I am a 38 year old woman experiencing generalised hair loss. What can I do about it and am I a candidate for hair transplant surgery.

There are many causes of hair loss in women. The first thing to do is have this worked up properly by your physician in Hong Kong. Hair loss in women is common after child birth because the hair becomes thicker during pregnancy. After pregnancy the hair will thin. Your situation sounds worse than this. Generalized hair loss is a common problem in women. In order to be a candidate for hair transplant surgery, you first need to have a donor supply. This means hair on the back and sides of your scalp. If you don’t have the donor area, you can’t have a hair transplant.

Again, the first thing you need to do is properly work up your hair loss to insure that it is female pattern loss and not due to some other cause. Those other causes include metabolic diseases such as thyroid disease and adrenal disease. You should have a TSH and T4 done to evaluate your thyroid. Both hypothyroidism and hyperthyroidism can cause hair loss. Make sure you are not producing too much male hormone. You should have a dihydroepiandrosterone or DHEA done. Also check your FSH and LH along with a free testosterone level. Then rule out syphylis with an RPR. Rheumatoid diseases can cause hair loss. Common ones are Lupus and Rheumatoid Arthritis. Do you have a skin rash or any joint pain? Finally, you should have a biopsy of your scalp done to make sure you do not have some other skin condition that is causing your hair loss. You should have two 4 mm punch biopsies done in the area of hair loss. It is of no value to take it where you are not loosing your hair. One biopsy should be read in vertical section and one in horizontal section by a pathologist experienced in reading biopsies related to hair diseases.

My office will send you an entire list of lab tests that I recommend for women experiencing hair loss.

I would say that over 95% of these work ups are negative and the diagnosis is female pattern hair loss. The reason you do these tests is to see if you have a treatable condition. Also, it is important to recognize that hair loss due to other conditions such as female pattern loss often do not respond to hair transplant surgery.

If you do not have a physician who can perform these tests for you, let me know. Female pattern loss does seem to have a common appearance. Usually, the frontal hair line remains in place while you begin to thin behind this. The crown area is usually affected later in the course of the hair loss. When you loose hair on the back and the sides, you really are not a very good candidate for the hair transplant. Loss is women can be frustrating in that it is progressive. You know that the donor area is finite. You only have so much hair in your donor area and the loss up top is progressive. Eventually, the amount of hair you have in your donor area may not be able to keep up with your hair loss.

Obviously, at age 38 it is important for you to have your hair so a hair transplant makes sense provided you are a suitable candidate. Regarding the graft count, you should be aware that a maximum of 800 to 1000 grafts up top in a single procedure is the most I would recommend in a woman. This is because higher densities are more likely to cause shock loss. This means that you could experience temporary loss that makes your appearance much worse. Eventually over several months the hair returns and your grafts grow, but I have found that women do not tolerate this temporary severe loss state well. It can be very depressing. Therefore, I recommend you have smaller sessions at a time to minimize the risk of shedding.

As far as physicians in your area, Dr. Tyng Tan is an affiliate physician with us. She is located in Singapore. Let me know if you have any more questions.