Hair loss is often thought of as a condition that primarily affects men, but many women also struggle with thinning hair and balding. In a recent discussion for the International Society of Hair Restoration Surgery (ISHRS), Dr. Sam Lam, a renowned hair restoration surgeon based in Dallas, and Dr. Shadi Zari, a board-certified dermatologist from Saudi Arabia, shared their expertise on diagnosing and treating female hair loss. Their conversation highlighted key medical and surgical approaches that can help women regain confidence in their hair.

The Prevalence of Female Hair Loss

Dr. Zari noted that about 70% of the hair loss patients he sees are women. However, only a small portion — approximately 5-10% — ultimately undergo hair transplantation. This is because many female patients benefit from medical treatments rather than surgery. In contrast, Dr. Lam’s practice sees a nearly equal distribution of male and female patients, with about 30% of his surgical cases being women.

Medical Treatment Approaches for Female Hair Loss

Both experts emphasized the importance of medical therapy as the first line of defense against female hair loss. Dr. Zari typically starts with topical minoxidil, the only FDA-approved medication for genetic hair loss in women. For women who are not planning to become pregnant, he may also prescribe oral treatments such as low-dose minoxidil, finasteride, or dutasteride, as well as autologous therapies like platelet-rich plasma (PRP) and micrografting.

Dr. Lam, on the other hand, has moved away from biochemical treatments in favor of more natural therapies. He focuses on plant-based growth factors delivered without needles, which he finds effective and less invasive. Additionally, he has developed a hair spray called Folliflo, which helps manage shedding and enhances hair growth.

When Is Hair Transplantation an Option?

Hair transplantation for women is more complex than for men, as female pattern baldness often involves diffuse thinning rather than distinct bald patches. Dr. Zari shared research showing that many women with advanced hair thinning also have compromised donor areas, making them poor candidates for hair transplantation. He advises patients to try medical treatments for at least a year before considering surgery, as this can improve both the thinning and donor areas, leading to better transplant results if needed.

Dr. Lam takes a different approach, believing that hair transplants can be beneficial for more women than traditionally thought. His technique focuses on strategically placing grafts to restore volume and coverage, using patterns such as the “T/L” shape to improve the frontal hairline and parting areas. He also emphasizes the importance of stabilizing hair loss before surgery to ensure long-term success.

Surgical Techniques: FUE vs. FUT

Follicular unit extraction (FUE) involves harvesting individual hair follicles from the donor area. In contrast, follicular unit transplantation (FUT) removes a strip of scalp containing multiple follicular units, which are then transplanted.

While Dr. Zari performs a mix of FUE and FUT, he prefers FUE for its quicker recovery time and ability to selectively extract healthy grafts. However, Dr. Lam exclusively uses FUT for women, arguing that it preserves overall donor density and produces optimal results without requiring head shaving.

Take the Next Step Toward Hair Restoration

If you’re a woman in the Dallas/Fort Worth area struggling with hair loss, expert help is available. Dr. Sam Lam at the Lam Institute for Hair Restoration in Plano, Texas, specializes in advanced, personalized treatments for female pattern baldness. Schedule a consultation today to explore your options.