The Patient's Guide to Hair Restoration - New Hair Institute

estrogen and progesterone. A portion of the estrogen circulating in a woman’s
body is normally converted into a hormone that has male sex hormone activity.
This process is more active in elderly and obese women. This helps to explain
why some older and overweight women have more facial and body hair than
others.
Men tend to wear shorter hairstyles than most women do. Transplanted
hair, like natural hair, grows at a rate of about 1 cm (0.5 inches) per month. For
most men, transplanted hair reaches a length where it adds additional bulk to the
background hair within 3-6 months. For women, this same process often takes
12 months because of the greater length of the background hair. Female patients
have a difficult time seeing the growth during this interim. No matter how often
they are reassured, many female patients may become discouraged.
Despite these problems, women make excellent hair replacement
patients. Many of the problems that men experience do not occur in women.
Women’s hair is often longer than men’s hair; therefore, immediate coverage of
the donor area is not usually a problem. While visualization of the additional bulk
of new hair takes more time in women than it does in men, women do not have
the problem of visibility of the grafts that bald men do. Women who are losing
their hair tend to style the remaining hair long enough to provide some coverage
of the balding area. This coverage also hides the new grafts while they are
growing in. This allows denser placement of grafts in the initial procedure, and
may reduce the total number of hair transplant sessions. This same factor also
allows a woman to schedule treatment sessions at longer intervals than is usual
for men.
Many women who have had face lift surgery are left with a band of scar
that runs from just in front of one ear across the top of the head to the opposite
side. The central part of this scar is easily concealed by long hair, but the scar
just in front of the ears is harder to hide. Women who have this problem must
adapt their hairstyles to cover the scars. Unfortunately, most women and many
doctors are not aware that the central part of the scar can be reduced in a simple
office procedure and the scar in front of the ears can be completely replaced with
hair transplants that have a natural appearance.
Traction alopecia is a form of hair loss almost unique to women. Traction
alopecia can result in recession of the hairline when hair is chronically pulled very
tight to form braids or pigtails. In the United States, it is most commonly seen in
African American women. This type of hair loss can often be corrected with
transplants.
The Key is Diagnosis
The degree of miniaturization of hair follicles must be assessed throughout
the scalp. This assessment is critical in qualifying women for surgery. In males,
miniaturization is usually localized in the balding pattern. In women, the
miniaturization of hair may be localized (as in males) or it may extend over the
entire scalp, including part or all of the fringe area around the sides and the back
of the head. The first step in deciding whether a woman is a candidate for
transplantation should be to assess the degree of miniaturization throughout the
scalp. Women whose entire "fringe" areas show significant miniaturization are
generally not good candidates for hair transplantation. For women with limited