Female hair loss treatment is referred to as any procedure that aims to stimulate hair growth and stop hair loss. Thinning or lost hair can be devastating to a woman’s self-confidence in their appearance. At City Facial Plastics, located in Manhattan, NYC, we offer advanced hair growth treatments for women to restore lost hair and self-confidence. Dr. Gary Linkov is an experienced women hair loss treatment specialist and facial plastic surgeon in New York who has extensive experience treating hair loss, especially in women.
What Is Hair Loss Treatment for Women?
Fortunately, members of the medical community do have an understanding of the common types of hair loss in women and the best hair loss treatment for women. Before treatment can be rendered, it is critical to do a thorough medical investigation into the reason for the hair loss. For women, unlike men, there are often several reasons for hair loss. There is some overlap with hair loss treatment options for men, though certain unique scenarios exist for female hair loss treatment restoration.
21 million women in the USA have hair loss to varying degrees. 40% of women experience hair loss before the age of 40. Hair loss is often a major emotional burden and can affect one’s self-esteem and how women are perceived in the workplace and in their social circles. Many women find creative ways of covering up their hair loss as addressing the underlying cause can often be challenging, confusing, and expensive.
What Is the Evaluation of Female Hair Loss?
Obtaining a sound hair loss history and medical history involves active listening. Most women really want to be heard and validated for their concerns.
Many times multiple reasons for hair loss are at play and involve different organ systems such as:
- Chemical agents
The doctor needs to connect the dots to figure out all the possible reasons that hair loss may have occurred. When it comes to specific questions that are asked to further understand the type of hair loss involved, these may include:
- When did the hair loss start?
- What is the location of hair loss?
- Are there associated symptoms (burning, itching, pain)?
- Were there any prior hair restoration treatments?
- Which hair care products are used?
Medical history is also important. Asking about past medical history, family history of hair loss, diet, and external stressors may be useful.
Female hair loss tends to occur in certain patterns that can be readily recognized to the trained eye. The basic patterns, and types, of hair loss in women, include:
- Androgenic Alopecia
- The most common form of hair loss in women (as it is in men)
- Strong genetic component
- Miniaturization of hair follicles with a progressive transformation of terminal hair follicles into vellus-like follicles (finer hairs)
- Presents as central thinning (Grade 1-3) with preservation of the frontal most scalp hairs centrally
- Telogen Effluvium
- Exists in an acute and chronic form
- Some hairs go from the anagen phase of hair growth into a telogen phase of hair loss
- In the acute form, the cause is a specific event in the past, and the hair will usually grow back within 9 months
- Steroid injections and/or platelet-rich plasma may help reduce the shedding
- Cicotrichial Alopecia
- A scarring form of alopecia
- Destroys the hair follicle, replacing it with scar tissue and causes permanent hair loss
- Hair loss can be gradual or rapid
- Associated symptoms may be may severe itching, pain, and burning
- Alopecia Areata
- An autoimmune type of hair loss in which the body attacks its own hair follicle
- May be associated with other autoimmune conditions
- Presents as small round or oval patches of baldness on the scalp. The area of bald skin looks smooth and normal.
- 90% of patients have regrowth of hair within 1 year, but some can progress to complete hair loss on the scalp (alopecia totalis), or even the entire body (alopecia universalis)
- Frontal Fibrosing Alopecia
- A form of lichen planopilaris
- Slowly progressive hair loss and scarring on the scalp near the forehead
- Eyebrows or eyelashes may also be involved
- Most commonly affects post-menopausal women over age 50
- Scalp biopsy may be helpful to make a diagnosis
- Incidence increasing in the population (sunscreen has been speculated to be a contributing factor)
- Traction Alopecia
- Affects one-third of black women and is a common reason for hair loss in black women
- Caused by wearing various forms of traumatic hairstyling for a prolonged period of time
- The pulling forces lead to mechanical damage of the hair follicles
While examining the hair, the quality and quantity of the hair are noted as well as specific changes to the scalp, skin, and nails. Dermoscopy (trichoscopy) can be performed to magnify the hair ostia and look for certain patterns of alopecia. Standardized photography is important for accurately tracking the progression of hair loss or response to treatment. Hair tests, such as the pull test (positive if >5 hairs removed when grabbing about 60 hairs) look for active shedding.
A biopsy is sometimes needed (4mm punch at 2 sites) to test for inflammatory conditions. Other hair tests, less commonly performed, include daily count, hair breakage test, hair check with densitometry, wash test, trichogram. Allergy testing may be done to look for tolerance to gluten, dairy, sunscreens, and hair product ingredients.
Also, lab work is helpful to identify any abnormalities, including:
- Iron; ferritin
- Vitamin D
- Hormones – estrogen, progesterone, testosterone, prolactin, DHEA
- Thyroid Panel
What Are the Types of Hair Loss Treatments for Women?
Hair loss treatments for women in UES, Manhattan can be divided into three main categories (temporary, semi-permanent, and permanent), based on how long the treatment lasts. Medical therapies require continued and repeated use to maintain efficacy. Other more procedural hair loss treatments last longer after single treatments. Most of the treatment options below are geared towards the most common cause of hair loss, androgenic alopecia.
The categories and subcategories of hair loss treatments include:
- Available as a 2% or 5% solution or 5% foam
- Mechanism: Opening of potassium channels
- Increases diameter of existing hairs more than hair count
- 15% will experience shedding initially
- Most common side effect: Contact dermatitis (propylene glycol) *Absent in foam preparation
- Women can get hirsutism (hair on face) if the solution or foam spreads
- Usually taken as 1mg by mouth daily
- Mechanism: 5alpha-reductase inhibitor, decreases serum and scalp levels of DHT (Dihydrotestosterone)
- Increases hair diameter, growth rate, and hair counts
- Signs of efficacy at 3 months, fully assess effects at 1 yr
- Not recommended in premenopausal women due to risk of adverse effects on the fetus
- The usual daily dose is 100–200 mg and is taken by mouth
- Mechanism: Reduces androgen levels
- Shown to restore hair growth and prevent further progression of hair loss
- Side effects may include: blood pressure changes, electrolyte disturbances, menstrual irregularities, fatigue, urticaria, breast tenderness, and hematological disturbances
- Blood pressure and electrolyte monitoring recommended
Nutraceutical (Viviscal; Nutrafol)
- Daily vitamins
- Biotin (vit B7) is the key active ingredient. Numerous other extracts and vitamins (ie Vit C, B-vitamins).
- Professional grade Viviscal has an additional marine complex
- Double-blinded placebo controlled study published in 2018 on Nutrafol with only modest subjective improvement ~5-10%
Low-level laser light therapy
- Many FDA cleared devices (iGrow, TheraDome, illumiflow, iRestore, Capillus, and HairMax)
- Mechanism: Increased blood flow to the scalp and decreased apoptosis (cell death)
- Wavelength 630 to 680 nm
- Yet to be determined: optimal frequency, power, diode count, and duration
- Can restore density due to the thickening of finer, miniaturized (vellus) hairs.
- Many applied for 15 min, three times daily
- Some companies offer money-back if low satisfaction
- Clinical trials blamed for lack of visual evidence, low sample size, and large variations in study duration and efficacy measurements
Platelet Rich Plasma (PRP)
- Scalp injections using your own blood
- Mechanism: Platelets release growth factors (i.e. – VEGF and EGF) that stimulate hair growth
- Studies including double blind placebo controlled show: higher hair density, high patient satisfaction scores, and higher terminal to vellus hair ratio
- As with laser light, Lack of standardization: Various machines, activation mechanisms, the volume of blood, platelet count, and injection techniques
- Local anesthesia used to anesthetize scalp prior to injections
- Repeat injections every 3-6 months
- Option for mild to moderate hair loss
- Most are resistant to perspiration and exercise
- The most commonly used products include hair building fibers, scalp spray thickeners, alopecia masking lotion, and topical shading.
Most of the medical treatments increase the terminal:vellus hair ratio so that there are fewer miniaturized hairs. Hair counts are less commonly implicated. And if no hair exists on a portion of the scalp then these remedies are unlikely to bring hair back (with alopecia areata being a rare exception).
Scalp micropigmentation (SMP)
- Used to be done by tattoo artists only with varied results, now more hair surgeons and hair techs are offering it
- Can cover up scalp scars and supplement transplant
- Usually, no anesthetic needed
- Several rounds of treatments, at least 10 days apart, using gradually darker ink
- Does not injure the hair follicles since ink placed closer to surface
- Lasts 3-5 yrs
Surgical hairline lowering (SHA)
- Most common non-transplant surgical hair procedure
- More popular in women due to a stable hairline
- Process: Marking, Numbing, Incision (beveled), Releasing, Endotines, excise forehead skin, and suture
- Typically performed under deep sedation
- As early as 4 months after the procedure, can perform a hair transplant to lower hairline even more and to round out the temporal area
- Most people have about 6000-7000 donor scalp hair grafts
- Different recipient sites: scalp, eyebrows, beard, underarms, chest, pubic, arms/legs
- Different donor sites: scalp, neck, chest, back
- Useful for women with androgenetic alopecia
- FUE (follicular unit extraction) is the most modern method for removing hair in which naturally occurring 1-4 hair grafts are removed one by one. Strip procedure (FUT) is another option.
- Graft survival affected by Dehydration, mechanical bulb injury, graft transection
- Procedures are time-consuming and require a team effort
- Performed with local anesthesia and usually oral sedation
- Scarring alopecia patients without active inflammation may be candidates for fat transfer to the scalp first, followed by a hair transplant several months later.
Are Patients Satisfied After Hair Loss Treatment for Women in Manhattan, NY?
Women with hair loss are very grateful patients when properly managed and counseled. Management requires a keen eye and ear to identify patterns of hair loss and to properly listen to the patient. Only then can appropriate care be provided.
What Is the Cost of the Best Hair Loss Treatment for Female?
The approximate cost of female hair loss treatments in NYC for hair restoration is summarized below:
- Minoxidil (Rogaine): $30 – $60 / month
- Finasteride (Propecia): $50 – $100 / month
- Spironolactone: $10 – 20 / month
- Nutraceutical (Viviscal; Nutrafol): $30 – $90 / month
- Low-level laser light therapy: $500 – $3000
- Platelet Rich Plasma (PRP): $700 – $3000 / treatment
- Scalp micropigmentation (SMP): $1500 – $5000
- Surgical hairline lowering (SHA): $7000 – $12000
- Hair Transplant: $4000 – $20000
Who Is the Best Hair Loss Treatment Specialist for Females in NYC?
Dr. Gary Linkov, an NYC hair restoration top-ranked expert, is a leading voice in hair restoration and hair loss treatment. He has advanced knowledge of underlying disease processes and is up-to-date on the latest therapies, offering his patients top of the line care. He also has alopecia areata himself which allows him to empathize with his patients and deliver the most compassionate hair restoration care in NYC.
Hair Loss Treatment for Women Before and After
Hair Restorations for Women
Women with androgenic alopecia receded hairlines or other causes of hair loss have options to improve their scalp appearance. At City Facial Plastics, located in Manhattan’s Upper East Side, we offer several different options to help our female patients find the right hair restoration solution.
These can include:
- Scalp micropigmentation (for thinning hair)
- FUE hair transplants
- Hairline lowering or advancement
The right choice of treatment for hair loss depends on the woman. The extent of hair loss, cause and desired result, all can factor into which treatment is best for the individual. Dr. Linkov, our hair loss specialist in NYC, offers minimally-invasive treatments that restore lost hair and improves overall appearance for female patients
If you are experiencing female hair loss and want to explore the options for hair restoration, contact City Facial Plastics in New York City. We will schedule your consultation with an internationally recognized plastic surgeon and hair loss expert in Midtown, Manhattan Dr. Linkov who will tell you more about all our hair restoration solutions. We use the most advanced options for hair loss treatment available.