Understanding Hair and Women's Hair Loss

Treatments for Female Pattern Hair Loss

Despite the claims of many over the counter products, and extensive research into the causes and treatment of hair loss, it is important that one hold realistic expectations. In my practice, once I rule out all treatable causes of hair loss and make the diagnosis of female pattern hair loss, I follow an algorhythm of treatment. Please note that this pathway applies only to female pattern hair loss, for in cases where the hair loss is due to any other number of causes (trauma, prior surgery, trichotillomania) I am likely to proceed right to transplantation, while with some other causes where I would expect a regrowth of most or all of the hair (post-pregnancy, crash diet related) observation and perhaps vitamins would be recommended.

First step: Minoxidil 2% applied twice, or at least once a day, to the areas of thinning. Vitamins and certain shampoos (Click here to see list). Assess response to this conservative treatment after 4 to 6 months

Second step: Obtain endocrinologist referral to assess for treatable hormonal abnormalities or imbalances. Sometimes this means switching or starting birth control pills or hormonal therapy. In general, I am not a fan of most antiandrogen (antitestosterone) treatments such as spironolactone or cimetidine as I have yet to see a patient who has demonstrated even a partial response to such treatment.

Third step: For nearly all women, the gold standard for treatment is hair transplantation. This is the only intervention that truly is capable of improving the density to areas experiencing hair loss. The success of this treatment is most dependent upon:

• Surgical technique- where the emphasis is on efficiently using the limited supply of donor hair while minimizing the damage to already existing hairs, both accomplished through microscopic dissection and planting techniques
• Patient expectations- the importance of establishing realistic expectations cannot be underemphasized. In addition to showing prospective patients numerous before and after photos, my office facilitates the speaking to some of my prior patients
• The type of hair loss pattern- in general, better results can be obtained when the hair loss is due to the actual loss of hairs (with spaces between existing hairs) than when the hair loss is due to thinning of the hairs in the area
• The donor density- where there is a higher concentration or density of hairs, or hairs that are actually individually thicker, in the back and/or sides of the scalp (donor area), the improvement in density will be greater.

To learn more about the different surgical treatments, please CLICK HERE.