Female Hair Transplant Advice

Written by Brandon Ross, MD on March 11, 2008

Hello, I am a 36 yr old female that has been dealing with thinning hair for a number of yrs. My hair loss is in my temporal region as well as at the top of my head. I am being treated for low iron (a current ferritin count of 46) and for sub-clinical hypothyroidism (current TSH level .098, before treatment; 2.9). My iron levels were much lower and have been stable for 1 ? yrs now so I am assuming that although it may have contributed to my overall thinning, it is not the only cause. My thyroid treatments have been going on for only 3 months so I have yet to see whether some regrowth may happen due to my new TSH levels.

I am adopted but I believe I may have a genetic disposition to thinning as a half-sister is apparently also dealing with this issue. I met with a dermatologist who specializes in hair transplantation and he said I have nothing to worry about in terms of balding but suggested I try Minoxidil if I was concerned. I have not yet started using the product as I am concerned with the initial shedding that can happen and fear that I will lose more without any regrowth. I know the density of hair I had in my 20’s and I know that I am definitely thinner (much) than in my younger years. I am very concerned with this and am interested in learning more of the drugs propecia, nizoral etc. I would welcome any correspondence and advice you could offer. Given my situation would I be a candidate for a hair transplant? I am finding this to be a very scary and upsetting– help!
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Hi there, and thanks for the question. Both iron deficiency and thyroid abnormalities can contribute to hair loss. It sounds as though you have wisely corrected your iron deficiency for an adequate length of time to see any effects on your hair growth. However, the 3 months time period during which your thyroid deficiency has been corrected is not nearly enough time to see a reversal of hair loss caused by this problem.

If your thyroid deficiency has been the key factor causing your hair loss, it will likely take a year or more of corrected thyroid levels before you will see any overall thickening of your hair. There are, however, a few other things which you may look for to help work out if the thyroid is indeed the problem. For example, people who experience hair loss due to hypothyroidism often notice their hair has become more coarse that it used to be. In addition these hair shafts often become more brittle and have a tendency to break more frequently. Therefore, you may soon notice a change in the texture of your hair before you actually see any change in the overall density. If your hair becomes less course and brittle, that is likely a good sign that the thyroid deficiency was a part of the problem. With your continued thyroid replacement and a bit more patience, you may notice some regrowth of your hair.

With regard to your mention of a genetic predisposition to hair loss, this factor is unlikely to effect your treatment options. Because there are several genes involved in hair loss on both the father and the mothers’ side, there is no way to pin down whether or not heredity is the culprit based on a review of the other members of your family. A physical examination of your scalp by a qualified hair restoration specialist is a far better means to make this determination.

Pharmaceutical treatment options for female pattern baldness are limited. The topical minoxidil idea offered by your physician is one good option. In my experience, this product does a decent job of preventing any more hair loss and has a very minimal side effect profile. Propecia is not an option for females because it is both ineffective and carries a high side effect profile. I do recommend the Nizoral shampoo, as its antifungal properties help eliminate dandruff.

The only accurate means to find out whether or not you are a good candidate for a hair transplant is to see a qualified hair restoration physician. I would encourage you to get several opinions so you can get as much information as possible prior to make any major decisions on how to proceed.

Brandon Ross, MD
Member, International Alliance of Hair Restoration Surgeons