Crowning Glory

The latest options for the growing number of men and women seeking noninvasive and surgical solutions to hair loss.
Crowning Glory

Hair restoration procedures in the United States jumped 27% from 2012 to 2014, and the worldwide market for hair restoration surgery increased 28% from $1.9 billion to $2.5 billion, according to the International Society of Hair Restoration Surgery (ISHRS) 2015 Practice Census Results.

“Hair restoration is about 40% of my practice, mostly men and a few women with androgenic alopecia, but we also see female patients for scar revision,” says facial plastic surgeon Sean R. Weiss, MD, of Khoobehi and Associates in New Orleans. “Facelifts can leave areas behind and in front of the ear where hair doesn’t grow properly, and I have great success restoring sideburns and hair lines for these patients. Although this is currently just a tiny fraction of our business, it is something I think we’ll be seeing more often in the future.”

While men have been the primary focus—and still make up the majority of patients—for practices that offer hair restoration services, a growing number of women are seeking treatment for age-related hair loss and thinning. In 2014, women comprised only 15% of surgical hair restoration patients, but they made up 40% of nonsurgical patients, according to ISHRS data.

“My husband is a hair transplant surgeon, and we found that his practice really didn’t serve the unique needs of his female clients,” says Mary Wendel, MD, medical director of Medi Tresse in Wellesley, Massachusetts, New England’s only medical hair rejuvenation center catering exclusively to women. “It is often harder for women to seek help, and we soon realized that a transplant office populated with men was not ideal.”

Nadia Satya Urato, MD, of Urato Dermatology in Framingham, Massachusetts, is also seeing an increase in female patients at her practice. “For women, hair loss is perhaps more devastating than for men because luxuriant hair is so tied to femininity,” she says.

While physicians specializing in hair restoration still don’t have the silver bullet many patients seek to stop hair loss, their ability to help men and women with thinning hair is improving with new noninvasive procedures and more effective surgical treatments.

Noninvasive Options

All of the physicians we interviewed recommend a comprehensive approach to hair loss that includes not only a thorough scalp examination and testing to rule out systemic conditions that might cause thinning hair, but also a discussion of nutrition and lifestyle. All but one of our panelists recommend minoxidil, which works by increasing blood flow to the follicles, and finasteride, which inhibits DHT, for appropriate patients.

Some patients even combine the two medications.

Richard P. Giannotto, MD, of Giannotto Clinic in McClean, Virginia, is cautious. “I feel that minoxidil and finasteride have too many side effects to be used long term,” he says. “I do recommend saw palmetto for many patients desiring a natural remedy to help slow down hair loss progression.”

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