. lupus
  • thyroid disease and medications
  • hormone imbalances or disorders - i.e. polycystic ovary syndrome
  • certain medications - i.e. birth control pill, seizure medication, mood-altering drugs, etc.
  • nutritional deficiencies - i.e. crash diets, bulimia, vitamin deficiencies
  • gynecologic conditions - i.e. pregnancy, postpartum period, post-menopause
  • stress - i.e. from surgery, general anaesthesia, severe emotional trauma
  • chemotherapy or radiotherapy

Localised hair loss
Non-scarring

  • alopecia areata – autoimmune condition resulting in bald patches
  • traction alopecia – hair loss at front and temples from continuous pulling on hair though hair systems or hairstyles like braids
  • trichotillomania – compulsive disorder characterized by pulling out one’s hair

Scarring alopecia

  • dermatologic and inflammatory conditions – i.e. tinea capitis, pseudopalade, lichen planopilaris, discoid lupus erythematosus
  • accidents
  • injuries
  • burns (fire or chemical)
  • cosmetic surgeries such as face or brow lift surgery (around incisions)

In the case of many medications, the diffuse hair loss or shedding that occurs can be confused with genetic balding if not properly diagnosed. However, once the medication is stopped, the shedding will most likely discontinue. The same is true for chemotherapy or radiotherapy, although the hair may not be as thick as it previously was. Some women who have taken medication or gone through either of these therapies could be suitable for a hair transplant depending from where the hair has been lost and if they’ve maintained a strong donor area.

Some of the above conditions come with other symptoms (for example, with hormone or gynecological issues, you may also experience increased body hair, irregular periods, cystic acne, appearance of secondary male characteristics like a deepened voice, breast secretions when not pregnant, or infertility) which can give a good indication that the hair loss is not androgenic and a hair transplant would not be successful. Be sure to tell the specialist if you’ve also had any of these symptoms

Why is it necessary to have a blood test if I go abroad for a hair transplant?

When you visit a hair loss specialist, they will perform a variety of tests to confirm what is the likely cause of your hair loss. Because female hair loss can have a myriad of causes and is difficult to assess by sight alone, a specialist can also do a microscopic hair evaluation (if most of your hair is “miniaturized,” then you are most likely not suitable for a hair transplant), a pluck or pull test, scalp biopsy or blood test.

When you contact Qunomedical about having a hair transplant, pictures will be requested of your head and hair to do an initial evaluation about the suitability of a hair transplant for you. If you have already spoken to a doctor and a hair transplant has been suggested, one of our Health Managers can immediately contact one of our partner clinics, depending on where you wish to go, for your treatment plan and price quote.

If you have not previously spoken to a doctor about your hair loss and confirmed that it is hereditary or due to another condition that would respond well to a hair transplant, then most clinics will also request a blood test to ensure that a hair transplant would be a viable option for you before you travel abroad.

You will be provided with a list of the necessary tests that you can take it to the GP or laboratory where your blood tests are performed.

The tests will typically check for (with test names):

1. Hormone or “androgen” levels

  • testosterone
  • free testosterone
  • estrogen
  • progesterone
  • andostrenidol
  • estradiol
  • prolactin
  • FSH
  • LH
  • DHEA - SO4

2. Anemia

  • iron
  • Fe/Febk
  • TIBC
  • ferritin

3. Thyroid conditions

  • TSH
  • T3 (FT3)
  • T4 (FT4)
  • anti-TPO
  • anti-TG
  • TRAK (anti TSH-R)

4. Other medical conditions or vitamin deficiencies

  • morphology
  • CBC (complete blood count)
  • OB (inflammation)
  • CRP (c-reactive protein) (inflammation)
  • ANA (Lupus or other autoimmune conditions)
  • D3-25
  • B12
  • cortisol
  • sugar levels
  • zinc
  • magnesium
  • folic acid

What kind of female hair loss would benefit from a hair transplant?

A hair transplant is only possible if an individual has a reasonable amount and density of stable hair (resistant to DHT) on the back and sides of their head to be transplanted to the affected balding areas at the top and front hairline.

So, while the following types of hair loss generally respond well to a hair transplant, it’s best to have a dermatological consultation to confirm that it’s an option for you:

  • Females with female pattern baldness: thinning hair on the top and crown of the head with little or no thinning of the hair in the back and sides of the head
  • Females with mechanical or traction alopecia or alopecia marginalis. Hair loss appears at the front hairline, temples and sometimes the sides of the head from the continuous use of hairstyles that pull the hair tightly, i.e. tight ponytails, braids (cornrows and weaves), tight buns, or hair systems
  • Females who have had cosmetic surgery such as facelifts and brow lifts and wish to conceal visible incision scars
  • Females with hair loss due to trauma such as burns (fire or chemical), accidents, or other injuries
  • Females with naturally high hairlines who wish to lower the hairline by a few centimeters
  • Transgender individuals transitioning from male to female and wish to create a more feminine hairline to frame their face

Once it’s decided that a hair transplant could be right for you, the specialist will discuss whether an FUE or FUT hair transplant is best.

Are there other treatments available besides a hair transplant?

Diffuse hair loss often responds better to medical interventions when a hair transplant is not an option. Some suggested treatments include:

  • Topical solutions like Minoxidil (often sold under the brand names Regaine or Rogaine), which have been shown to help slow down hair loss in females.
  • Platelet Rich Plasma (PRP), which utilises the blood’s own plasma for its richness of platelet growth factors. When re-injected into the body, the PRP can aid in wound healing and is also thought to promote hair growth, although more scientific research needs to be conducted.
  • Laser Therapy uses low-level laser light to reduce hair loss and help stimulate hair growth but again evidence is more anecdotal and further scientific research is needed.
  • Scalp micropigmentation (SMP) is a cosmetic tattoo that mimics closely shaven hair and can be used to fill in thinning areas to give the appearance of more volume.
  • Cosmetics such as hair colouring, which can reduce the contrast between the skin and hair colour, as well as hair fibers are also options for giving the appearance of fuller hair.

Before spending time and money on a hair transplant, it's important to first figure out the underlying cause of your hair loss through a thorough consultation to determine if it could be successful and give you the look you want. At Qunomedical, we can help you with your journey to finding the best treatment for you!

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About the author

Coree Howard, Content Writer

Coree has worked in international development, travel, and trained as a Health Coach. First as a Health Manager and now a content writer, her time on the front lines working with patients helped her understand their needs and what information they want when looking for the best healthcare options.

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