 |
 | ZOTOS HAIR POTHICS FOR FINE,THIN,AND THINNING HAIR |  |  | US $17.99 | 28d 11h 32m |
 | Nioxin System 1 Maintenance Kit for Fine to Thin Hair | | | US $28.99 | 24d 8h 4m |
 | Nioxin Scalp Treatement System 6 Fine Thin Hair 1.4 oz | | | US $17.99 | 20d 4h 34m |
 | NUTRI-OX NUTRI-BASICS THINNING HAIR SERUM / FINE THIN | | | US $29.99 | 11d 4h 22m |
| Powered by phpBay Pro |
|
No items matching your keywords were found.
Fine Thin Hair
What are some good haircuts for a heart shaped head and black thin fine hair?
If you had any ideas or haircuts for a black thin fine faired heart shaped head, could you sent the pics to me? i'm looking for a new hairstyle since im bored with my long hair, and due to a craZy punk hairstylist my bangs are now up to my eyebrows instead of my chest, so take taht into consideration, Thanks!!
im a girl, and blahblahblahblah
try http://www.hairstyles.com or haircuts.com or homebeautytips.com
|
| ZOTOS HAIR POTHICS FOR FINE,THIN,AND THINNING HAIR | | | US $17.99 | 28d 11h 32m |
| Nioxin System 1 Maintenance Kit for Fine to Thin Hair | | | US $28.99 | 24d 8h 4m |
| Nioxin Scalp Treatement System 6 Fine Thin Hair 1.4 oz | | | US $17.99 | 20d 4h 34m |
| NUTRI-OX NUTRI-BASICS THINNING HAIR SERUM / FINE THIN | | | US $29.99 | 11d 4h 22m |
| Powered by phpBay Pro |
|
No items matching your keywords were found.
|
No items matching your keywords were found.
| | Apple Ginseng Volumizing Conditioner For Thin Fine Hair 325ml/11oz by Back To Basics $32.47 Apple Ginseng Volumizing Conditioner ( For Thin Fine Hair ). Product Line: Back To Basics Hair Care. Product Size: 325ml/11oz |
| | Serious Volume Conditioner For Fine/ Thin Hair 250ml/8.4oz by Jonathan Product $41.65 A 100 vegan conditioner Loaded with proteins botanicals for reinforcing conditioning Provides your fine lifeless hair with body Plus UV Filters for protection Enhances nourishment without adding weight Best for outofcontrol hair that needs body controlling. Product Line: Jonathan Product Hair Care. Product Size: 250ml/8.4oz |
| | Fashion Thin Sequined Bow Headband Hair Hoop Black $3.99 This is a Black Fashion Thin Sequined Bow Hair Hoop, fine workmanship and fashion shape, shining, make you more charming. It's comfortable and easy to wear. The hair hoop is perfect gift for you or friends. |
| | Fashion Crystal Wide Sequined Bow Hair Thin Edge Hoop Headband $4.99 This is a Fashion Crystal Wide Sequined Bow Hair Thin Edge Hoop, fine workmanship and fashion shape, shining, make you more charming. It's comfortable and easy to wear. The hair hoop is perfect gift for you or friends. |
| | Thin-to-Thick Hair Thickening Conditioner 8 fl oz: K $10.3 Step 2: The Pro-Vitamin Thin-to-Thick™ Hair Thickening Conditioner: Your hair and scalp are aggressed by an increasingly more hazardous environment and this super revitalizing conditioner provides them with precisely the type of complete nutritional, environmental and UV protection you need. Reinforces and strengthens weak, chemically processed hair, by infusing amino acids into the hair cortex. Your hair and scalp are ravaged by an increasingly hazardous environment and this revitalizing conditioner provides your hair with precisely the type of complete environmental and UV protection it needs. It reinforces and strengthens the weak, fine, and chemically-processed hair, by infusing 22 Amino Acids into the hair cortex, filling in missing protein links. Our conditioner smoothes down cuticles, mends split ends, and helps prevent and correct and prevent further damage. Jason's exclusive hydrating complex, Planthenol-3, Aloe Vera plus hair-loving proteins and seaweed extracts, thicken hair fibers by at least 10%; with better results when used after Thin-to-Thick Natural Hair Thickening Shampoo. This conditioner restructures and retextures hair, giving it great shine, manageability, and a thickness and body that you can feel. Detangles your hair for dry and wet combing. Keeps hair shiny and clean longer. Improves manageability, and gives fine, limp hair extraordinary volume, and dull, dry, brittle hair softness and luster. |
| | Thin-to-Thick Body Building Hair Spray 8 fl oz: K $10.3 Step 3: The Pro-Vitamin Thin-to-Thick™ Body Building Hair Spray: A unique and natural formula, this hair spray is a styling aid as well as a treatment ideal for all hair types. Thin, fragile and weak hair will not become dry or brittle with continued use. Protects hair against environmental pollutants, UV rays, and humidity. Long-lasting hold for even the most demanding styles. Thin-To-Thick Hair & Scalp Therapy. Super styling control, all day hold, shine & protection. Created with a unique and natural formula, this hair spray is a styling aid as well as a treatment ideal for all hair. Thin, fragile and weak hair will not become dry or brittle with continued use. This body building and conditioning formula contains Jason's exclusive Planthenol-3 Complex to bind moisture to the hair shaft, while Whole Wheat Proteins and 22 Keratin Amino Acids reinforce and thicken hair fiber and smooth down hair cuticles. Thin-to -Thick Hair Spray protects hair against environmental pollutants, UV rays and humidity to provide maximum and lasting hold. Provides lift and support even to very fine, limp, hard-to-manage hair. Leaves hair full-bodied, shiny and bouncy. Because of its supple texture, hair remains soft to the touch and can be re-applied without hair becoming stiff, sticky or flaky. At the end of the day, your hair can be combed out effortlessly, without risk of damaging hair fiber. For best results, use with Thin-to-Thick Shampoo, Conditioner and Scalp Elixir. Non-aerosol. |
| | RevitaLash Hair $180 Hair by Revitalash is a unique hair conditioner that fortifies and strengthens hair so it appears thicker, fuller and healthier. This remarkable cosmetic breakthrough can enhance the appearance of fine, thin and fragile looking hair in a matter of weeks. Packed with conditioning agents like Ginko Biloba, Ginseng Root, Japonica, fruit extracts and wheat proteins, Hair by Revitalash is revitalizing and easy to use. Directions: After cleansing hair with shampoo, pump one or two pumps into the palm of your hand. Massage the product into the hair in those areas where you want the hair to appear thicker and fuller. Do not rinse hair. Dries in about one minute. Use any styling products that you wish. It is important to be consistent and use it daily. Net Weight: 46 ml/1.57 oz. Ingredients: Water, Acrylates Copolymer, Ginko Biloba Leaf Extract, Panax Ginseng Root Extract, Propylene Glycol, Swertia Japonica Extract, Serenoa Serrulata Fruit Extract, Hydrolyzed Wheat Protein, Trifluoromethyl Dechloro Ethylprostenolamide, Glycerin, Disodium, EDTA, Aminomethyl Propanol, Chlorphenesin, Biotin, Panthenol, Sodium Cocoyl Glutamate, Polysorbate 20, Phenoxyethanol, Fragrance. |
| | VOLUMIZING SHAMPOO FOR FINE & TONELESS HAIR $25 VOLUMIZING SHAMPOO FOR FINE & TONELESS HAIR |
| | PureStrength Strengthening Conditioner -Fine Hair $25 PureStrength Strengthening Conditioner -Fine Hair |
| | Hair Thickening Shampoo and Conditioner $19.99 Thicker, longer hair can be yours. Shampoo and conditioner contains amino acids, vitamin B and soy protein to stimulate hair growth and make it more manageable. Provides great results for individuals with thin or fine hair. Includes 1 each 3-fl oz. bottle of shampoo and conditioner. |
| | FOLICURE Flexible Hold Hair Spray for Fuller, Thicker Hair Strengthens Fine or Thinning Hair Adds Control & Fullness, Long Lasting Hold, Incredible Shine & Prot $9.17 The Folicure System promotes a clean scalp and fuller, thicker looking hair with scientific formulas specially developed for fine or thinning hair. Folicure treatment, shampoos, conditioners and styling products may be used individually or in conjunction with one another for maximum benefits. Fine, thin or limp hair requires a lightweight but body-building hair spray. Folicure Flexible Hold Hair Spray holds all day and protcts delicate hair from sun damage and airborne pollutants. This formula is quick-drying, non-sticky and adds a beautiful shine to hair. It washes cleanly from the hair without residue. |
| | Natural Volumizing Shampoo for Fine Hair 12 fl oz: K $6.29 Use this shampoo if your hair is thin or limp and you want to add body & texture. It is exceptionally mild and can be used on baby-fine hair daily without drying or causing breakage. It is fortified with neutral henna, aloe vera, collagen protein and jojoba -- natural ingredients which add body-building life to fine hair. pH balanced at 7.0. These products are plant based, low detergent, naturally pH balanced, extra gentle and leave incredible shine and manageability. The secret is nature's own natural soap-free cleanser, wildcrafted shikakai. Our special ''ShiKai Extract'' is the primary sudsing agent and provides rich gentle cleansing so we can use less detergent and bring you these gentler shampoos. A blend of Aloe Vera and Panthenol provides extra moisturizing and conditioning. |
| | Leonor Greyl Bain Volumateur Aux Algues (For fine or limp hair) $41 Volumizing shampoo for thin and limp hair. Volumizing shampoo with a conditioning effect. Gives bounce and body. It is recommended to apply a styling product: STRUCTURE NATURELLE SPRAY to improve the volume. Washes gently. Leonor Greyl Bain Volumateur Aux Algues Gives volume. Detangles without weighing the hair down. Gives shine Directions: Apply Leonor Greyl Bain Volumateur Aux Algues as a shampoo in a small quantity (5ml) leave it on at least 1 minute before rinsing it thoroughly. A second application is recommended. Net Weight: 7oz. Ingredients: Seaweed, Oligo elements, Wheat protein |
| | Fine Hair Strengthening Set - Warren-Tricomi $93.95 Fine Hair Strengthening Set - Warren-Tricomi |
| | Strengthening Shampoo - Fine Hair - Warren-Tricomi $22.5 Strengthening Shampoo - Fine Hair - Warren-Tricomi |
| | Innova Hydrate Shampoo For Normal to Fine Hair 300ml $28.96 Innova Hydrate Shampoo ( For Normal to Fine Hair )Product Line: Indola Hair CareProduct Size: 300ml |
| | NuHair Hair Regrowth for Men 60 tablets: K $35.99 America's #1 Selling Natural Supplement for Hair Loss The Natural Solution for Hair Loss Thickens Hair Naturally Energizes Follicular Growth Provides Intensive Nourishment Safe, Effective and Drug Free Dietary Supplement How NuHair Work: NuHair is a natural nutrients booster for fine and thinning hair. It energizes the scalp and nourishes the hair shaft to help produce stronger, thicker hair. Provides Intensive Nourishment for: Receding Hairlines Poor Hair Density Excessively Thinning Hair Breakage Around the Hairline Fact: Age-related hair loss affects 80% of American men. The good new is this form of hair lass is gradual, so the sooner treatment is started, the better the chances of slowing the hair loss process... and keeping the hair you have! For best results: Use the complete 3-step system, including Hair regrowth for Men, DHT Blocker and the Thinning Hair Serum. 1 Step One Support Thickens hair naturally Energizes follicular growth Provides intensive nourishment Safe and effective 2 Step Two Block Help block negative effects of DHT Support hair regrowth from inside out Result is thicker, stronger, healthier hair 3 Step Three Nourish Delivers vital nutrients to nourish the scalp Strengthens thin, lifeless hair Helps restore shine and fullness |
| | Hair Volumizing Treatment For Thinning or Fine Hair 125ml/4.25oz by Therapyg $47.97 An efficacious treatment for thinning or fine hair Developed with a complex of proteins vitamins botanicals Imparts Tryptobond Guard to individual shafts of hair Helps shield hair from sun exposure damage including breakage styling stress color changes Reinforces hydrates hair shaft corrects hair texture Unveils thicker fuller more resilient hair To use: Apply onto towel dried hair. Leave on style as wanted. Product Line: Therapy g Hair Care. Product Size: 125ml/4.25oz |
| | Thin-to-Thick Revitalizing Scalp Elixir 2 fl oz: K $10.3 Step 4: The Incredible Thin-to-Thick™ Revitalizing Scalp Elixir: This revitalizing, preventative and corrective elixir purifies and energizes the scalp. Helps free hair follicles of debris which inhibit hair growth. Revitalizing Scalp Elixir. Natural & Revitalizing Scalp Elixir. Active plant extracts help stimulate micro-circulation to provide the hair bulb with vital nutrients. With Biotin, Folic Acid, Inositol, Cysteine, (all essential to healthy hair growth), and Hydrolyzed Proteins, it helps control thinning hair, excess hair loss, and greatly strengthens fine and limp hair. All Natural. |
| | Organic Hair Care Root 66 Max Volume Enriched with Certified Organic Botanicals Shampoo 8.5 fl oz: K $7.15 Increases volume in limp, lifeless hair, cleans and adds weightless bounce, stregthens thin, fragile hair, protects fine hair from damage while building body, and has zero sulfates. |
 | Oxo Stainless Steel Strainer, Double Rod |
Description6 strainer is 14 in overall length, with a2-1/2 deep bowl. 8 strainer is 16 in overall length, with a 3-1/2 deep bowl. 6 and 8 indicate diameters including the outer rim of the bowl.Available in 6 and 8 sizes, the Oxo Good Grips strainers feature fine mesh for straining vegetables, berries, pasta and more... |
 | Revlon RV484 Ion 1875 Watt Hair Dryer List Price: |
DescriptionLightweight, Super Quiet, Fast DryCeramic Technology: High, even heat for shinier, healthier -looking hair Ionic Technology Helps dry hair fast while retaining moisture and reducing "frizz" 3 heat / 2 speed settings for complete drying and styling flexibilty Removable end cap for eay cleaning Concentrator attachment for precise drying and styling Cold Shot Button releases cool air for setting the style Bonus Volumizing Finger Diffuser gently dries hair without blowing out the style Hanging ring for convenient storage Two-year limited warrantyThe Ionic® Pro Stylist™ Anti-Static Dryer uses a patented ion air delivery system to dry hair fast... |
 | Mars Coat King Stripping Comb Medium List Price: |
DescriptionMars Coat King Stipping Combs The Coat-King has been tested by well-known groomers, all of whom named it an indispensable tool. Use to trim out the undercoat, remove the dead hair, unravel and demat the coat... |
 | Nioxin Cleanser, System 2 (Fine/Untreated/Noticeably Thinning ) |
DescriptionNioxin Cleanser System 2,for fine,non chemically enhanced hair that is noticebly thinning-gently cleanses and removes toxins like DHT,adds thickness and strenghtens the hair shaft.Bionutrients and Active Renewal helps provide a more youthful looking scalp cpmplextion... |
 | Nit Free Terminator Lice Comb, Professional Stainless Steel Louse and Nit Comb for Head Lice Treatment, Removes Nits |
DescriptionNit Free TERMINATOR Comb is the ultimate Tool to fight Head Lice and their eggs (nits). ANTI-SLIP BANDS allow for better gripping and control. ADVANCED LASER TECHNOLOGY welding make the comb sturdy and long-lasting... |
 | MoroccanOil Intense Curl Cream, 10.2-Ounce Bottle List Price: |
DescriptionWater, Mineral Oil, Cetyl Alcohol, Polyquatermium-7, Gel Y Ceryl Stearate, Dimethicone, Argania Spinoza Kernel Oil (Aragon oil), Petrolatum, Cetrimonium Chloride, Tocopheryl Acetate, Panthenol, Fragrance (Supplement), Propylparaben, Methylparaben, Citric |
 | 1875W Fine Hair Ion Dryer List Price: |
DescriptionVidal Sassoon Answers For Fine Hair - 1875 Watt Ion Select Dryer. Patented ION SELECT Dial customizes ion output to exact level needed for elminating frizz and maintaining maximum volume. 2 heats and speeds for varying hair thickness... |
 | Scunci No-slip Grip 2-strand Plastic Split Headband, Colors may vary List Price: |
DescriptionDream | Imagine | Create™No-Slip Grip™ All Day HoldU.S. and International Patents Pending800 - 3 - CONAIR or visit scunci.comMade in China |
 | hairdo. BANG from Jessica Simpson and Ken Paves 1 ea |
DescriptionCreate your favorite bangs look with the Tru2LifeTM fiber clip in bangs from hairdo®. Ready to cut, curl, and wear any way you want. Your options are limitless. Wear it as your favorite style bangs or add lift and volume to the crown of your head... |
 | 909 Men's Cow Hide Leather Money Clip Card Holder |
Styling Fine Hair by Julien Farel
Densitometry and Video-Microscopy in the Hair Transplant Evaluation
Densitometry is a technique that analyzes the scalp under high-power magnification to give information on hair density, follicular unit composition and degree of miniaturization. It can be used to help evaluate a patient's candidacy for hair transplantation and help predict future hair loss. More recently, video-microscopes have been developed that can project the image onto a computer screen and provide a permanent digital record. This paper describes the value of taking objective measurements, using densitometry or video-microscopy, in the hair transplant evaluation.
Background
One of the earliest methods of measuring hair density was devised by Bouhanna, who used camera attachments to create a "phototrichogram," an ultra close-up photograph of hair exiting the scalp. This method provided the capability to document the quality and quantity of hair shafts. However, the disadvantage of this innovation was that an assessment could not be done until after the film had been developed. [1]
In 1993, Rassman introduced a small hand-held instrument, the Hair Densitometer, to make densitometry easy to perform during a consultation. [2, 3]. The hair densitometer is a self-contained, portable, device that houses a magnifying lens and an opening of predetermined size. The hair is clipped short (~ 1-mm) and the unit is placed directly on the scalp. An assessment is made from a standard 10mm2 field. Multiple measurements taken from different parts of the scalp are often helpful, particularly if there is significant variability from one location to another. [4] An advantage of the hand-held densitometer is that it is inexpensive and readily available to be used during the consultation and can provide immediate information regarding a patient's candidacy for surgery.
A number of other hand-held instruments to measure density have been developed with the similar basic elements of magnification, illumination and a calibrated field or ruler. With more recent technology, digital trichograms allow the physician to take quantitative measurements of hair shaft diameters and provide an immediate, permanent record of this information. [5-7]
The densitometer was initially used to quantify a patient's donor density, to estimate the total number of grafts that could be safely obtained from the donor area, and help predict the change in reserves over subsequent transplant sessions. [3] With the introduction of Follicular Unit Transplantation in 1995, these authors began to use densitometry to assess follicular unit composition (the number of terminal and miniaturized hairs that each individual unit contained) and follicular unit density (the spacing between units), as these additional factors were found to be important in the assessment of the donor supply and in the overall surgical planning of follicular unit transplantation procedures. [8-10]. The use of densitometry was soon expanded to guide the surgical treatment of those with racially distinct hair characteristics, to improve the diagnosis and treatment of balding women, and to further define the conditions of diffuse patterned and un-patterned hair loss. [10-12]
A number of other hand-held instruments to measure density have been developed with the similar basic elements of magnification, illumination and a calibrated field or ruler. With more recent technology, digital trichograms allow the physician to take quantitative measurements of hair shaft diameters and provide an immediate, permanent record of this information. [5-7] [Figure 2]
The densitometer was initially used to quantify a patient's donor density, to estimate the total number of grafts that could be safely obtained from the donor area, and help predict the change in reserves over subsequent transplant sessions. [3] With the introduction of Follicular Unit Transplantation in 1995, these authors began to use densitometry to assess follicular unit composition (the number of terminal and miniaturized hairs that each individual unit contained) and follicular unit density (the spacing between units), as these additional factors were found to be important in the assessment of the donor supply and in the overall surgical planning of follicular unit transplantation procedures. [8-10]. The use of densitometry was soon expanded to guide the surgical treatment of those with racially distinct hair characteristics, to improve the diagnosis and treatment of balding women, and to further define the conditions of diffuse patterned and un-patterned hair loss. [10-12]
Miniaturization
Normally, follicular units contain 1-4 terminal hairs of uniform diameter and, occasionally, fine vellous hairs, with the two hair populations being clinically distinct. In androgenetic hair loss, the action of DHT causes individual terminal hairs in some follicular units to miniaturize, where they begin to decrease in diameter and in length until they resemble vellous hairs. Eventually, these hairs will disappear. In androgenetic alopecia, hairs in varying stages of involution (and thus of varying diameters) cause these two distinct populations of hairs to merge into one continuum. The changes eventually cause visible thinning in affected areas, but may initially be detectable only through densitometry.
At first, miniaturization involves only one or two hairs in select follicular units, but eventually progresses to involve all the hair follicles in genetically susceptible areas. It has been the observation of these authors that a shift from focal to generalized miniaturization precedes the actual loss of affected hairs, so that total hair counts remain relatively constant until end-stage baldness. [8] Said another way, the progressive thinning associated with androgenetic hair loss (particularly in the early stages) is caused by a decrease in the hair shaft diameter of an increasingly larger number of hairs, rather than by the actual loss of individual hair follicles.
Miniaturization, unfortunately, can also occur in the back and sides of the scalp. When it affects a person's donor area, it will have profound implications for surgery. Although miniaturization in the donor area is a relatively uncommon occurrence in men, it is quite common in women, explaining why so many more men with hair loss are candidates for surgery compared to women. In all cases, donor miniaturization must be assessed prior to considering surgery.
Densitometry Measurements
Densitometry is extremely helpful in evaluating patients for hair transplantation. When determining which persons are candidates for hair transplantation, it can be used to measure the absolute donor hair density (i.e. # of hairs/mm2), the composition of follicular units (i.e. the number of 1-, 2-, 3- and 4-hair units), and the degree of miniaturization.
Although the precise hair density and composition of follicular units will not be known until after the donor strip has been completely dissected, at the time of the consultation, densitometry can tell the doctor the approximate hair density. This will enable him to determine how much hair will be obtained from a certain size strip or how large a strip will be needed for a required number of follicular unit grafts.
Densitometry will also give information regarding the cosmetic impact of the hair restoration. Other hair characteristics being equal, if a person has a high number of 3- and 4-hair grafts, he/she would be expected to have a fuller hair transplant than a person with predominately 1- and 2-hair follicular units.
For example, a typical Caucasian would have follicular units in his/her donor area that contained, on average, 2.25 hairs each. If there were 1 follicular unit per mm2 in the donor area (0.9 to 1.0 is normal) then one would need 2,500mm2 of donor tissue for a 2,500 graft procedure. A donor strip that was 1cm wide would need to be approximately 25cm long to contain 2,500 follicular unit grafts. See the following table.
Stereo-microscopic dissection of the donor strip would yield approximately 14% 1-hair grafts, 53% 2-hair grafts and 33% 3- and 4-hair grafts. The single-hair grafts would be used to create a soft, natural frontal hairline and the 3- and 4-hair grafts would be used in the forelock area to create the appearance of central density.
Small variations in follicular unit density can have a significant impact on the procedure. A person of similar hair shaft characteristics (i.e. hair diameter, color and wave) that had 2.0 hairs per follicular unit, also spaced 1mm apart, would require exactly the same size strip for a 2,500 graft procedure. In this case, however, the follicular units would, on average, have less cosmetic value and the person should expect a thinner look from the surgery as only 17% of the grafts contain 3- or 4- hairs. In addition, the ability to create central density via graft sorting would be reduced. On the other hand, with a donor density of 2.4 hairs per unit, 40% of the grafts will contain 3- or 4-hairs and the ability of the surgeon to create density in the forelock area using only naturally occurring follicular unit will be significant
If we look at the total number of hairs contained in the follicular units, we note that for a 2,500 graft procedure, a person with 2.4 hairs per follicular unit will have 1,000 more hairs than a person with a density of 2.0.
Densitometry, therefore, gives the physician information regarding the number of single hair units that can be anticipated from a given size donor strip (without having to subdivide larger units) and the degree to which the larger follicular units can create central and forward weighting to enhance the aesthetic impact of the procedure.
Donor Miniaturization
Normally, the donor area shows little or no miniaturization and the density counts described above are useful in predicting both the short- and long-term outcome of the procedure. However, if genetic hair loss affects the donor area, the situation changes dramatically. Once full-thickness terminal hair begins to miniaturize, the cosmetic value of the follicular unit begins to decrease and the value of the grafts will be diminished. In other words, just because hair is transplanted, it doesn't make the hair transplant permanent - the hair in the donor area must be permanent.
Early detection of miniaturization in the donor area is a warning sign that the donor area is not stable and that the person may not be a good candidate for surgical hair restoration. If any miniaturization is detected in a young person, i.e. under the age of 25, red flags should go up that their donor area may not be stable. When miniaturization is noted in a teenager, the risk of developing diffuse un-patterned hair loss (see below) is significant. In an older adult male, some miniaturization, perhaps up to 20%, is consistent with being a good surgical candidate.
Unlike men, adult women often have significant levels of miniaturization in the donor area, so the mere presence of miniaturization is not necessarily a contraindication to surgery. However, miniaturization does indicate an unstable donor supply and one has to make a judgment regarding the risk/reward of the procedure. The physician needs to consider the absolute number of full terminal hairs that are available for the hair transplant, the risk of further miniaturization, the area that needs to be covered, and the risk of the surgery accelerating the hair loss. This is particularly important to consider in women, since hair is often transplanted into an area that has a considerable amount of existing hair - some of which is at risk of being shed from the surgery.
In women, when the risk of continued miniaturization of the donor area is added to the risk of the surgery accelerating hair loss in the area to be transplanted, a far fewer percentage of women are good candidates for surgery compared to men. To think otherwise is disingenuous.
Diffuse Patterned and Un-patterned Alopecia
The importance of donor miniaturization as a factor affecting a person's candidacy for a hair transplant was emphasized almost a decade ago in the paper "Follicular Transplantation: Patient Evaluation and Surgical Planning."[4] In this writing, we described two conditions; "Diffuse Patterned Alopecia" (DPA) and "Diffuse Un-patterned Alopecia" (DUPA). These were first mentioned by O'tar Norwood when he devised the classification of androgenetic alopeica that bears his name. These two conditions, however, were not detailed in his paper and never received much attention. This was unfortunate because their understanding gives important insights into how to determine who will be a candidate for hair restoration surgery. [5]
Diffuse Patterned Alopecia (DPA) is characterized by diffuse thinning (miniaturization) in the front, top, and vertex of the scalp in conjunction with a stable permanent zone. DPA is usually associated with the persistence of the frontal hairline and, in the early stages, the thinning is relatively even across the top of the scalp. This contrasts with regular Norwood patients that have early hair loss at the temples and in the crown with balding that spares the top of the scalp. Patients with DPA can be good candidates for hair transplantation due to their stable permanent zone; however, they have an increase risk of shedding after the hair transplant, due to the diffuse miniaturization across the top of the scalp.
In the less common Diffuse Un-patterned Alopecia (DUPA), the miniaturization process occurs over the entire scalp, so that the person lacks a stable permanent zone. People with DUPA tend to lose their hair at an early age, often beginning in their teens. In the early stages, there may be only a slight suggestion of decreased hair volume overall and actual thinning may only be noted through densitometry. Over time, the back and sides of the scalp can take on a transparent appearance, particularly when the hair is cut short. Because the donor area is not permanent, hair transplantation is contra-indicated in patients with Diffuse Un-patterned Alopecia.
Although fully manifest diffuse un-patterned hair loss is relatively uncommon in men, there are many younger patients who have slightly increased degrees of miniaturization in the back and sides of the scalp, making the long-term stability of the donor area questionable. In these patients, the decision to recommend hair restoration surgery is particularly difficult. As a general rule, if the decision is difficult, it is best postponed, since, over time, the stability of the donor area will become more obvious. A mistake can leave the patient with transplanted hair that will thin over time and a donor scar(s) that may become visible.
Both Diffuse Patterned and Un-patterned alopecia also occur in women. However, in contrast to men, the DUPA pattern in women is much more common, possibly occurring 10 times as frequently as DPA. As in men, female patients with DUPA are not good candidates for a transplant, except in the instance where the goal is solely to soften the frontal edge of a hairpiece. The high incidence of Diffuse Un-patterned Alopecia in women partly explains why many fewer women are good candidates for hair transplantation as compared to men.
It is important to emphasize that other, non-genetic, causes of hair loss must be considered in cases where the balding pattern is diffuse. These include anemia, thyroid disease, connective tissue disease, gynecological conditions, severe emotional events, and medications. Although the presence of miniaturization likely points toward a hereditary cause of the hair loss, with diffuse hair loss other etiologies must always be entertained.
Conclusion
Densitometry is an important tool for the evaluation of hair loss and for assessing candidacy for hair transplantation. Measuring donor density and assessing the degree of miniaturization in the donor area should be an integral part of the evaluation of every patient in which surgical hair restoration is considered. This will enable physicians to better select those who are good candidates for a hair transplant and help identify those patients in whom the procedure is contraindicated. For patients having a hair transplant, these measurements will enable the physician to better estimate the size of the donor strip and be better able to anticipate the aesthetic outcome of the hair restoration procedure.
References
1. Bouhanna P: Phototrichogram: a technique for the objective evaluation of the diagnosis and course of diffuse alopecia. In W Montagna et al. (eds). Hair and Aesthetic Medicine. Roma, Salus Ed. 1983: 277-280.
2. Rassman WR, Pomerantz, MA. The art and science of mini-grafting. Int J Aesthet Rest Surg 1993; 1:27-36.
3. Rassman WR, Carson S. Micro-grafting in extensive quantities; the ideal hair restoration procedure. Dermatol Surg 1995; 21:306-311.
4. Bernstein RM, Rassman WR, Seager D, Shapiro R, et al. Standardizing the classification and description of follicular unit transplantation and mini-micro-grafting techniques. Dermatol Surg 1998; 24: 957-63.
5. Stough DB, Haber RS. Hair Replacement: Surgical and Medical. St. Louis: Mosby-Year Book, Inc., 1996: 139-140.
6. Van Neste D, Dumortier M, De Coster W: Phototrichogram analysis: technical aspects and problems in relation to automated quantitative evaluation of hair growth by computer assisted image analysis. In Van Neste D, Lachapelle JM, Antoine JL (eds). Trends in Human Hair Growth and Alopecia Research. Dordrecht, Kluwer Acad. Pub, 1989: 155-165.
7. Hayashi S, Hiyamoto I, Takeda K: Measurement of human hair growth by optical microscopy and image analysis. Br J Dermatol 1991; 125:123-129.
8. Bernstein RM , Rassman WR, Szaniawski W, Halperin A: Follicular Transplantation. Intl J Aesthetic Restorative Surgery 1995; 3: 119-32.
9. Bernstein RM, Rassman WR: The logic of follicular unit transplantation. Dermatologic Clinics 1999; 17 (2): 277-95.
10. Bernstein RM, Rassman WR: Follicular Transplantation: Patient Evaluation and Surgical Planning. Dermatol Surg 1997; 23: 771-84.
11. Bernstein RM, Rassman WR: The Aesthetics of Follicular Transplantation. Dermatol Surg 1997; 23: 785-99.
12. Norwood OT. Male pattern baldness: classification and incidence. So. Med. J 1975; 68:1359-1365.
About the Author
Dr. Bernstein is Clinical Professor of Dermatology at Columbia University in New York. Dr. Bernstein's hair restoration center in Manhattan is devoted to the treatment of hair loss using his state-of-the-art hair transplant techniques. To read more publications on hair loss, visit http://www.bernsteinmedical.com/.
Posted in 
Tags: 
Hair Styles for Thin, Fine Hair