For many women, femininity is tied to our hair even before we begin to retain memories: the bows tied around our infant heads, the cartoons we watch featuring characters with waist-length hair, and the decorative clips placed carefully into our braids. As we get older, our hair continues to be a symbol of womanhood and even overall health. We spend thousands of dollars giving it haircuts, highlights, at-home treatments, etc. So, when the first signs of hair loss appear, the feeling can be daunting for many. For many women, losing hair isn't just an aesthetic concern—it can feel like losing part of our identities.
Female hair loss is way more common than you might think. A 2023 study found that more than half of women will experience hair thinning in their lifetime, and another study found that 32 percent of women will experience female-pattern hair loss. In the United States alone, there are currently 21 million women experiencing hair loss—just slightly less than the entire population in Florida. Despite these crushing numbers, most treatments to reverse hair loss are overwhelmingly marketed to men. As such, the taboo and shame surrounding female hair loss can feel heavier and lonelier when it happens to us.
While genetics is the biggest culprit of female hair loss, board-certified dermatologist Doris Day, M.D., adds that hormonal changes—such as PCOS, menopause, and pregnancy—are also common triggers for hair loss. These transitions can cause damage to the hair follicles, disrupt their life cycle, and/or prevent the necessary nutrients and oxygen levels from reaching the follicle.
Apart from that, your metabolism, nutrition, age, lifestyle, and stress levels could lead to exacerbated hair loss and thinning. In fact, one of the most significant contributors to hair loss is stress. A 2021 study found that increased cortisol levels (aka the stress hormone) cause hair to enter the phase telogen for extended periods, preventing new hair from forming. Certain medical conditions and their treatments, such as chemotherapy, are also known to cause hair loss. Consistently wearing tight hairstyles like braids, buns, and weaves can also lead to traction alopecia. While not nearly as dramatic, Kseniya Popova, the executive director of R&D and innovation at The Rootist, says the products you use on your scalp and exposing your scalp to excessive heat can also lead to damage that causes hair loss.
In most cases, hair loss reverses within a few months, but in more severe instances, women are unable to grow it back naturally. One study found that even a small amount of hair loss can impact someone's self-esteem and feelings of self-worth, and another found that many people even limit their social lives to avoid confronting feelings of embarrassment or shame. To reclaim their strands and the confidence that comes with it, sometimes their best option is to get a hair transplant.
Getting a female hair transplant can feel daunting, but this is likely because of the lack of conversation and education surrounding them. (For context, surgical procedures such as rhinoplasties and breast augmentations, involve general anesthesia but may feel more approachable because we've grown accustomed to talking about them in the cultural zeitgeist.) So, we're here to clarify the many questions surrounding this procedure and help you understand whether or not you may be a candidate. We'll start from the top:
What is a hair transplant?
A hair transplant is a minimally invasive surgical procedure that takes hair follicles from one area of your head and are placed to the balding/thinning areas. The donor area typically comes from the back part of the head as it usually has more hair density and can cover any extraction scars naturally. Hair transplant procedures are performed under local anesthesia—meaning you're awake the whole time—and can take several hours depending on how many follicles are harvested (taken from the donor site) and grafted (implanted).
Hair transplants can provide a more permanent solution to hair loss by redistributing hair follicles to thinning areas, and while this solution has mainly been marketed to men, Zafer Çetinkaya, MD, a surgeon at Este Nove, a leading hair transplant clinic in Istanbul, assures that women can reap the benefits of it as well.
For women, hair transplants typically tackle the widow's peak area and the top of the head. Mehmet Ziroğlu, MD, another surgeon at Este Nove, explains that the first step for this treatment involves a thorough consultation in which your doctor will review your medical history, discuss your hair goals, and design a natural-looking hairline according to your facial proportions. For the best results, he recommends patients bring "before" photos of themselves to try and mimic what they originally had.
On the day of your surgery, Dr. Çetinkaya explains your doctor will give you local anesthesia to numb the treatment area, which both doctors agree is the most uncomfortable part of the treatment. Your doctor will shave a small rectangular section of your hair off that's less than an inch above the nape of your neck—aka the donor area—and will extract hair follicles individually from there.
Patients are placed under local anesthesia, laying on their stomachs while their surgeon extracts hair grafts from the donor area. Then, they will be asked to turn around and lay on their back while their surgeon implants the hair grafts into the desired treatment area. The total time of surgery depends on how many implants they receive, but it lasts a few hours.
What are the most popular hair transplant methods for women?
Not all hair transplants are the same. FUE (follicular unit extraction) is a popular choice for men, but experts say that it may not be the best approach for women.
Craig Ziereng, DO, a California-based hair transplant surgeon, says he prefers FUT (follicular unit transplantation) since FUE "requires that the entire back and sides of the head be shaved short for the donor harvest, so it is typically not suggested for women as it thins out the hair in the back and sides of the head." With FUT, only a thin strip—"usually about 1 to 1.5 centimeters wide and 15 to 30 centimeters long"—of the designated donor zone is shaved. Once the donor tissue strip is excised, the wound is closed and then covered by the hair above, which has been left long. From there, he says the donor strip of tissue is slivered and dissected into the naturally occurring follicular units of one to four hairs. "Next, the hair transplant surgeon creates tiny recipient sites according to the agreed hair transplant design," Dr. Ziereng concludes.
For women, Dr. Çetinkaya says they typically use the DHI (direct hair implantation) method where individual follicular units are extracted directly from the donor area using a specialized handheld tool called a Choi implementer pen, without the need for a strip of skin. He prefers this because it "allows for hyper-precision and minimal scaring." Furthermore, it tends to have a higher success rate as the finesse of this technique reduces the amount of trauma to the follicles.
How should women with textured hair know before getting a hair transplant?
While some say that there is no real difference to consider for different hair textures seeking transplants, others say that there are things to consider. On one side, Dr. Ziering says having afro-textured or curly hair is an advantage since "the natural coarseness and curl of the hair [means] these patients often achieve visible results with fewer hair grafts, meaning a smaller-size surgery may deliver the desired result." However, scarring can be more visible for people with afro-textured hair as they tend to have more melanated skin. So, in the same way that you would seek a hairstylist who has experience with your hair, Dr. Ziering encourages you to do the same with your transplant surgeon.
Hair transplant aftercare
As with any surgical procedure, proper aftercare is essential to healing and ensuring the best results. For hair transplants, most of the focus is on minimizing discomfort, reducing swelling, and avoiding follicle friction. As such, your surgeon will provide you with antibiotics, pain medication, and a list of dos and don'ts to follow.
For swelling, doctors recommend good ole' ice packs. While icy headbands are often seen sported by men post-surgery, it's typically only used for women who treat their Widow's Peak since it's at the front of your hairline. Your surgeon will also recommend you sleep on an angled pillow to reduce swelling overnight and to keep from moving around in your sleep, which Dr. Ziroğlu explains could lead to friction and, therefore, the weakening (and consequential fallout) of your fresh grafts.
To avoid irritating the sensitive incision points, he also recommends using baby shampoo as they're paraben, sulfate, and fragrance-free. Obviously, your scalp is delicate, so he recommends gently tapping the shampoo into the scalp—no harsh scrubbing or side-to-side motions—and rinsing it off. The first two weeks are the most important for retaining your new grafts, so avoiding hairstyling products, wearing hats, using hairdryers, or styling your hair in any way that would create tension on the scalp is also recommended.
It's important to note that many grafts will fall out, and that's to be expected and isn't cause for alarm. "The transplanted hairs will fall out around the two-week post-op mark and then slowly begin regrowing and following the natural hair growth cycle," shares Dr. Ziering. "For most women, the mature result can be expected between 12 to 18 months post-surgery."
Potential side-effects
It's always important to thoroughly vet your surgeons before going into the type of treatment to ensure you're getting the best care and that it is in the hands of a specialist. In this case, choosing a licensed doctor specializing in hair transplants is vital. (After all, surgeries are no joke, and you want to make sure you go to someone who won't leave you with scars.)
Once you've found a doctor you trust and whose work you like, Dr. Çetinkaya says that the most common side effect is post-surgical swelling—as mentioned above—which can last up to two weeks. Your doctors should provide you with a special pillow to keep your head in place while you sleep at a 45-degree angle during this time, as well as antibiotics and medication for any added discomfort, such as itching.
How long do results last?
The only hair loss treatment that renders permanent results are hair transplants, but you still need to maintain a healthy lifestyle to keep your new hair strong and in place. Dr. Ziroğlu explains that new hair will act like regular hair, so factors like the type of water a person showers with, their diet, and their psychological state can impact longevity.
What hair loss treatments should you try before getting a transplant?
Depending on where you're at in your hair loss journey, there are different approaches you can take. First, though, it's important to understand the life cycle of hair and at what point it stops. It has four phases: anagen, catagen, telogen, and exogen. Anagen refers to the growth phase, and roughly 85 percent of our hair is at this stage at any given time. Catagen refers to the period when a hair follicle loses its blood supply. Telogen is the resting phase where hair begins to shed, and exogen is the active shedding phase. Then it all circles back and repeats itself.
People experiencing early-stage hair loss, aka thinning, can begin treatment with topicals and supplements. "At this stage, women should consider lifestyle changes, dietary supplements, and topical treatments such as minoxidil to promote hair growth and prevent further thinning," says Marc Dauer, M.D., the medical director of Dauer Hair Restoration. We recommend Nutrafol's Hair Growth Neutraceutical ($88) as Dr. Day says it can "fill nutrient gaps you may be experiencing, lower stress levels within the body, and support balanced hormones." All of this will encourage the hair growth cycle and lead to better hair health.
In terms of products, Popova says to first analyze what you already have and use. Harsh shampoos, volumizing sprays, dry shampoos, and conditioners applied to the scalp can weaken the scalp's barrier, impacting hair follicles. Furthermore, she says high heat can also contribute to hair loss. Popova recommends looking for products that nourish the scalp and its microbiome and says The Rootist's BioBrew Strengthening Serum ($48) targets the roots, scalp, and hair. Once it's strong and healthy, Nulastin's Vibrant Scalp Treatment ($129) will activate the follicle and encourage thick hair growth.
Those experiencing moderate hair loss, characterized by notable yet not extensive loss or thinning, can take several approaches to regain hair thickness and stimulate hair growth before going under anesthesia. "When hair loss becomes more apparent, treatments like PRP (platelet-rich plasma) therapy or laser treatments can be effective," says Dr. Dauer. "These treatments can help stimulate hair growth and improve hair density."
PRP treatments involve drawing blood from the patient, processing it in a centrifuge machine to separate red blood cells and platelet-poor plasma from platelet-rich plasma, and then injecting those back into the scalp to stimulate hair growth and increase its density. Dr. Dauer says that for the best results, he typically recommends a series of three to four treatments spaced about a month apart.
While prices vary depending on where you're located and the doctor you go to, PRP is definitely an investment. "Generally, patients can expect to invest in the range of several hundred to a few thousand dollars per session," says Dr. Dauer. However, results improve hair thickness and growth, and they can be observed within a few months of starting treatment.
Another solution is LED light therapy. Nicole Ruth, DO, a board certified dermatologist based in New York City, says that it stimulates cellular activity in hair follicles, increases blood circulation to the scalp, and reduces inflammation. All this helps prolong the growth phase of the hair cycle, prevents hair thinning, and encourages new hair growth. In fact, a recent study proved that this type of low-level laser therapy (LLLT) was as effective in stimulating hair regrowth as topical minoxidil. For the best results, she says to use CurrentBody's Skin LED Hair Growth helmet ($859) in tandem with a holistic health-boosting approach. For even faster and quicker results, the study also suggests using topical minoxidil. Dr. Dauer says that this approach can increase hair density and reduce hair loss with ongoing treatment.
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