http://www.hairtx.com Dallas hair transplant surgeon, Dr. Sam Lam, shows in this slideshare the fundamentals of diagnosing and evaluating female hair loss and how to properly treat female hair loss along with candidacy for hair transplantation and principles of transplant design.

1. Diplomate, American Board of Hair Restoration Surgery
Fellow, International Society of Hair Restoration Surgery
Dallas, Texas
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2. Unstable Stable
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First divide the problem into

3. You need to
be a sleuth
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4. History
Physical
Labs
Biopsy
These are
things to
consider…
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5. Hair loss
can occur
shortly
after
delivering
a baby
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6. History Sickness
Weight Loss
Surgery
Fever
Or be caused by…
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7. History
Trauma
Extensions
Product Damage
Or be caused by…
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8. Patchy or Patterned
Hair Loss
On physical exam,
you should
look for…
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9. Patchy Hair Loss
Consider Biopsy: This is Alopecia Areata
and cannot be transplanted
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10. Patchy Hair Loss
Consider Biopsy: This is Frontal Fibrosing
Alopecia and cannot be transplanted.
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11. Patchy Hair Loss
Consider Biopsy: This is Central Centrifugal
Cicatrial Alopecia (a type of scarring hair loss)
that usually cannot be transplanted.
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12. Patchy Hair Loss
Consider Biopsy: This is Lichen Planopilaris
(a type of scarring hair loss) that
cannot be successfully transplanted.
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13. Patterned Hair Loss
(Diffuse)
A diffuse Ludwig pattern can be transplanted
if there is sufficient donor hair.
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14. Patterned Hair Loss
(Diffuse)
Ludwig Classification
This is the Ludwig Scale for Female Hair Loss.
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15. Patterned Hair Loss
(Christmas Tree)
This patterned hair loss looks like a Christmas
tree and can be transplanted if there is sufficient
donor hair.
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16. Patterned
(MPB)
This patterned hair loss is called Androgenetic
Alopecia, or Male-Pattern Baldness and can
be transplanted if there is sufficient donor hair.
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17. Full Blood Panel
Thyroid Function Tests
ESR “Sed Rate”
All Iron Levels
Hormones: Male+Female
These are helpful labs
to evaluate…
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18. Unstable Stable
Patchy Patterned
Bad Transplant
Candidate:
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Good Transplant
Candidate:

19. Hormone Therapy
Viviscal
Low Level Laser Therapy
Minoxidil
Useful Medications for Women:
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20. Finasteride
(Only for Post-Menopausal Women)
Spironolactone
Additional Medications…
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21. Hormones Laser Therapy
+ Minoxidil
Combination therapy can help more…
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22. Female hair loss has been shown to be inflammatory in nature,
so a combination of minoxidil and low-dose steroids can work best.
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23. Shock Loss
Minoxidil
Laser
Education
Before
Beware of Temporary Shock Hair Loss
after a Hair Transplant
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24. Shock Loss
6 weeks of Minoxidil
6 weeks of Low Laser
Thorough Education
Things you can do
before surgery…
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25. Epinephrine
Trauma
Tumescent fluid
Dense Hair Packing
Reduce
Shock Loss
Things you can do
during surgery…
Reduce
Reduce
Reduce
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26. Minoxidil
Laser
Camouflaging
Products
Wig (only if needed)
Shock Loss
Things you can do
after surgery…
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27. Expectations
It is important always
to establish realistic
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28. Hair Loss
Hairline Lowering
Here are two reasons for a transplant:
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29. With limited donor hair,
it is important to strategize
where to transplant hair.
Right Hair Part Left Part Center Part
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30. To design a natural female hairline,
the surgeon must study natural,
non-balding hairlines…
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31. …& evaluate the variety of shapes and patterns…
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32. …that exists for different women.
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33. This shows the recipient sites for a male hairline
in which all sites go straight forward…
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34. …a female hairline is much more complex
and should be designed to mimic nature.
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35. Again, contrast this male hairline design…
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36. …with this radial female hairline design
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37. This shows recipient sites for a woman who wanted
to improve hair density in the central forelock,
midscalp, and the crown area in a dumbbell pattern…
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38. Female
Crown
Here is the dumbbell pattern
shown in the last slide.
Dumbbell Design
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39. This is an example of a woman born with a high
hairline who underwent hairline lowering.
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40. This is a top down view of the same woman.
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41. This woman has male-pattern baldness
and is shown before and after hair transplant.
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42. This woman has hair loss due to years of steroid
use and is shown before and after hair transplant.
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43. This woman shows fronto-temporal
hair loss of male-pattern baldness.
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44. This woman had her hairline and
hair part improved with hair transplant.
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45. This woman had traction hair loss from tight hair
braiding and is shown before and after hair transplant.
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46. This is a male-to-female
transgender hair transplant result.
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47. This is an eyebrow hair transplant over an
overplucked and poorly tattooed eyebrow region.
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48. This shows a woman who has significant Ludwig 3
hair loss and who underwent hair transplant.
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49. This woman is shown before and after
hairline and central density hair transplant.
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50. This woman underwent a hair transplant
to restore the lost volume to her hair.
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