Female Baldness: Finding Help for the Medical and Psychological Impacts

Aug 2007

Baldness may be rarer in women than in men, but still affects more than 30 million females in the United States.

Baldness in women, as well as men, is 90 percent genetic.

Dr. Robert Leonard, founder and chief surgeon of Leonard Hair Transplant Associates, said women who come into his office are assumed to have genetically caused baldness unless subsequent blood work shows the presence a medical condition.

About 2 percent of all female baldness cases are caused by medical conditions such as hypo/hyperthyroid, anemia, or other endocrine conditions.

In the past, the medical community believed that baldness was inherited from the mother, but that is a myth, Leonard said.

“Today we know that both male and female baldness is polygenic, inherited from either side of the family,” he said.

Once a woman has been diagnosed, there are several treatment options:

— Monoxadil (Rogaine) – This has been around since the 1980s. It is a topical solution that has been proven to stabilize the progression of hair loss in 70 percent of women, and to re-grow hair in 50 percent. For it to be effective, it must be used every day, twice a day on a long-term basis. Monoxadil should not be used by pregnant women.

— Low Level Laser Light Therapy – This is a newer treatment that developed over the last five to eight years. The procedure is performed in-office over the course of a year.

The number of office visits starts with two times a week for the first two months and gradually decreases to once a month for the last three months of treatment. Laser light is used to stimulate capillary blood flow in the dermis (skin layer) where the hair follicles live. The treatment converts 70 percent of hair that’s in the telogen or resting stage of the hair growth cycle, back into the anagen or growth stage.

It also stimulates cellular activity in the dermal papilla in the follicle, which is the area that grows the hair shaft. This process stabilizes further hair loss in 90 percent of women and results in re-growth in 50 percent. Serious side effects aren’t a concern because the light used is in the infrared range, not the ultraviolet.

— Hair Restoration Surgery — “This surgery has changed over the past 10 years,” said Leonard. “It isn’t plugs.”

The current technique uses thousands of tiny grafts of skin that contain between one to three follicles each. The hair along the sides and back of the head is the donor area because it is genetically programmed to grow forever. When this hair is transplanted to areas that are bald, it isn’t affected by female pattern baldness, and maintains its genetic integrity to grow. The transplanted hair can be cut, curled or colored because it is the woman’s natural hair.

“Today’s woman doesn’t want a wig,” Leonard said. “That’s why it’s important to recognize that there are real treatment options to help her regain her hair and her sense of self-worth.”

Psychological Impact

Beyond the numbers, hair loss in women has a more profound psychological effect on women than it does in men, according to the International Society of Hair Restoration Surgery.

Studies from the society have shown:

— Women have a larger psychological investment in their appearance than men do. This causes them to react more negatively to an event such as hair loss because it changes their appearance for the worse.

— Women are extremely sensitive to the belief that their hair is “their crowning glory". When a woman perceives that hair loss detracts from her appearance, she is likely to experience a loss of self-esteem.

Society provides very little support for women who are experiencing baldness.

“Women who have been to other doctors are told don’t worry about it, or find something else in your life to worry about,” Leonard said. “These doctors don’t realize how upsetting it is for a woman to lose her hair.”

The society urges women to consult with a hair restoration doctor to get help for both the medical and the esthetic aspects of hair loss.