The hair transplant in women exists and is possible, although it is barely known. Because even in this, medicine has marginalized women. True that although baldness affects both men and women, it does not manifest in the same way, and that pattern has caused it to progress faster in men than in us. In men, that alopecia manifests as a gradual loss of hair density, especially at the temples and on the crown. In women, however, that frontal line usually remains, and what we see is a progressive decrease in density in the central area, with widening of the part.
This is clinically known as androgenetic alopecia, a type of hair loss that is genetic and hormonal. It affects more than 60% of men and 20% of women over the course of their lives.
Our hormones also have something to say
As explained by Dr. Cristina Hoyos, a medical-surgical dermatologist specializing in aesthetic dermatology, trichology, and hair transplantation, and director of the medical area at Clínica Ceta in Leganés (Madrid), «the hormonal fluctuations that women experience favor that androgenetic alopecia may manifest earlier or much later than in men. Therefore, although the genetic basis is common in men and women, in women it is more common that the hair loss is diffuse, fluctuating, and with more systemic factors».
It is easy to see women who begin to manifest symptoms before menopause, which is called early-onset alopecia. In others, it begins after menopause, late-onset androgenetic alopecia.
Unlike male alopecia, which is not associated with any disease, in women baldness can be linked to a vitamin or iron deficiency, eating disorders (anorexia or hypocaloric regimens), hormonal disorders, adrenal or ovarian tumors, etc.
Not the first line of treatment
The hair transplant, until now always associated with men, can also be a solution for women. According to the International Society of Hair Restoration Surgery, although it remains a field dominated by men —they represent 87% of the market—, the approach is changing and more and more women are being encouraged: between 2021 and 2024 there has been a global increase of 16.5% in female grafts. Experts note, however, that in the case of a female patient, other factors must be taken into account.
“Hair transplantation in women is not the first line of treatment. First we must confirm the diagnosis, stabilize the loss and control possible underlying medical causes,” explains Dr. Hoyos. “We indicate it when there is an established and stable androgenetic alopecia, or in cases of localized density loss (central area, temples). Also in cases of sequelae from stabilized cicatricial alopecias (when the loss is irreversible and the follicle has been destroyed) or localized defects (bald patches in eyebrows, scars, traction).”
Act quickly and without delay
For the intervention it is not necessary to wait until you are completely bald. “In fact, in women there are rarely areas that are completely hairless. Transplantation can be indicated when the hair is too fine and density is insufficient, as long as there is an adequate donor area and space between follicles in the area to be transplanted,” notes Dr. Hoyos.
Addressing this problem as soon as possible reduces the anxiety caused by a problem that still carries a social stigma, that of the hairless woman as unfortunate or cursed.
They tell it, they silence it
Male baldness has been sold to us as a symbol of masculinity, from Bruce Willis to The Rock. Growing hair back is also experienced as something natural. There are many famous men who have publicly announced their hair transplant and have even been seen in public with shaved heads. However, there are hardly any women who have spoken openly about theirs. Even if they have not admitted it explicitly and camouflage it under the name of treatment for hair loss, it seems that Jennifer Aniston, Keira Knightley, or Naomi Campbell have undergone one.
In the collective imagination, women are expected to have long and lush hair. Female alopecia, by contrast, has been an invisible topic, and that has delayed its normalization. As Dr. Hoyos explains, “there are women affected by alopecia who do not know that they can also have a transplant. They think it is only something for men.”
It is more complex than the graft in men
Then one must consider that the pattern of hair loss is different from that of men and makes it necessary, if the donor area is affected and the area to treat is very large, to undergo several transplants to obtain a good result. Moreover, in women hair loss is more often reversible or multifactorial. Many improve with medical treatment and do not require surgery.
But perhaps the factor that weighs the most is that the women’s transplant has greater technical complexity. For example, before undergoing the procedure one must carefully evaluate the donor area, since it is essential to extract strong follicles. “Another difficulty is that we cannot shave completely. We have to work between the existing hair and increase density without damaging the miniaturized hair (when the follicle is not completely destroyed, but the hair is very fragile and thin). In short, it is technically more demanding and the results depend a lot on the proper case selection,” explains the specialist.
What the FUE technique consists of
Women who come to the trichologist’s consultation seeking information are usually between 25 and 60 years old and have in common a stabilized androgenetic alopecia that is producing a strong psychological impact. The dermatologist explains that “many of them have a family history and others have been treating their alopecia with drugs for years, they have stabilized the loss and now seek to recover density.”
Female hair transplantation is performed using the FUE technique (Follicular Unit Extraction). First, the follicular units are extracted one by one from the donor area, which is usually the back of the head. In that area a shaved window is created that allows the patient to camouflage the resulting defect until the hair regrows in that area. “Once all the necessary hair has been extracted, implantation is carried out using the Direct Hair Implantation (DHI) technique. It consists of placing the follicles directly, using the implant. This reduces inflammation, the need for anesthesia in the transplant area, and damage to the follicle that occurs with other techniques, such as incision and placement with forceps,” explains the doctor.
The procedure lasts between 4 and 8 hours depending on the number of grafts.
Much more than aesthetics
In recent years, the technique of hair transplantation in women has advanced notably, but the future looks promising. New advanced regenerative therapies, greater follicular survival, and personalized treatments according to the genetics of each patient are on the horizon. But above all, an increasing visibility of female alopecia, which will probably raise demand.
“Female hair transplantation is expanding because we now understand the biology of alopecia in women better and select candidates with greater precision. This means more affected women will be able to access effective solutions, recovering not only hair density but also confidence and emotional well-being,” concludes the dermatologist.
