Hair loss (alopecia) in women. Stop it and regrow again. Find here the causes, diagnosis, and treatment (April 2025):
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Understand the hair loss in women: |
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Life cycle of a hair: Each hair develops from a follicle — a narrow pocket in the skin — and goes through three phases of growth. The Anagen phase (growing phase) -Figure A:
The catagen phase (transition phase) - Figure B:
The telogen phase (resting phase) - Figure C:
Your shorter hairs, like eyelashes, arm and leg hair, and eyebrows, have a short anagen phase (about one month). Your scalp hair can last up to eight years. |
What are the types of hair loss in women?
Technically, there are three types of hair loss in women:
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Genetic Hair Loss:
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Patterns of female hair loss:
While men tend to experience hair loss beginning at the forehead and crown of the head, women are more likely to experience thinning hair at the top of the head, usually along the top third or half of the scalp. |
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Symptoms (signs) of hair loss in women: Hair loss may present in different ways depending on the cause. You may notice sudden hair loss or a gradual thinning over time. Key signs and symptoms of hair loss include:
The other signs of hair loss in women may include:
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What causes hair loss in women? There are several possible causes of hair loss in women, including:
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Know more about the causes of hair loss in women: Androgenetic alopecia:
Other types of alopecia include:
Telogen Effluvium: Telogen Effluvium (TE) is typically temporary. According to the American Academy of Dermatology (AAD), TE isn’t defined as “hair loss” but rather as excessive hair shedding. Stress causes many hairs in the active hair growth (anagen) phase to abruptly enter the resting (telogen) phase. When the hairs reenter the growth phase, the hairs suspended in the resting phase are suddenly released, causing shedding. You can sometimes identify TE by looking at the strand. Telogen hairs have a bulb of keratin at the root. TE is generally caused by stress or a shock to the body. For example, you may lose hair in the months after giving birth. But there are many other possible triggers, such as:
TE is typically reversible and often resolves 6 to 8 months after your body readjusts or the trigger is gone. Chronic health conditions: Chronic health conditions that may lead to hair loss include:
Menopause and hormone imbalances: Hormonal changes of any kind, particularly decreasing estrogen levels, can temporarily disrupt the hair life cycle. Women may experience hair loss during menopause due to slowed production of the hormones estrogen and progesterone. Menopause can also lead to uncomfortable symptoms such as night sweats, weight gain, and vaginal dryness, which may raise your overall stress levels. This can also contribute to hair thinning or loss. Some women may even notice hair growth changes after going off hormonal birth control pills. Polycystic Ovary Syndrome (PCOS): PCOS is a common hormonal disorder that causes an excess of androgen levels (male sex hormones). It usually affects women during their reproductive years and can cause several symptoms that affect their quality of life:
When PCOS causes hair loss in women, it is classified as male pattern baldness because androgen levels result in thin hair. As a result, the treatment for this type of hair loss is the same as that for pattern baldness. Lupus: Lupus is a complex but relatively common autoimmune disorder affecting many body areas, including joints, skin, and major internal organs and vessels. While both women and men can have lupus, it is more commonly found in women. Lupus is difficult to diagnose because it can imitate other diseases. Although there is no cure for lupus, and the cause is unknown, patients can usually manage it with medication. After it is under control, most patients experience improved hair growth. If you have been diagnosed with lupus, it’s best to seek treatment from a specialist in the field. Iron-Deficient Anemia: A common side effect of iron-deficient anemia is hair loss. Like many other diseases on this list, this type of anemia is most often found in women. A simple blood test can determine if you are anemic. Luckily, the treatment is relatively straightforward: taking an iron supplement can prevent further damage and help promote healthy hair growth. In severe cases, more aggressive therapies may be required. Severe Stress or Anxiety Disorders: When people experience chronic stress, it can manifest itself in physical ways. We commonly hear about weight gain or loss, but thinning hair is another symptom. Sometimes, it is so gradual that the person may not notice it until they have substantial hair loss or the hair begins to grow back, resulting in patches of coarse hair next to longer hair or a thinning hairline. Treatment for chronic stress and anxiety typically involves cognitive behavioral therapy, lifestyle changes, and sometimes medication. In this case, hair regrowth is often possible through treatment, although eliminating stressors is often sufficient in reducing loss, and hair will typically regrow after. Some patients experience temporary hair loss from temporary stressors. In these cases, their hair grows back when the stressor is eliminated. If you think you may be suffering from any of these diseases, your doctor can run blood tests and refer you to a specialist if necessary. Thyroid Conditions: The thyroid impacts our heart rates and metabolism. If you experience a thyroid imbalance, it is also expected to experience thinning hair. A slow thyroid (hypothyroidism) and a fast thyroid (hyperthyroidism) can cause hair loss and changes in texture. While hyper- and hypothyroid are perhaps the most well-known thyroid conditions, they are not the only disorders that affect this gland. Hashimoto’s thyroiditis is a common autoimmune disorder in which the body attacks the thyroid and is most commonly found in middle-aged women. Treatment for any thyroid disorder typically includes medication. |
What are the risk factors for hair loss in women? Hair loss in women can affect any female at any age. However, it’s usually more common if it runs in your biological family history and/or after:
Hair loss can affect anyone. But some factors may make a woman more likely to experience hair loss:
Hair loss due to the side effects of Medications: A whole host of medications have hair loss listed as a side effect. Some of the medicines commonly linked to hair loss include:
If you experience hair loss from taking any of these medications, adjusting them can help you control your hair loss. You can also talk to your doctor about taking a different generic form of your medication. Each medication will have a slightly different formula; one drug may work better for you. |
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Diagnosis and Tests: |
Dermatologists have expertise in diagnosing hair loss and counseling their patients on what may help them regrow their hair. In the below figure, a dermatologist is using a dermatoscope to examine a patient’s scalp: |
How will a healthcare provider diagnose hair loss in women? A healthcare provider will do a thorough physical examination and take a detailed history to understand changes in your hair growth. The healthcare provider will observe the pattern of hair loss, check for signs of inflammation or infection, and possibly order blood tests to investigate other possible causes of hair loss, including hyperthyroidism, hypothyroidism, and iron deficiency. A hormonal evaluation is usually unnecessary unless there are signs of excess androgen activity (such as menstrual irregularities, acne, and unwanted hair growth). Your provider will also ask about what medications or supplements you currently take. What tests diagnose hair loss in women? The tests to diagnose hair loss in women may include: Pull test: Your doctor gently pulls several dozen hairs to see how many come out. This helps determine the stage of the shedding process. Blood tests: These checks are performed for vitamin and mineral levels (like vitamin D, vitamin B, zinc, and iron) and hormone levels (like thyroid). This might help uncover medical conditions that can cause hair loss. Scalp biopsy: Your doctor scrapes samples from the scalp skin or plucks a few hairs from the scalp to examine the hair roots under a microscope. This can help determine whether an infection is causing hair loss. Light microscopy: Your doctor uses a special instrument to examine hairs trimmed at their bases. Microscopy helps uncover possible disorders of the hair shaft. What questions might a healthcare provider ask to diagnose hair loss? To diagnose hair loss, your doctor is likely to ask you some questions. Being ready to answer them may save time going over any points you want to spend more time on. Your doctor may ask:
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Management and Treatment of hair loss in women: Effective treatments for some types of hair loss are available. You might be able to reverse hair loss, or at least slow it. With some conditions, such as patchy hair loss (alopecia areata), hair may regrow without treatment within a year. Treatments for hair loss include topical solutions, medications, surgery, and lifestyle changes. Treatment for hair loss also depends on the cause. It may include:
Medications, hair transplant surgery, topical use of oil, massaging, medicated shampoo, air conditioners on the scalp, healthy diet, mental peace, and some specific procedures are the most common treatments for hair loss in women. They include the following: |
Topical solution: Minoxidil (Rogaine, or generic versions):
When used as directed, minoxidil can:
Minoxidil tends to be more effective when used along with another treatment for hair loss.
How to use minoxidil: Be sure that your hair and scalp are dry. Using the dropper or spray pump that's provided with the over-the-counter solution, apply it twice daily to every area where your hair is thinning. Gently massage it into the scalp with your fingers so it can reach the hair follicles. Then air-dry your hair, wash your hands thoroughly, and wash off any solution that has dripped onto your forehead or face. Don't shampoo for at least four hours afterwards. Some women find that the minoxidil solution leaves a deposit that dries and irritates their scalp. This irritation, called contact dermatitis, is probably caused not by the minoxidil itself, but rather by the alcohol that is included to facilitate drying. At-home treatments for hair loss: Minoxidil (Rogaine®): Over-the-counter (nonprescription) minoxidil comes in liquid, foam, and shampoo forms for topical use (at 2% and 5%) and oral capsules. Many people prefer the foam applied when the hair is wet. Should you see regrowth, you will need to keep using it every day. In a 2020 clinical trial comparing the effectiveness of a low-dose oral formulation (1 milligram [mg]) to the 5% formulation, both were associated with increased hair density after 6 months of use:
This hair loss treatment is generally safe and well-tolerated in low doses for various causes of hair loss. But you should speak with your doctor first before trying it. You’ll need a prescription for oral minoxidil. Side effects of hair of minoxidil hair treatment:
Hair loss shampoos: Some minor hair loss may happen due to clogged pores on the scalp. Gently massaging shampoo into the scalp and resisting the urge to rub it into the hair when rinsing can help to prevent hair damage, according to the American Academy of Dermatology Association (AAD). They also recommend using conditioner each time after shampooing. An older review from 2015 notes that using certain types of medicated shampoos may also help reduce and prevent hair loss. Avoiding damaging treatments such as heat, curling irons, and dyes may also help. Ketoconazole: The drug ketoconazole may help treat hair loss in some cases, such as androgenetic alopecia, where inflammation of the hair follicles often contributes to hair loss. It is noted that topical ketoconazole might help reduce inflammation and improve the strength and look of the hair. Ketoconazole is available as a shampoo. Nizoral is a well-known brand that can be purchased over the counter. Nizoral contains a low concentration of ketoconazole, but stronger concentrations will require a prescription from a doctor. Scalp massage: Massaging the scalp may increase circulation in the area and promote hair growth. Research from 2016 showed that regular scalp massage helped to make hair thicker. The researchers noted that this may be due to how scalp massage stimulates the tissues of the skin in the area. |
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Medications: Prescription medication that can regrow hair: One of the treatment options is to take prescription medication. The type of medication prescribed will depend on your:
With any medication, side effects are possible. Ask your dermatologist about possible side effects that you might experience while taking one of these medications to treat hair loss. The medications include: Finasteride and other alpha-reductase enzyme inhibitors: Finasteride (Propecia® or Proscar): This is a prescription drug for men. You take it daily as a pill. Many men taking finasteride experience a slowing of hair loss, and some may show new hair growth. It may take a few months to tell whether it's working for you. You'll need to keep taking it to retain any benefits. Finasteride may not work as well for men over 60. It is the U.S. Food and Drug Administration (FDA) approved medication to treat male pattern hair loss, but not women. Doctors may sometimes prescribe it off-label to women who don’t plan on having children in the future. Finasteride inhibits 5 alpha-reductase, blocking the conversion of testosterone to dihydrotestosterone (DHT), the androgen responsible for male pattern baldness. When taken as directed, finasteride can:
Finasteride is a pill that you take once a day. Taking it at the same time each day seems to produce the best results. Like other treatments for hair loss, this, too, takes time to work. It usually takes about 4 months to notice any improvement. Finasteride tends to be more effective if you begin taking it when you first notice hair loss. A dermatologist may also prescribe this medication to treat a woman who has hereditary hair loss and cannot get pregnant. If finasteride works for you, you will need to keep taking it to continue getting results. Once you stop, you’ll start losing hair again. Before taking this medication, be sure to discuss possible side effects with your dermatologist. Hormone therapy: If hormone imbalances due to menopause, for example, cause hair loss, doctors may recommend some form of hormone therapy to correct them. Some possible treatments include birth control pills and hormone replacement therapy for either estrogen or progesterone. Other possibilities include antiandrogen medications, such as spironolactone. Androgens are hormones that can speed up hair loss in some women, particularly those with Polycystic Ovary Syndrome (PCOS), who typically produce more androgens. Antiandrogens can stop the production of androgens and prevent hair loss. These medications may cause side effects, so always speak with a healthcare professional about what to expect and whether antiandrogens are suitable. Spironolactone(Aldactone) and other anti-androgens:
Spironolactone (Aldalactone) treats hair loss by acting on hormones. Specifically, it binds to androgen receptors and decreases your body’s processing of testosterone. For women who have female-pattern hair loss, this medication may be an option. It can:
Studies indicate that this medication is effective in about 40% of women who have female pattern hair loss. In one study of 166 women taking spironolactone, 42% said they had mild improvement, and 31% reported increased thickness. A 2020 study tracked 79 women who had been taking spironolactone daily (doses ranged from 25 to 200 mg) for at least 6 months. Twenty-nine of the 45 participants who used it for more than 6 months saw some improvement after 1 year. Those who began the trial with more pronounced hair loss benefited most from the medication. However, not all researchers agree that spironolactone works for hair loss. The Food and Drug Administration (FDA) hasn’t endorsed it as a treatment for androgenic alopecia. Nevertheless, the medication has still been used off-label. But you’ll need a prescription from your doctor first. More research is needed before definitive claims can be made regarding its effectiveness. Immunosuppressants: People with alopecia areata may also benefit from immunosuppressive medications like methotrexate, azathioprine, or cyclosporine. It’s typically combined with low-dose corticosteroids. While a very low percentage of patients who take Methotrexate for autoimmune disorders may experience hair loss, this isn’t a common side effect of the medication. Medications for Alopecia Areata: Alopecia areata is an autoimmune disorder that causes your body to attack healthy hair follicles. As a result, the hair follicles fall out, and some patients experience hair loss in clumps. Every case of alopecia areata is different, but many individuals lose chunks of hair randomly on the scalp. In rare cases, individuals lose all their head and body hair. Although this disease is not cured, your hair can grow back with the proper treatment. Common, effective treatments include:
JAK inhibitors: Janus kinase (JAK) inhibitors work by slowing down the overactivity of the immune system that can lead to inflammation and pain. JAK inhibitors are a newer treatment under intense study for alopecia areata. While they’re FDA-approved for treating certain skin conditions, more research is needed on their effect on hair regrowth. Other medications:
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Laser for at-home use: You can buy laser caps and combs to treat hair loss at home. While only a few studies have looked at these devices, the results are promising. In one study, more than 200 men and women who had hereditary hair loss were given either a laser hair comb or a sham device that looked like a laser comb. The patients used the device that they were given 3 times per week for 26 weeks. The researchers found that some patients using the laser rather than the sham device saw overall thicker and fuller hair. It’s important to understand that not everyone who used a laser saw regrowth. More studies are needed to find out who is most likely to benefit from this treatment and whether these devices cause long-term side effects. |
Procedures to help regrow hair: While at-home treatments offer convenience, a procedure performed by a board-certified dermatologist tends to be more effective. For this reason, your dermatologist may include one of the following in your treatment plan: Steroids (Corticosteroids) injection: Some females may also respond to corticosteroid injections. Doctors use this treatment only when necessary for conditions such as alopecia areata. Alopecia areata results in a person’s hair falling out in random patches. According to the National Alopecia Areata Foundation (NAAF), injecting corticosteroids directly into the hairless patch may encourage new hair growth. However, this may not prevent other hair from falling out. Topical corticosteroids, which are available as creams, lotions, and other preparations, may also reduce hair loss. To help your hair regrow, your dermatologist injects this medication into the bald (or thinning) areas. These injections are usually given every 4 to 8 weeks as needed, so you will need to return to your dermatologist’s office for treatment. In one study of 127 patients with patchy alopecia areata, more than 80% who were treated with these injections had at least half of their hair regrow within 12 weeks. This is considered the most effective treatment for people who have a few patches of alopecia areata, a condition that causes hair loss. It helps to reduce inflammation. You can either apply them to your scalp or have them injected into the affected area. Hair transplant surgery:
Follicular Unit Extraction for Hair Loss in Women: Follicular unit extraction (FUE) is a treatment that extracts hair follicles from one area and places them in another to allow for improved density and natural-looking hair growth. During the procedure, the Doctor will take hair follicles from portions of your scalp that are less affected by hair loss. He can take up to 20% of those donor follicles before they become noticeably thinner. He will then move the follicles to areas of the scalp where you would like thicker hair growth. Depending on the severity of your hair loss, the Doctor can also perform autologous conditioned plasma (ACP) treatments. During an ACP treatment, he will draw a blood sample from you and process it in a centrifuge to extract plasma. He can apply the plasma to your scalp with a thin needle to support the new growth. The results from FUE are long-lasting if you take good care of your scalp, and the follicles will allow new strands of hair to grow as if they had never been disturbed. No new hair will grow in the donor site, but a doctor will carefully harvest your follicles so their absence should not be noticeable. Light therapy (Laser therapy): If using minoxidil every day or taking medication to treat hair loss seems unappealing to you, laser therapy may be an option. Also called low-level laser therapy, a few studies suggest that this may help:
Studies indicate that laser therapy is safe and painless, but requires many treatment sessions. To see a bit of hair growth, you may need several treatments a week for many months.
Platelet-rich plasma (PRP) injection: Injections of protein-rich plasma (PRP) are used to encourage hair growth. Early evidence suggests that injections of platelet-rich plasma may also help reduce hair loss. A plasma-rich injection involves a healthcare professional drawing the person’s blood, separating the platelet-rich plasma from the blood, and injecting it back into the scalp at the affected areas. This helps speed up tissue repair. The entire procedure takes about 10 minutes and usually doesn’t require any downtime. You will need to return for repeat injections. Most patients return once a month for 3 months and then once every 3 to 6 months. Within the first few months of treatment, you may notice that you are losing less or minimal amounts of hair. Studies show that this can be a safe and effective hair loss treatment. It is noted that this therapy reduces hair loss, increases hair density, and increases the diameter of each hair. However, because most studies up until now have been very small, the review calls for more research using platelet-rich plasma for androgenic alopecia. Microneedling: A microneedling device contains hundreds of tiny needles. A few studies have shown that it can help stimulate hair growth. In one study, men between the ages of 20 and 35 years old who had mild or moderate hereditary hair loss were treated with either:
After 12 weeks of treatment, the patients treated with minoxidil and microneedling had significantly more hair growth. Other studies have shown that using microneedling along with another treatment, including platelet-rich plasma or a corticosteroid that you apply to the thinning area, helps improve hair growth. While you can buy a microneedling device without a prescription, it’s best to check with your dermatologist first. Microneedling can worsen some conditions. It’s also important to get the right microneedling device. The devices used for hair loss contain longer needles than those used to treat the skin. Microneedling of the scalp with and without the application of minoxidil can be recommended by the dermatologist as per the need.
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Eat a nutritious diet:
Vitamins, minerals, and other supplements: If your blood test reveals that you’re not getting enough biotin, iron, or zinc, your dermatologist may recommend taking a supplement. If you’re not getting enough protein, your dermatologist can tell you how to boost your intake. You should only take biotin, iron, or zinc when your blood test shows that you have a deficiency. If your levels are normal, taking a supplement can be harmful. For example, if you take too much iron, you can develop iron poisoning. Early signs of this include stomach pain and vomiting. Other supplements meant to help with hair loss tend to contain a lot of one nutrient. Because this can cause you to get too much of the nutrient, many dermatologists recommend taking a multivitamin instead. Iron supplements:
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Lifestyle and home remedies: You might want to try various hair care methods to find one that makes you feel better about how you look. For example, use styling products that add volume, color your hair, and choose a hairstyle that makes a widening part less noticeable. Use wigs or extensions, or shave your head. Talk with a hair stylist for ideas. These approaches can be used to address permanent or temporary hair loss. If your hair loss is due to a medical condition, the cost of a wig might be covered by insurance. |
Wigs and concealers: Do you feel uncomfortable taking medication? Does your schedule limit the amount of time you have for treatment? Is the cost of treatment, which insurance generally will not cover, too expensive? If you answered yes to any of these questions, your dermatologist may recommend a wig or concealer. While these cannot slow hair loss or help you regrow hair, they can boost your self-esteem. Another advantage is that a wig or concealer offers immediate results. Many types of wigs, including ones that can be custom-made for you, are available. If you’re looking for a concealer, such as a spray or powder that can hide hair loss, you’ll find many products available online. With endless choices, it can be helpful to have a dermatologist guide you in selecting one. |
Ways to cope with hair loss: It's also important to address the psychological impact of hair loss. If you've lost your hair, even temporarily, life will be easier if you can accept what's happened and learn to live with your altered appearance. Here are some useful self-help tips:
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Benefits of Treatments for Hair Loss in Women: Hair loss treatments provide several benefits, including:
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Frequently Asked Questions (FAQs): |
How common is hair loss in women? Many people think that hair loss only affects males. However, studies show that more than 50% of females will experience noticeable hair loss. The most significant cause of hair loss in women is female-pattern hair loss (FPHL). This affects about 30 million people in the United States. |
Can hair loss in women be prevented? You can’t prevent all cases of hair loss in women. You can prevent hair loss caused by chemical hair treatments by not using them. You might be able to prevent hair loss by eating nutritious foods that provide necessary nutrients (like vitamins, minerals, and protein) or adding vitamins to your daily routine. |
What is the relationship between hair loss in women and menopause? Your body experiences changes during menopause. This can affect your hair and cause:
These changes happen due to varying levels of hormones during menopause. In addition, your hair follicles shrink. This makes your hair grow finer (thinner). |
What is the outlook/prognosis for hair loss in women? The type and severity of hair loss you experience may determine the outcome (prognosis). Some types of hair loss are permanent, especially if you have damage to your hair follicles. But not all cases are. For example, anagen and telogen shedding may stop with time. Managing any underlying health conditions improves hair loss. Early treatment of alopecia may reduce the speed of thinning and promote regrowth. A healthcare provider can tell you more about what to expect in your situation. |
Who treats hair loss in women? A dermatologist usually treats hair loss in women. |
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When should I see a healthcare provider? Your hair falls out naturally all the time. It’s expected to lose between 50 and 100 hairs a day. That said, you should reach out to a doctor if you notice:
You're likely to first bring your concerns to the attention of your family doctor. He or she may refer you to a doctor who specializes in the treatment of skin problems (dermatologist). See a dermatologist as soon as possible when you notice hair loss. The sooner you get treatment, the more effective it’ll be. |
What questions should I ask my healthcare provider?
For hair loss, some basic questions to ask your doctor include:
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How do dermatologists find out what’s causing hair loss? To pinpoint the cause of your hair loss, a dermatologist begins by gathering information. Your dermatologist will:
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When do dermatologists recommend treatment for hair loss? While your hair may regrow on its own, your dermatologist may recommend treatment to help it grow more quickly. Sometimes, treatment is essential to prevent further hair loss. |
Can I perform treatments for female hair loss on my own? Over-the-counter products like minoxidil for women can be helpful. Still, a thorough evaluation by a professional is essential for achieving the best outcome and identifying underlying causes for lasting results. |
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Are hair transplants for women’s hair loss safe? Yes, hair transplant surgeries are well-tolerated and have helped thousands of women achieve stunning results. |
Will I have scars after treating female pattern baldness? Follicular unit extraction (FUE) does result in some scarring at the donor sites, but these scars are tiny and non-linear. They are often well hidden beneath the surrounding hair. |
Living With: What are some tips for dealing with hair loss? There are some things you can do to manage your hair loss and feel more comfortable, including:
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When can hair regrow on its own? Yes, your hair may regrow on its own. This can happen if you recently:
Sometimes, to see regrowth, you need to make some changes. Changing your hair care (or hairstyle) may help. Some hairstyles and hair care habits can damage hair, leading to hair loss. If your dermatologist finds that this may be causing your hair loss, your dermatologist can recommend changes that will help you stop damaging your hair. |
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Disclaimer: |
We tried to provide authentic and updated information on the subject. This blog is prepared using data compiled from various websites, as mentioned in the blog. The content given in this blog is only for information purposes. The information and materials contained in this blog are not intended to constitute a comprehensive guide concerning all aspects of the therapy, product, or treatment. Information about a therapy, service, product, or treatment does not in any way endorse or support such therapy, service, product, or treatment. It is not intended to serve as medical advice and can not replace medical advice in any form from a doctor or other registered health professional. It is not a legal or medical document. Always keep in mind that the particular medications and their dosages are decided by the health care provider (doctor or specialist) as per the needs of the individual. It varies from one person to another. I am not a health professional, and this blog is not AI-generated, instead, it is manually written. Therefore, I do not take any responsibility (legal or otherwise) for its editing and compiling errors, correctness, completeness, consequences, etc. Before following anything from this blog, it is strongly requested to consult a specialist, doctor, or healthcare provider. Self-medication can be harmful. |
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