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, 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

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.

Today hair loss sufferers have several legitimate and proven treatments for restoring their hair.

Over the past decade in particular, treatments for hair loss have made huge advances. Hair loss medication like Propecia (finasteride), Avodart (dutasteride), and to a lesser degree topical treatments like Rogaine often can stop or even reverse hair loss in most people.

However, neither Propecia nor Rogaine has been proven to restore hair in the frontal areas. Only hair restoration surgery has been successful in restoring hair in the frontal hairline area once it has been lost.

Done right, hair transplants are so natural that even a hair stylist cannot detect that a person has had a hair transplant. The days of the “corn row” or “Barbie doll” hair transplant are long gone.

Hair replacement systems or “hair systems” have also improved and become more refined. Those who are extensively bald and want to restore a full looking head of hair may find a hair replacement system to be appropriate.

There are also topicals, such as sprays and applications, which can do a surprisingly effective job of giving a person the appearance of having a much fuller head of hair.

Future hair loss treatments also hold the promise of making baldness a disease of the past.

Despite attempts by the FDA to regulate the promotion of hair loss products, balding men and women still need to be wary of the many questionable treatments that are often heavily advertised.

Each hair loss treatment has its advantages and disadvantages. We believe in empowering you with the tools and assistance to explore and evaluate all your treatment options. Ultimately the best hair loss treatment is the one that works best for you.

We encourage you to take your time and explore all your options before committing to any hair loss treatment.

Explore this and other web sites and compare notes with other hair loss sufferers about what does or does not work.

Our hair restoration discussion forum has over 180,000 searchable postings by other hair loss sufferers.

If you post your question or concern, typically several people will reply with helpful advice and suggestions.

To get expert medical advice and review all your hair loss treatment options, consider doing a free consultation with one of our quality member physicians.

To learn about our physicians, or to arrange a consultation, visit our physician finder.

For many hair loss suffering men and women, topical concealers are a necessary aspect of the "daily routine." Usually composed of hair shaft adhering microfibers or darkening cream, concealers help balding men and women both camouflage areas of noticeable baldness and increase the apparent density of thinning hair. Below, we provide our readers with a product review of the new and popular hair loss concealer Caboki.

Caboki was released back in 2005 but is only just now receiving more attention, most likely due to increased advertising. Like others before it, Caboki concealer claims to be a "hair loss breakthrough". Despite ambitious promises, Caboki's claims leave several unanswered questions: is Caboki really a breakthrough concealer? How does it compare to other, similar products like Toppik, DermMatch and COUVre? Is Caboki a worthwhile product for purchasing, or will it fall from grace like other alleged "breakthrough" hair loss miracles before it?

While many products, such as "Toppik" (a popular microfiber-style concealer) and "Couvre" (a concealing cream) are popular and trusted within the hair loss community, new, unproven concealers arrive on the market every day. What's more, many of these new concealers try to "best" the products currently offered and claim to camouflage hair loss in a way "never seen before." However, as with many alleged miracle cures, these products often fail to meet expectations and leave hair loss sufferers disappointed and discouraged. So let's explore how Caboki works to conceal hair loss below.

Caboki is comprised of a series of charged microfibers that, when applied to the scalp, tightly bind hair shafts and create a denser, fuller appearance. According to the manufacturer, these microfibers are comprised of two different elements: Moroccan Gossypium Herbaceum fiber and iron oxide-based natural (mineral-based) colorants. The makers of Caboki claim these elements allow the product to create a natural, healthy appearance, capable of withstanding harsh lighting conditions, sweat, wind, and rain.

However, because these elements have been used in other concealer products (Toppik particles, for example, are both charged and made from natural keratin), Caboki still must demonstrate why it's revolutionary. So, what makes Caboki a "hair loss breakthrough?" According to the manufactures, Caboki differs from other concealers in the following ways:

• Caboki particles, unlike other microfiber concealers, are negatively, not positively charged. Allegedly, positively charged particles (usually made from wool fibers) possess a greater tendency to repel and oppose not only each other, but also the positively charged hair shafts. Because of this, when the particles attach near each other on a hair shaft, they are more likely to repel and detach. According to Caboki creators, negatively charged fibers (made from Moroccan Gossypium Herbaceum fiber) do not experience this intense phenomenon, and create a much greater (200%), electronically attractive (negative to positive), bond. If this is true, Caboki microfibers should bind and adhere to hair shafts with a much stronger, more permanent affinity.
• Because Caboki particles create a stronger charged bond, the thicker, more volumized hair shafts are likely to stand erect and less non-bonded concealer will collect on the scalp. This combination, according to Caboki, will eliminate the "dull, flat" appearance associated with other concealer products.
• By only utilizing natural elements (Moroccan Gossypium Herbaceum fibers and iron oxide colorants), Caboki avoids some of the potentially harmful synthetic dyes, fillers, and artificial preservatives used in other concealer products.

So, it's now clear why the manufacturers of Caboki believe it is a superior product, but does this mean Caboki is a legitimate hair loss concealer? Does it truly outshine other concealer product currently on the market?

While the product is still fairly new, most anecdotal experiences and testimonials from real hair loss suffering men and women are positive. Most individuals believe the negatively charged Caboki particles bind strongly to the positively charged hair shafts and create a longer-lasting increase in density. Furthermore, the particles seem to be more resistant to potentially damaging elements like water, sweat, and wind. Having said that, many individuals report some common problems experienced with other concealer products – concealer wiping off on pillows and clothes, some smearing with sweat, and difficultly creating a natural appearance in the hairline. However, these same individuals claim the problems occur less frequently with Caboki. Altogether, it's likely that Caboki is both a helpful hair loss concealer and equivalent to other products currently on the market. While it is clear that Caboki does possess some advantages and interesting claims, it could be difficult to quantify whether it truly exceeds or simply meets the standard set by other available hair loss concealers. Truthfully, only time and the opinion of hair loss sufferers will determine whether Caboki lives up to its claims and defines itself as a legitimate concealer breakthrough.

Over the past several years surgeons have used various techniques to perform follicular unit hair transplantation. One such technique is the Lateral Slit Technique, also known as Coronal or Perpendicular Grafting. This technique’s name is derived from the angle and direction in which the graft incisions are made.

While there are other techniques for performing densely packed and highly refined follicular unit transplantation, the lateral slit technique offers a high degree of control over the angle and direction in which the transplanted hairs will ultimately grow.

The lateral slit technique has been used both intuitively and systematically for years by hair restoration physicians. However, it has recently gained popularity as a systematic and precise way of performing follicular unit hair transplantation.

How our member physicians use the Lateral Slit Technique.

Many of our physician members use the Lateral Slit Technique exclusively or in combination with other techniques for creating graft incisions. The lateral slit technique enables a surgeon to create graft incisions at varying angles (ranging from 10 to 90 degrees to the scalp), including very acute angles that will make the transplanted hair grow out lying flatter to the scalp. The ability to create incisions at very acute angles is particularly useful in areas such as the front temples and sides where the hair normally grows out lying flat on the scalp.

The graft incision determines the direction of the hair growth

The lateral slit technique also helps enable a surgeon to determine the direction of the graft incisions. This then determines the ultimate direction of the transplanted hairs growth. Thus a surgeon can use this technique to control and vary both the direction and angle at which the transplanted hair will grow in order to mimic the subtle changes in hair direction that occur naturally.

Each graft incision is created by analyzing the neighboring hair so the surgeon can reproduce the correct hair pattern. As a result, as each transplanted hair emerges from the scalp it will grow and lay in a similar direction as its neighboring non-transplanted hairs.

Lateral slits can enable denser packing of grafts

Lateral slit incisions also tend to be more parallel to the scalp and thus more superficial and less invasive to the scalp’s underlying vascular structure. This parallel alignment also enables a physician to place more grafts per square centimeter with out the grafts compressing or popping up since the pressure exerted on the grafts does not push them upward from the scalp.

Using blades cut to the size of the grafts

Some of our members use custom blade cutters to create tiny blades to make incisions that match the size and depth of each follicular unit graft being transplanted. This enables a surgeon to safely dense pack more grafts into a given area during a surgical session. Healing time is also more rapid, with minimal scarring.

Typically most clinic’s blades range from 1.5mm to 2mm in size. However, by using the custom blade cutter our physicians can create blades as small as .7mm for a single hair graft and .9mm for a multi hair graft.

In addition, the blades created by the custom cutter are squared off to match the shape of the bulb end of a hair follicle. Non custom cut blades are typically spear pointed which requires them to be inserted deeper thus causing more trauma to the scalps vascular structure.

The ability to control the depth of the incision each blade makes is also critical. Each blade is placed in a blade holder that is set to not allow the blade to go any deeper than required for the graft to being placed in the incision. This minimizes unnecessary trauma to the deep vasculature of the scalp, thus enabling close tight incisions, minimal tissue swelling, and quick healing that leaves no visible scaring, pitting, or cobble stoning of the scalp.

Placing grafts to maximize their aesthetic result and coverage

The plane and direction in which each follicular unit graft is placed on the scalp can also impact the ultimate appearance of density that can be produced with a given number of grafts. This is because hairs within a follicular unit are typically next to each other inline.

Therefore by arranging each multiple hair graft on the scalp in a linear fashion to the line of sight, each follicular unit will provide the maximum appearance of fullness and scalp coverage. This also mimics how hair is normally aligned on the scalp.

Special thanks to Dr. DeYarman, Dr. Sharon Keene, Dr. Jerry Cooley, Dr. Alexander, and Dr. Glenn Charles for contributing their expertise and photos for this section.