For more than 20 years, Angela Roisten noticed that the hair on the sides and top of her scalp began gradually getting thinner and sparser. Roisten, a 34-year-old banker and mother of two from Richmond, Virginia, attributed her noticeable hair loss to years of tightly pulling her hair into braids and weaves -- popular hairstyles often started during childhood. "It got to the point where my hair would just break off and not grow back, and it bothered me a lot more as a I got older and experienced more hair loss on the top and sides of my head," said Roisten. "In trying to disguise my hair loss over the years with weaves, it only made the problem worse." Although Roisten tried several topical products in an attempt to reverse her hair loss, nothing worked -- until she met Edwin Epstein, MD, a Virginia Beach, Virginia, hair restoration surgeon who recommended that Roisten undergo a hair transplant. "There are many different types of hair loss, which is why it is extremely important to understand the root cause of the condition before we can treat it," said Dr. Epstein, president of the International Society of Hair Restoration Surgery (ISHRS). "In Angela's case, she experienced two common forms of hair loss -- traction alopecia and female pattern hair loss." Traction alopecia is a form of hair loss caused by repeated tension on the hair, such as hairstyles, and commonly occurs in black women. In Roisten's case, years of braiding caused a severe case of traction alopecia that Dr. Epstein explained set the foundation for hair damage -- which may have been accelerated by the use of chemical relaxants and straighteners, or by a genetic component seen with female pattern hair loss.
Female pattern hair loss, which is the most common type of hair loss in women, can be attributed to genetics or hormonal fluctuations prior to or during menopause. With most cases of female pattern hair loss, the frontal hairline is usually spared, while the rest of the scalp shows generalized thinning. While minoxidil 2% is the sole topical medication approved by the Food and Drug Administration (FDA) for female pattern hair loss, Dr. Epstein explained that the product works by stimulating hair growth factors and results in a thicker hair shaft diameter. However, he cautioned that minoxidil might not stop the hair loss cycle if the underlying cause is not treated. "With any hair loss treatment, the goal is to stop the hair loss from getting worse and to improve the condition," explained Dr. Epstein. "Angela was a perfect candidate for hair restoration surgery because her hair loss was confined to localized areas." During a typical hair transplant procedure, hair restoration physicians split tiny grafts from the patient's existing hair and plant them into the scalp in thin and bald areas while the patient remains awake. Hair grows in gradually and is expected to be fully restored in six to 12 months. Since Roisten kept her hair restoration surgery a secret, she appreciated that the results were subtle. Nine months following her surgery, Roisten is thrilled with her initial results and proudly shares her experience with others. "Having a hair transplant has impacted every aspect of my life," said Roisten. "I have more confidence than ever before, and people are shocked to see the 'real' me without weaves or wigs. Hair restoration surgery is a lifetime investment -- like buying my first home -- but I calculated that over time spending money on weaves and wigs cost more than this surgery." Dr. Epstein noted that more women are turning to hair restoration surgery as an option to fight hair loss, especially since the results are natural looking and virtually undetectable.
"Since we first started polling ISHRS members five years ago about trends in their practices, we found that the percent of hair restoration surgical patients worldwide who were female increased from 11.4 percent in 2004 to 13.8 percent in 2006 and 15.1 percent in 2008," said Dr. Epstein. "Women simply do not want to be committed to wearing wigs and hair extensions, and baldness is not acceptable in women as it is in men."
Dr. Epstein recommended that women suffering from hair loss should see a hair restoration physician -- who will determine the cause of hair loss, examine the scalp and donor hair under a microscope to evaluate hair density and characteristics, and discuss medical and surgical treatment options -- to determine if they are a good candidate for hair restoration surgery.
In order to demonstrate the virtually indistinguishable appearance of today's hair transplants from everyday hair, the ISHRS invites the public to take the "Hair Transplant Challenge." This new online survey is designed to test a person's ability to correctly identify hair transplant patients from decoy patients in a series of photos. To take part in the survey, go to www.ishrs.org/survey.