Bernstein Medical - Center for Hair Restoration - Female Hair Loss

Female Hair Loss

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ISHRS Operation Restore

August was declared National Hair Loss Awareness Month by the American Academy of Dermatology (AAD) in 2001 in order to raise the public’s awareness of hair loss as a common problem affecting millions of men and women. In appreciation of this cause, Bernstein Medical – Center for Hair Restoration has launched a fundraiser for the International Society of Hair Restoration Surgery‘s (ISHRS) pro bono program, ‘Operation Restore.’ This program provides free hair transplants for those who experience localized hair loss due to trauma or illness.

Raising Awareness of Women’s Hair Loss

Now is the ideal time to bring awareness to women’s hair loss as the stigma of the topic has begun to diminish. Women’s hair loss is now frequently discussed in the media including television programs like the Dr. Oz Show and The Doctors, and in magazines such as Vogue, Cosmopolitan, The Wall Street Journal, New York Magazine, and New York Post.

Background

Androgenetic alopecia (common genetic hair loss) accounts for more than 95% of hair loss in both men and women. While some falsely believe that women do not experience hair loss, about 40 million women in the US alone are affected by hair loss, along with about 60 million men.

Other causes of hair loss include surgical and non-surgical trauma, congenital defects, auto-immune disease, and other medical illnesses. Radiation and cytostatic drugs or other forms of chemotherapy used in cancer treatments also causes hair loss. In cases where hair loss is localized, surgical hair restoration may provide benefit.

Our Cause

We understand the emotional toll hair loss can have on the individuals affected, especially when dealing with their other medical problems. Operation Restore and Bernstein Medical aim to help those who may benefit from hair transplant surgery by assisting in this process and covering expenses.

Dr. Bernstein has worked to advance the techniques of hair restoration and have helped tens of thousands of patients around the world. His pioneering work continues to make hair loss and its treatment more socially acceptable.

Click here to donate to Operation Restore! Bernstein Medical will match all donations made during this fundraising campaign. To qualify for the match, please ensure that you list “Bernstein Medical” in the “This Donation is Being Made on Behalf of:” box. Thank you for your support!

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Q: I’m a 42 year old African-American woman and I’m losing hair on the crown of my head. Would I be a good candidate for a hair transplant? — E.E., Philadelphia, P.A.

A: Hair loss in the crown of an African American female can have several different etiologies, so the first thing to do is to make the right diagnosis. The most common causes of hair loss are androgenic alopecia (AGA) and scarring alopecia, also called ‘Central Centrifugal Cicatricial Alopecia,’ or CCCA. A biopsy is often useful to differentiate these two causes of hair loss when the diagnosis is unclear. A biopsy can also identify other, but less common, causes of crown hair loss.

AGA presents with a history of gradual thinning in the front and/or top of the scalp, a relative preservation of the frontal hairline, a positive family history of hair loss and the presence of miniaturization in the thinning areas. Miniaturization, the progressive decrease of the hair shaft’s diameter and length in response to hormones, can be identified using a hand-held device called a densitometer. If the diagnosis is AGA, then a hair transplant can be very successful provided there is enough donor hair.

CCCA presents as a progressive form of scarring alopecia that occurs almost exclusively in African American women. The onset of CCCA is very slow, typically developing over the course of years. CCCA starts near the vertex or top of the scalp and spreads in an outward direction. The involved area is usually smooth and shiny with decreased hair density.

Central Centrifugal Cicatricial Alopecia is diagnosed with a scalp biopsy performed in the area of hair loss. Those patients with CCCA are generally not candidates for a hair transplant procedure since the body may reject the transplanted hair. This condition is better treated with oral and injectable anti-inflammatory medications. Surgical treatment for cosmetic benefit may be an option in some cases after the disease has been inactive for many years.

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Q: What is female androgenetic alopecia?

A: Female androgenetic alopecia, also called female pattern hair loss, is caused by the shrinking of susceptible hair follicles in response to normal levels of hormones (androgens). It is the most common type of hair loss in women, affecting perhaps 1/3 of the adult female population. It is seen as a general thinning over the entire scalp, but can also present in a more localized pattern i.e. just limited to the front and top. The condition is characterized by a gradual thinning and shortening (miniaturization) of individual hair follicles, rather than their complete loss and, although the condition tends to be progressive, it rarely leads to complete baldness.

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British Vogue Oct 2012 CoverHair transplantation for women is in vogue. As a pioneer in the surgical treatment for female hair loss, Dr. Bernstein was featured in an article in the ‘Beauty’ section of the October 2012 issue of British Vogue.

After describing a visit to Bernstein Medical – Center for Hair Restoration in New York City and giving readers a primer on hair transplant surgery, the article turns to Dr. Bernstein to describe the surge in popularity of the treatment of hair loss in women.

“A quarter of my consults are women. It was 10 per cent five years ago,” says Dr Bernstein. “These improved [hair transplant] techniques work especially well for female hair loss, where it is usually localised patches of thinning that need attention.” And while in the chair, you can even have your eyebrows boosted to Arizona Muse quality, too, if they’ve also taken an ageing hit.

Dr. Bernstein speaks to the difficulty of being a woman suffering from hair loss:

“This is life-changing. Bald men are commonplace, but to have less than a full head of hair for a woman can be isolating. Although there are more tricks women can use to disguise the problem.”

The article also discusses a variety of products and techniques to boost hair volume or camouflage hair loss. Among these are: Kérastase, Nicky Clarke’s ‘Tease Me’ powder, Viviscal Hair Nutrition, laser stimulation, Michaeljohn’s ‘Fine Hair Clinic’, and Touché by Flavien.

Reference
“Hold Onto Your Hair”, Vogue Magazine, October 2012; p375-6.

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O, The Oprah Magazine - March 2010O, The Oprah Magazine featured hair loss in women in the beauty section of their March 2010 issue.

Dr. Bernstein was consulted for the article:

Hair transplant: A possibility if your hair loss is concentrated in specific areas. Hair follicles (in groups of up to four) are surgically removed from an area on your scalp where growth is dense and then implanted in the thinning patches. Since female hair loss is often diffuse, only about 20 percent of female patients with thinning hair are candidates, says Robert Bernstein, MD, a New York City dermatologist who specializes in these surgeries. (The price tag can run from $3,000 to $15,000.)

In October 2008 Dr. Bernstein appeared on the Oprah Winfrey Show, where he spoke with Oprah and Dr. Mehmet Oz about hair transplantation and gave a live demonstration featuring the hair transplant results of one of his patients.

Watch a video clip of Dr. Bernstein and Oprah discussion hair transplantation.

Read the full article at Oprah.com.

Reference:
“The Truth About Hair Loss,” “O” – Oprah Magazine, March 2010; p90.

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Q: I had a baby 12 weeks ago and have recently been diagnosed with a hyperactive thyroid, although only slightly. I was also taking Prozac for 7-10 days. I am 27 and have been experiencing a significant amount of hair loss from all over my scalp. What are the chances that this would be permanent?

A: Based upon your history, you have three possible reasons for having a type of hair loss called telogen effluvium; thyroid disease, medication induced (Prozac) and pregnancy.

Telogen effluvium is diagnosed by a hair pull test and observing club hairs under the microscope. It is generally a reversible condition, regardless of the cause. Telogen effluvium most often occurs 2-3 months after the inducing event, so your pregnancy is the most likely cause. Prozac would less likely be the problem since you have only been on it for a short time. Besides causing Telogen effluvium, thyroid disease can also alter your hair characteristics, which can make your hair appear thinner.

Other causes of hair loss, such as genetic female pattern hair alopecia, must be ruled out. Please see the Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website for more information.

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Q: I am a 45 year old woman and I am beginning to thin on the top of my scalp. I don’t want to use medications and I don’t think that I am quite ready for surgery. Is there anything else I can do? — E.H., Rye, NY

A: There are a number of things that you can do that can make you hair look more full and help disguise the thinning. Lightening ones hair will allow the hair to reflect more light and appear thicker. In lighter-skinned races it will have the additional advantage of decreasing the contrast between the hair and skin and thus the skin will essentially act as a filler between the strands of hair.

Streaking the hair is also helpful to make the hair look thicker. Waving or perming will help as well, as it will give the appearance of more volume. Normally, the hair tends to fall into a natural part where it is the thinnest. If you part your hair in the thickest area (usually the side opposite from where you are used to, or slightly lower on the same side) this will make the hair appear fuller and less see-through.

Finally, there are a number of cosmetic products that can make you look like you have more hair.

Visit the Cosmetics for Hair Loss page on the Bernstein Medical – Center for Hair Restoration website.

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Q: Dr. Bernstein, a lot of older women are taking testosterone to restore libido, but are they going to experience hair loss as a consequence?

A: They can. In women there is a delicate balance between the androgens, i.e. testosterone and estrogens. Estrogen is protective to some degree against hair loss in women, which is why most women don’t experience such severe hair loss as do men.

When a woman takes testosterone supplements it upsets that balance and can cause hair loss. However, hair loss in post-menopausal women is usually due to age related changes. Typically, the hair decreases in size in a genetically determined progression that seems not to be directly related to changes in the levels of hormones.

For more information, please see the Causes of Hair Loss in Women page on the Bernstein Medical – Center for Hair Restoration website.

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Q: I have early thinning on the top of my scalp and I was told to use Propecia, but I heard that is was only for men. What do you think? — T.G., Staten Island, NY

A: Women can’t take Propecia during the child-bearing years because, if ingested, it can cause birth defects in male offspring.

In post-menopausal women, where we see the greatest frequency of hair loss, it doesn’t seem to be effective.

In pre-menopausal women who do not plan to become pregnant or who already have children, we are still cautious about using the medication, since there effectiveness has not been proven and its long-term safety in this population has not been tested.

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Hair loss has a variety of causes. Diagnosis and treatment is best determined by a board-certified dermatologist. We offer both in-person and online photo consults.

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