• Female Hair Loss - Treatment and Restoration

    Female hair loss

    Female hair loss, otherwise known as Female Pattern Baldness (FPB), affects 1 out of every 4 women in the United States. Recent findings have found that the incidence of FPB has been reported to be as low as 8% and as high as 87%. And, it does appear to be as common for women as for men. Most often, menopause is the most frequent time for hair loss in women to become apparent.

    For a woman to lose her hair can be even more troubling than for men. A woman with thinning hair is not generally accepted as part of the normal aging process. Society has come to expect a thick, luxurious head of hair as part of the attractiveness in women.

    While males and females can both experience thinning hair, they typically do not lose their hair in the same order or appearance.

    Women with thinning hair compared to Men

    Typically men observe their hair loss earlier, whereas women will first notice it in their late 20's through their early 40's. Female Pattern Baldness (FPB) is often seen during hormonal changes. These include the use of birth control pills, following childbirth, or during or after the time of menopause.

    Top view of patient
    Top view of patient, showing excellent growth of transplanted hair.

    In addition, men typically have localized areas (patterns) of thinning, whilein women this usually occurs as thinning across the top, or over an even wider area. When women have very diffuse thinning over much of their scalp they are generally not good candidates for hair restoration surgery. However, women with localized hair loss, similar to the typical male pattern baldness, can successfully undergo hair restoration surgery.

    Thinning hair in females is also characterized by an increase in the combination of normal thick hairs mixed in with finer, smaller hairs. This results in decreased density, and not total hair loss.

    A woman's hair has also been proven to be more sensitive to the effects of stress than men's hair. Stress can result in hair loss in women and men. But this type of loss is not female pattern baldness. Rather, it is known as “telogen effluvium.” This type of hair loss is the shedding of hair in the resting phase when the body senses that it needs to divert its energies elsewhere. Therefore stress can temporarily changes the amount of hair that is shed. But the lost hair is likely to grow back.

    The production of the hair loss-inducing androgens is also different among men and women. A woman produces a small quantity of androgens in the adrenal glands and the ovaries. The ovaries also produce pre-hormones, which are then converted to androgens on the outside of the ovaries or adrenal glands.

    Generally speaking, a woman with hair loss will probably not experience total balding in a given area. But if there is total hair loss, this is most likely a sign of a previously hidden disease. For this reason, it’s important for females to have their hormone levels checked by a physician if they are experiencing heavy hair loss.

    Finally, men and women react differently to various hair loss treatment options. In men, hair loss may be halted or even reversed by finasteride (brand named "Propecia"). However, Propecia is not safe for females or children. Minoxidil (Rogaine) can be effective for both men and women in treating hair loss.

    However, for some women the causes of their hair loss are much more complex than the classic "male pattern baldness". Thus proper diagnosis of the underlying cause is vital before any hair loss treatments are attempted.

    The following physicians are nationally well known experts in female hair loss. Feel free to contact them.

    David Whiting in Dallas, Texas - 214 824-2087

    Vera Price in San Francisco, California 415 353-4163

    Maria Hordinsky in Minneapolis, Minnesota 612 625-1493

    Wilma Bergfeld in Cleveland, Ohio 216 444-5722

    For a web community that is dedicated to female hair loss visit HerAlopecia.com

  • Follicular Unit Hair Transplantation - Step by Step

    Follicular Unit Hair Transplantation - Step by Step

    We believe that patients have a right to full disclosure and a complete understanding of exactly what hair restoration surgery involves.

    This step by step presentation shows how today’s state of the art follicular unit hair transplant procedure is typically performed.

    Step 1 - hair transplant donor area

    Patient is prepared for surgery

    During surgery hair follicles from the back of the head that are genetically resistant to going bald will be removed and relocated (transplanted) to the balding areas.

    Step 2 - Patient is prepared for surgery

    Donor area is trimmed

    Prior to surgery, the hair in donor area that will be surgically removed is trimmed.

    Donor area is prepared for surgery

    Once the donor area has been prepared it is given local anesthesia.

    Donor tissue is removed

    Donor tissue is removed

    The donor tissue containing the bald resistant hair follicles is then surgically removed.

    Donor area is sutured

    Donor area is sutured

    The donor tissue containing the bald resistant hair follicles is then surgically removed.

    Hair combed over sutures

    Hair combed over sutures

    When patient’s hair is combed over the donor area the sutures are not visible. These sutures are typically removed approximately ten days after surgery.

    Donor tissue is trimmed into follicular unit grafts

    Donor tissue is trimmed into follicular unit grafts

    Surgical technicians then use microscopes to view the donor tissue in order to dissect and prepare follicular units hair grafts.

    Bald recipient area is prepared

    Bald recipient area is prepared

    After being given local anesthesia, the balding recipient area is ready for surgery. No trimming or shaving of hair is needed in the top recipient area.

    Incisions are made in the balding areas

    Incisions are made in the balding areas

    Tiny incisions are made in the recipient areas in irregular patterns that mimic nature. The follicular unit grafts will then be placed carefully into these tiny incisions.

    Grafts are placed into the incisions

    Grafts are placed into the incisions

    Follicular unit grafts are gently placed into the recipient incisions.

    Grafts are placed in varying densities

    Grafts are placed in varying densities

    Typically the smallest one and two hair grafts are placed in the very front of the hairline, with three and four hair grafts placed behind them.

    Patient immediately following surgery

    Patient immediately following surgery

    Following surgery a patient will have hundreds of tiny incisions with short hair stubble showing from the new grafts.

    Close up of recipient area after surgery

    Close up of recipient area after surgery

    The tiny graft incisions heal rapidly. The redness and scabbing in the recipient area normally clears up within about one week.

  • Dr. Timothy Carman

    Dr. Timothy Carman
    Dr. Timothy Carman
    Dr. Timothy Carman performs large sessions of ultra refined follicular unit transplantation with excellent results
  • Nettle Root Extract

    Nettle Root Extract

    Contained in Several Popular Hair Loss Treatments for Men

    Nettle root extract can be found in a number of popular hair loss treatments, such as Provillus and Procerin, and at your local health food store as a standalone product. Conjectured to effectively inhibit the production of DHT, below we examine whether or not nettles are as effective as Propecia (finasteride) in blocking DHT and stopping the progression of male or female pattern hair loss.

    DescriptionNettle Root

    “Nettles” is the common name for Urtica Dioica, an herbal plant also known as the Stinging Nettle. This perennial herb is often eaten in many parts of the world and is often added to soups, salads or cooked as greens, though less frequently. Nettle leaves are long and pointy, but only the shoots and top of the plant are eaten. Nettle plants have dark green leaves and typically grow about 2 or 3 feet tall and its flowers are covered with tiny stinging hairs that contain an irritant. Allergic reactions are common if they come in contact with human skin.

    Use of Nettles

    Nettle root extract was found to partially block 2 enzymes by researchers such as R. Hartmann.  The first is 5-alpha-reductase that when combined with testosterone, produces DHT (dihydrotestosterone). DHT is the hormone responsible for androgenic alopecia hair loss. The second enzyme is aromatase, which makes estrogen.  Combining nettle root extract with another herbal agent pygeum has been found to inhibit these two enzymes more effectively than either one alon It was shown that nettle root extract had to be used at high dosages in order to effective whereas lower doses of pygeum worked well.  Prostatonin, the combination product of nettles and pygeum have been used to treat BPH (benign prostatic hypertrophy).

    Studies by researchers JJ Lichius and others have shown a reduction in prostate growth in mice when large doses of nettle extract were taken orally. Combining nettle root extracts with saw palmetto berries in BPH patients reduced the amount of testosterone and estrogen. Conversely, it has been conjectured that nettles can block testosterone from binding to the sex hormone globulin, a carrier protein that binds testosterone and limits its bioavailability in the body. As a result, nettles have been called an aphrodisiac since it may help maintain testosterone levels.

    Other uses of Nettles include treatment for arthritis, asthma, kidney, urinary tract infections, and last but not least, baldness.

    Nettle Root ExtractNettle Root as a Hair Loss Treatment

    Like many other herbal supplements with some clinical evidence suggesting efficacy in treating enlarged prostates (BPH), some have claimed that nettle root extract may stop hair loss and maybe even aid hair regrowth.  Because Propecia (finasteride) works to stop the progression of male pattern baldness by inhibiting the production of DHT, it is conjectured that nettle root extract may be of similar benefit.

    Nettle root is a popular ingredient taken orally in a couple big name hair loss products such as Provillus and Procerin.  Some have also conjectured that applying nettle root extract topically to the scalp may also facilitate new hair growth. Because many topical irritant type products are used to treat alopecia areata hair loss, some suggest nettle root extract applied topically may be effective in treating it. Those who conjecture its efficacy to treat baldness recommend doses of 500mg or more daily.

    Though some have declared that nettle root extract may be an effective hair loss treatment, no clinical controlled studies have been performed proving its efficacy for androgenic alopecia (genetic female hair loss and male pattern baldness) or alopecia areata. 

    Possible Side Effects of Nettles

    Despite claims made that “all natural” herbal supplements are free from side effects, nettle root has its share of warnings. When topically applied, irritation of the scalp or an allergic reaction can occur. When taken orally, it can cause upset stomach, burning, difficulty with urination, bloating and edema.  Nettle root extract should not be used in patients with heart or kidney problems, due to fluid retention properties.
    Those who want to try nettle root extract as a hair loss treatment should proceed with caution and consult their doctor before using it.

  • Rogaine 2% Liquid for Women

    Rogaine for womenRogaine for women is the most recommended treatment for hair loss on the market for women today, and the only FDA approved and clinically proven treatment available for female hair loss sufferers.

    Note: Despite what the insert says, Rogaine works just as well for frontal hair loss, recession, and thinning hair.

    This product includes the original 2% minoxidil solution manufactured over 15 years ago. While it only reports a 46% success rate as opposed to the 5% liquid solution's 64% and the foam's impressive 85%, Rogaine for women reduces the possibility of unwanted side effects, including the unpopular unwanted facial and body hair growth.

    How It Works:

    Rogaine works by stimulating the hair follicles and revitalizing them. This sometimes stimulates the regrowth of miniaturizing hairs, promoting a thicker and fuller appearance of hair.

    Developing Realistic Expectations:

    Rogaine for women is a good starting point for women with thinning hair. While it's not as effective as the 5% liquid solution or Rogaine foam, the possibility of side effects are reduced. Thus, women may want to start small and work their way up to the more advanced Rogaine solutions.

    Don't expect immediate results. Just as hair loss is a slow process, regrowing it is too. Thus, it's recommended to use Rogaine for approximately 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you better evaluate the results.

    Hair shedding is a common symptom the first few months and a sign that the medication may be working for you. It's crucial to push past this stage with continued use for the recommended period of time.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultationwith one of our prescreened hair restoration physicians.

  • Nizoral Shampoo (Regular Strength) for Hair Loss

    Anti Inflamitories Nizoral

    While Nizoral 2% shampoo is more effective at inhibiting DHT production and its binding to hair follicles, Nizoral regular strength offers a smoother, gentler approach to treating hair loss while minimizing scalp irritating effects from other topical treatments such as Rogaine 5% liquid.

    This product includes 1% of the active ingredient ketoconazole. To view the clinical abstract proving the effectiveness of ketoconazole in the treatment of androgenetic alopecia, view "Ketoconazole as a hair loss treatment". Alternatively, you can obtain a prescription from your medical practitioner for the more concentrated 2%.

    Developing Realistic Expectations:

    Men and women sometimes suffer from hair loss for different reasons. Thus, diagnosing its cause is necessary to facilitate and promote proper treatment.

    Don't expect immediate results. It's recommended to use Nizoral in conjunction with other proven treatments for at least 6 to 12 months before determining its effectiveness. Documenting your progress with bi-monthly photos can help you determine whether or not Nizoral has been successful in helping you maintain existing hair.

    To date, only surgical hair restoration is proven to grow hair in completely bald areas. You are invited to have a free virtual consultation with one of our prescreened hair restoration physicians.

  • Hair transplantation FAQs

    Hair restoration procedure results

    Hair transplantation is really about relocating (transplanting) the bald resistant hair follicles from the back of the head to the balding areas on the top of the head.

    This process works for a lifetime because the hair follicles taken from the back of the head are genetically resistant to baldness, regardless of where they are relocated to.

    Learn more about hair transplantation.

    Hair transplantation, when done right, can be so natural that even your hair stylist will not know that you've had it done.

    But the skill and techniques of hair transplant surgeons does vary widely, as do their results. It's important to choose the right procedure and clinic to assure that you will get completely natural results.

    The state of art hair transplantation procedure that we recommend is called "Follicular Unit Hair Transplantation".

    To learn more about the leading hair transplantation physicians who perfrom this procedure, visit our recommended physicians page.

    A typical session of between 1,500 to 3,000 grafts normally involves a full day of surgery on an out patient basis. Most patients will arrive in the morning and will have their procedure completed by late afternoon.

    View a step by step overview of a typical hair transplant procedure.

    Patients are given local anesthesia in the donor and recipient areas. Most patients find that once the anesthesia is given that they feel no pain or discomfort during the surgery. Following surgery patients will typically feel some amount of soreness and numbness, with some mild discomfort. Most patients are pleasantly surprised by how minimal the discomfort from the surgical procedure is.

    Today hair restoration clinics typically provide free no obligation consultations, with surgical sessions priced either per graft or by the session. Prices typically average around $5 to $6 per graft.

    It is normal for the price per graft to drop as the size of the surgical session increases. Many clinics will offer a reduced rate per graft once a certain surgical session size (i.e. 1,000 or 2,000 grafts) is exceeded.

    To compare the long term costs of hair transplantation to other hair loss treatments, visit our hair transplant cost section.

    The amount of grafts you will need ultimately depends on your degree of hair loss, now and in the future, and on how full you desire your hair to be.

    For help estimating the amount of grafts/hairs you may need, click here.

    To use our interactive graft calculator, click here

    With today’s very refined micro hair transplantation procedure the incisions are very small and less invasive than past procedures. This results in more rapid healing. Most patients feel fine within a day or two following surgery, although some numbness and mild soreness can be expected for several days following surgery.

    Immediately following surgery a patient’s recipient area is typically pink with scabs forming around the micro incisions. These hundreds of tiny incisions will heal rapidly within a week to ten days.

    During the first few days after the surgery a person’s hair transplants will be noticeable if there is no previous hair to mask these temporary scabs. However, most patients feel comfortable being in public without wearing a hat within 5 to 7 days following surgery.

    Once the transplanted hair grows out the results should look entirely natural, even under close examination.

    Normally it takes between three to five months following surgery before the transplanted hair follicles begin to grow new hair. The transplanted hair grows in very thin initially and gradually grows thicker and fuller over time. After one year a patient’s transplanted hair will be fully mature and will continue to grow for a life time.

    Since the hair follicles that are transplanted to the balding areas are genetically resistant to going bald, they will continue to grow for a life time – just as if they had been left in the bald resistant donor area.

    To understand why some hair follicles are genetically resistant to going bald, while other are not, click here.

    The most important decision in restoring your hair is the physician you choose. The skill, talent, and experience of hair restoration physicians vary widely, as do the end results. Who you choose will determine how natural and full your new hair will be for the rest of your life.

    View tips on selecting a hair restoration clinic.

    Find an excellent hair restoration physician in your area.

  • Hair loss Myths - What is or isn’t true?

    Non Genetic Causes of Hair Loss

    Hair loss Myths - What is or isn’t true?

    Maybe you’ve heard that wearing a tight baseball cap too often will make you bald or that if you wash your hair too much you’ll suffer hair loss. Well, they’re both old wives’ tales.

    So what really causes hair loss and what’s myth?

    Brushing to Grow Hair?

    PCOS (Polycystic Ovarian Syndrome) and Female Hair Loss

    The idea of brushing the hair 100 times a day to stimulate the scalp circulation is a fantasy. In fact, if you brush your hair too much, you may end up injuring and losing hair.

    This myth stems from the thought that hair loss was due to poor circulation and that brushing or massaging would improve blood flow and nutrition to the follicles. The truth is, bald or not, there’s no major difference in scalp circulation.

    Styling and Hair Loss?

    There’s some truth and some fiction when it comes to hair styling and Hair Loss.

    It is true that certain hair styles, such as corn-rows or tight ponytails, can cause hair loss. These styles put undue tension on the hairs. But as for hair sprays, perm solutions, or coloring resulting in hair loss there’s no truth to that idea. These applications may cause some damage to the hair strands. But the all-important follicles, located under the skin, stay safe.

    And what about the idea that haircuts will make your hair grow back thicker and faster? That’s wishful thinking. Everyone’s hair growth and length depends on their own unique hair cycle, which is based on both nutrition and heredity. The longer your growth phase the longer your hair growth.

    Blowing away your hair?

    What about hair dryers? Are these follicular incinerators?

    The good news is there is no evidence that hair dryers cause thinning hair. However, too hot or too much drying may lead to brittle and breakable hair. Let common sense guide you and hold the hair dryer at a normal distance from your scalp and dry to your heart’s content.

    Vitamins and Steroids?

     medical hair loss treatment

    Think about this – if you were losing hair because of a lack of vitamins or minerals in your diet, why wouldn’t the back and sides of your head be affected? In actuality, vitamin deficiency results in an even distribution of hair loss all over the head. Of course, it doesn’t hurt to take vitamins on a regular basis for your overall health.

    Your follicles width and amount are based on heredity. So claims of hair growing miracle drugs or natural hair loss treatments are untrue.

    However, steroids use can cause hair loss. Research has proven that anabolic steroids raise the levels of baldness-inducing male hormones. For those who are genetically prone to hair loss, this can speed up the loss in as little as 3 to 6 months. While this loss may be reversed, it can be permanent.

    Sexual Activity to Grow Hair?

    Unfortunately, there is no truth to the idea that the more sex you have, the less hair you’ll lose! And the same goes for the rumors that the chemicals released during sex can affect hair loss. Science has yet to uncover any proof to this fantasy. But that doesn’t mean you shouldn’t keep experimenting.

    The Hair Loss Family Tree

    Many men believe that if their father has a full head of hair, they’ll keep a good head of hair. But hair loss or hair growth is set by a genetic combination determined by both sides of your family.Of course, if your family tree is filled with balding scalps, you do have a better chance of losing hair.

    Treatments that work

    Hair Transplant Cost

    While hair loss sufferers spend small fortunes on treatments based on myths, there are several proven treatments, non-surgical and surgical.

    Currently there are only two non-surgical hair loss treatments that are FDA approved for Hair loss. These two are Propecia (Finasteride) and Rogaine (minoxidil).

    Other treatments may or may not help stop or reverse hair loss, but they are not formally approved by the FDA

    To learn about proven treatments visit our Hair Loss Solutions section.

  • Dr. Özlem Biçer MD

    Dr. Ozlem Bicer
    Dr. Ozlem Bicer
    Dr. Biçer provides ultra-refined follicular unit extraction (FUE) at an exceptionally low-price. Dr. Biçer's practice combines quality with affordability with a patient-centered focus and attention to detail.
  • Questionable Hair Loss Treatments

    Questionable Hair Loss Treatments

    Balding Has Been Cured

    Try telling that to 80 million men and women who are suffering from hair loss in the United States. They will laugh at you. Yet on a daily basis we are bombarded with ads for hair loss treatments like Avacor, Hair Genesis, Fabao and Procerin that use misleading advertising to sell their products. Thanks to their persuasive messages promising to regrow hair, consumers will spend nearly one billion dollars trying to find an effective hair loss remedy and fall victim to misleading advertising like this.

    Thinning hair is a source of distress for millions of men and women so it is not unusual for them to seek help from anything that sounds like it will work. Most questionable hair loss products use similar, misleading marketing techniques ranging from claims to testimonials and photos.

    Hair Loss Product Claims

    Many hair loss products claim to be able to restore hair through the use of drugs, herbal lotions or other exotic applications like lights, lasers or electrical fields. While many of these products have been around for years, there is little evidence that they can restore hair.

    How are they allowed to make such claims? These products often use small amounts of generic drugs found in Propecia and Rogaine (finasteride and minoxidil) which allows them to make the claim to stop hair loss or they imply hair growth with 'cosmetic' claims.

    Misleading Marketing

    Some hair loss products lead you to believe that they can stop hair loss by parsing their words. They can't come out and claim to regrow hair or stop hair loss, so they advertise vague claims like "thicker, fuller hair". This is a 'cosmetic' claim that any product can make. Be advised that cosmetic claims cannot restore hair or grow hair because they are not proven to do so.

    False Testimonials

    With the anonymous nature of Internet postings, people posing as users will mislead others with false testimonials. Often, positive reviews are produced by people compensated to post these messages. Since there is no real regulation of online postings, consumers are advised to take testimonials with skepticism.

    Phony Photos

    Most product advertising that claim that you can "Regrow Hair!" or make your hair 'thicker and fuller' and show a photo of a balding person with thin hair next to a photo of the same person with thicker hair covering the baldness. Photos don't lie, do they?

    Well, yes they do.

    You can prove it yourself. Take a photo of a head with thinning hair using a flash camera and then photograph the same head without the flash. The photo with the flash will look like a bald head and the photo without the flash will look like more hair.

    Lighting, length of hair and how the hair is arranged on the head determine whether a photo of a head looks bald or not. Most people go through the same routine as balding advances: they push hair from here to there and hair spray it into place in the hope that no one will notice that we are going bald. To the extreme, this becomes the 'comb-over' hair style.

    Review the photos of hair loss products you've seen. In most cases there will be just a few and they will all have misleading elements like lighting, hair style and length of hair in the 'before and after' photographs. If the products or services are really legitimate, there should be dozens of photos, if not hundreds or thousands.

    The FDA and the FCC

    Sadly, we think that the United States Food and Drug Administration and the Federal Communications Commission (agencies who regulate such issues) can stop these scams. Unfortunately, they can't. Since the FDA approved Minoxidil and Finasteride as effective in stopping hair loss, any inclusion of these products in any form enables marketing companies to make hair restoration claims.

    Even the studies done for Rogaine and Propecia are not that encouraging. When Rogaine was studied (active ingredient is minoxidil), 16% of the placebo group had measurable new hair growth. Four out of twenty-five people had real, measurable hair growth when they believed they were using something that worked. Both studies were limited in time and scope. To read the studies that were done achieve FDA approval, visit the FDA web site and scroll down to Propecia and Rogaine. (http://www.fda.gov/cder/foi/nda/index97.htm )

    Hair Loss and Hair Restoration

    If a person is genetically prone to hair loss and balding, FDA proven hair loss treatments may help slow the process if they are used early and often. If you are like many and have already lost more hair than you're happy with, there is only one option to restoring your own natural hair: hair transplants. Hair transplants have become an art in the restoration of natural hair which is genetically resistant to the causes of balding.

    Like any surgical solution, your success depends upon the quality of the doctor you choose. Doctors who are successful in restoring a natural looking head of hair are carefully reviewed by the Coalition of Hair Restoration Physicians for membership in this exclusive organization. They must allow access to past patients, confirm their training and provide photos and videos of their patients.

    While hair transplants are not possible for everyone, they are now more natural and affordable than ever before.

    View hundreds of real hair transplant photos done by the world's top hair loss specialists who are members of the Coalition of Hair Restoration Physicians.