Author: Dr. William Rassman

This is a common finding in some women, although it is more common as women get older. I have treated many of these women with a hair transplant to put back the rounded hairlines typical of the female hairline. You should be look at my an expert to make sure that you don’t have an autoimmune disease like Frontal Fibrosing Alopecia. a diagnosis that is easy to make when your doctor is skilled in the examination of a female hairline

If you have thinning and possibly PCOS, treatments like Scalp Micropigmentation works very well to make your hair look fuller: https://scalpmicropigmentation.com/gallery/smp-for-women/

I have performed a HAIRCHECK test on this now 24 year old male with a receding hairline last year and then again today. His hair has shown stability and very little loss as the drug finasteride seems to be helping him hold onto his hair. I told him to return in a year for another HAIRCHECK test and to see if his corner frontal recession bothers him. A hair transplant is a viable option.

He appears to be thinning in two areas and his forelock appears strong and he wants a hair transplant. Forelocks tend to last a lifetime if it remains strong until a man is over 35 and these tend to run in families. This man is not a candidate for a hair transplant yet at 23, but possibly when he get to be 25 or 26, he will see these areas bald more. If he takes the drug finasteride, it might not happen.

Should I get a HT ? Im 23 i used minoxidil for 2 years and did nothing just stopped the shedding so what you advice me to do ?

No one ever gets back their normal density. The question that should be answered is did you meet the expectations that you are your doctor set at the time of the surgery?. . Maybe your hair was fine or that the number of grafts were insufficient or you had less than good growth. In any event, you must o back and meet with your surgeon if you are unhappy

My mother and aunt have a similar problem. What should I do?

Clearly you are very thin and have a see through appearance. If this is in the female side of your family, it is most likely genetic. First, you want to make sure that it is not caused by some medical condition.

Female hair loss is a difficult analysis and requires many tests, not just thyroid testing. I simply can not write a textbook on the subject on this site, but here’s a list of past posts that may help you understand what you’ve got going on:

1. Female Genetic Hair Loss Is Different From Male Genetic Hair Loss
2. Birth Control Pills and Hair Loss
3. Woman With Thinning Hair After Family Tragedy
4. Diseases Causing Women’s Hair Loss
5. Female Hair Loss

The first step in evaluating hair loss in women, after a detailed history and physical exam, is to rule out any underlying medical causes of hair loss which can be treated. If clinically appropriate, the following disease processes should be considered: anemia, thyroid disease, connective tissue disease, gynecological conditions and emotional stress. Furthermore, over 50% of women going through change of life hormone fluctuations (menopause) experience significant hair loss. It is also important to review the use of medications that may cause hair loss, such as (but not limited to) oral contraceptives, beta-blockers, Vitamin A, thyroid drugs, coumadin, and prednisone. The following laboratory tests have been recommended to rule out the aforementioned medical conditions:

Some common blood tests for female hair loss:

• Sex Hormone tests
• SHBG (Sex Hormone Binding Globulin) used to test status of male hormones
• Estradiol is a sex hormone
• FSH (Follicle Stimulating Hormone) *not hair follicle but follicle in the ovary*
• LH (Luteinizing Hormone) is a sex hormone
• Free Testosterone
• Total Testosterone
• ANA (Anti Nuclear Antibody) used to test for Lupus or other autoimmune diseases
• TSH (Thyroid Stimulating Hormone) used to test for hyper or hypo-thyroid disease
• Test Iron status
• TIBC (Total Iron Binding Capacity)
• Ferritin
• Iron

Assuming that you do not have a medical cause and it is genetic female hair loss as seen in your aunt and mother, then one of the better cosmetic treatments for this is Scalp Micropigmentation: https://scalpmicropigmentation.com/smp-for-women/

At 10 weeks, many of the grafts will have shed. This may give the appearance of gaps that may not be real. Wait until the 8th mont. By then, you will see 80% of the growth and know if the gaps are real or not.

When you have an advanced balding pattern as you do, transplanting the frontal half is a great starting point because the man in the mirror will look hairy. Make sure that your doctor and you discuss your residual donor supply to see if you can address the crown at a future time. I have written articles on transplanting men with advanced balding patterns when they don’t have the donor supply to meet their needs. If your surgeon follows my published articles, you can work your way to the back of your head, regardless of your donor supply. I like what you are doing!

The hair loss behind what is still a strong hairline. In some Indian men, these strong hairlines can persist for many years even if the hair behind it goes. His pattern from other photos not shown here, is almost certainly going to develop into a Class 6 pattern so I told him to postpone surgery at this time. He should try the drug Finpecia (available in India) as this drug might reverse the hair loss especially when used in conjunction with minoxidil.

Too many young men want to rush hair transplants and too many doctors are happy to take their money and do it; however, hair transplants done too early, may leave the man with a balding pattern that the doctor and the patient never planned for (and that would be bad for the patient but the doctor has already pocked the money and I am sure it cleared his bank account)