What can I really do about... Thinning Hair

First I overheard it: Oh, it's that thing that happens to women in their 40s. What thing?

Then I read it in a magazine: Women start losing their hair in their 40s and 50s. Losing?

Then I noticed on a friend who has the thickest red hair imaginable, but just at the top of her hairline it looked thinner. Then I looked in the mirror…

Yael Halaas, M.D., FACS, a NYC facial plastic surgeon specializing in surgical hair restoration, heaved a sigh of relief. "Women talk about everything," she says. "There's nothing we don't share…but no one talks about hair loss.  Her clients run the gamut but mainly in the 50–60 rage age for women with hair loss issues.

So if you've noticed this happening for you — and it happens to 70% of women — there are a number of options to address it, if that's what you'd like to do.

Dr. Halaas says it's a natural occurrence in most women. But for African-American women, braiding hair really tightly can strain the roots and accelerate hair loss. "A lot of women will benefit from framing the face," Dr Halas explains, referring to grafting hair to the hairline where the first signs of thinning occur.

Grafting using the traditional strip method is anywhere between $4–6 depending upon the number of grafts.  Another technique, called follicular unit extraction (FUE) — more common for men — is a more tedious process, which runs $6–8 per FUE graft.   

A hairline advancement commonly runs about 1200–1600 grafts, so roughly $6,00–8,000. But women with diffuse thinning, which is a thinning of hair all over the head rather than just the hairline, can run from 1,200–1,800 grafts, so $6,000–9,000. The number of grafts per procedure of course depends upon the density and thickness of the hair in the donor area, and the area you're seeking to be covered. This holds true for both men and women.

A procedure can last anywhere from 5-9 hours, depending upon the number of grafts, but after 5 or 6 days you should be fine and can resume your normal daily activities. She also recommends Rogaine for women — a topical solution, but is less enthusiastic about Propecia — the pill is generally not a good choice for women; much more suited to men.

There are some interesting new treatments coming down the pike, too, Dr. Halaas says. PRP: platelet rich plasma — nutrients form your own blood "for healing and growth, and lasers to increase blood flow and protein synthesis" are being used and look promising, she explains. 

Although hair loss can be just part of the aging process, there are nutritional aspects that can accelerate it as well. Dr. Halaas says they have patients get a physical and blood work-up to see what's behind the hair loss.

This is where Philip Kingsley might come in. A renowned trichologist with a reputation as a hair healer for over 50 years, Kingsley is the author of The Hair Bible and coiner of the famous phrase 'bad hair days' — back in the 60s, in case you're wondering. But he's trying to get 'happy hair days' to catch on, "to be more positive," he laughs.

Women are not generally losing hair, Kingsley explains, so much as the hair itself is thinning. Dr. Halaas calls it 'miniaturizing'. 

Hair analysis is required to determine any number of factors, such as thyroid issues or other health inhibitors that are contributing to the problem. A friend of mine discovered she had something called Sjögren's syndrome, which affects moisture-producing glands —dry eyes and mouth — and in some cases, hair.

To see the guru himself is $300, or there are other trichologists in the NYC or London clinics who can help determine both the medical and cosmetic issues relating to your scalp and hair health.

Then a protocol — some combination of supplements, serums and treatments is arrived at to target your specific issues. Nutritional supplements can often help the hair grow faster, if not so much thicker; and the hair quality itself can be improved with treatment.

Hairstylists can help here. Dr. Halaas says they're often the first to notice the problem, but you want to make sure they're not doing any thing to accelerate it.

Wigs, especially good ones like the line Raquel Welch has developed, are growing increasingly popular. And there are stalls with hairpieces and additions in almost every mall these days.

Even adding highlights can help mask thinning hair by deflecting attention and creating dimension.

Michael Todd, a hair specialist at J. Sisters Salon in NYC, agrees. "If I see something that's going on with their hair, I try to talk to them about it gently, so they don't get insulted or alarmed," he says. Todd has recommended clients see a hair transplant specialist, but before they get to that point, there are other options.

"There are new, lighter hairpieces on the market," he says, "that aren't as heavy or cumbersome as a wig." But he's also an expert at applying hair extensions to many of his 50 – 60-year-old clientele, especially since he's tried them on himself first.

"I start with a small amount of extensions to get them used to the feel and care," Todd explains, noting that everyone loses 80–100 hairs per day; people often mistake this for damage from having extensions but it's only the normal shedding process. He also tries to work within a client's budget — a first round often starts at about $300. "They like the feel of them so much, they soon become addicted."