Oh, look! There’s Gwyneth Paltrow on Instagram, sitting in a plastic surgeon’s office with a smile on her face and a gizmo aimed at her head. It’s a device that emits ultrasound vibrations, pushing a serum into the hair follicles to make them more robust. I’m right there with her.
Not literally, but close. Because I had the same gizmo pressed to my scalp by the same plastic surgeon, Dr. Ben Paul. I smiled too, but not quite as radiantly.
The machine, called TED, helps people regrow hair, and it couldn’t enter my life soon enough. As I sat under its painless vibrating tip, I alerted my group chat to run immediately to the doctor’s office.
The sky is falling, and so is our hair. Spend five minutes on Instagram and you’ll become convinced that we’re in the middle of a balding epidemic.
I was hoping that this flurry of news had made me a hypochondriac. It turns out the issue is not my imagination; my hair is actually disappearing before my eyes. “I don’t think people really imagine their hair loss,” says Dr. Marc Avram, a dermatologist in New York who’s a leading expert in the field. “If anything, it’s sometimes denial.” Well, that’s a pity.
To approach this in a glass-half-full way, Dr. Paul tells me I’m a good candidate for one of the many hair-restoring treatments that seem to outnumber the strands on my head.
Dr. Paul specializes in hair loss and rhinoplasty. If he wanted to, he says, he could spend 100 percent of his time on hair patients. And he would, “but I love, love, love facial plastic surgery.”
Doesn’t everyone? Hair loss is less sexy but no less urgent. And yet people tend to avoid addressing it, with women often going years without seeing a doctor, says Dr. Avram. “It’s very common for someone to come in and say, ‘You may think I’m crazy, but I know my hair is not as thick as it was a year ago. It dries quicker, and there’s not as much density. I just figured it was going to go away.’ If you think your hair is thinning, it’s thinning. You need to lose about 40 to 50 percent of your hair for it to become cosmetically apparent. If it’s female pattern hair loss, chances are it’s been going on for months or years.”
For centuries, there wasn’t much you could do about hair loss other than buy a hat and a wig. “It’s much more psychologically important for females,” says Dr. Paul. As evidence, he points to the slightly cringe term “looksmaxxing.”
In every fairytale, Greek myth, and painting, long, abundant hair is the ideal. Barbie has it. So does Botticelli’s Venus. When Chris Rock joked about Jada Pinkett Smith’s bald pate, we all watched Will Smith’s reaction, the slap that destroyed his own career in the process.
Now that there are multiple treatments to address the situation, people are less ashamed and more open about hair loss. “We have oral minoxidil, PRP, home lasers, and in-office lasers,” says Dr. Avram. “We regularly perform hair transplant surgery for women.” This doesn’t include the jillions of supplements, shampoos, and elixirs on the market. “If the person had come when they first noticed it, they never would have gotten to a point where it was cosmetically evident to anyone.”
The most common medical cause for hair loss among women is hyper- or hypothyroidism. Iron and other nutritional deficiencies—especially resulting from Ozempic and other GLP-1 drugs—can trigger shedding. So can emotional trauma or physical stress from COVID and childbirth. Most of this hair loss reverses itself, usually about nine months after its onset.
For many women, though, the cause is female pattern hair loss, where the hairline is intact but there are fewer hairs on the crown, “so it becomes more see-through,” says Dr. Avram. Many treatments aim to stop the fallout and encourage regrowth.
Maybe hair shouldn’t be important, and maybe it isn’t worth all this attention and angst. But there’s no denying that losing it chips away at self-esteem. One scientific study found that 52 percent of women ranked the emotional stress from losing their hair as “very-to-extremely upsetting.” They also reported increases in social anxiety, negative body image, and a sense of powerlessness. And 75 percent displayed signs of a personality disorder. In another study, sexual function—desire, arousal, orgasm, and satisfaction—was compromised as a result of hair loss. “Women will come in and say to me, ‘Dr. Avram, I know this is not breast cancer. I know this is not Alzheimer’s. But it really bothers me.’”
Minoxidil, PRP, and Prescription Serums
Doctors often start a patient with topical minoxidil, but some women find it too sticky and greasy. Low-dose oral minoxidil gained popularity about three years ago as a simple, effective, inexpensive alternative. Women who take it sometimes grow hair on their cheeks and chin, but that’s easily managed with a few flicks of a Japanese razor or a Dermaflash machine.
A more elaborate treatment is platelet-rich plasma (PRP), in which a doctor injects PRP into the scalp to send a message to the hair follicles to grow longer and thicker. A painless alternative is the TED machine. Dr. Paul applies a serum containing dutasteride, a derivative of finasteride, the proven hair-stimulating drug. “On its own, it doesn’t penetrate the scalp. But the device pushes the medicine through the scalp, and it can then take those miniaturized hairs and help them grow thick again.” Doctors generally recommend PRP or TED treatments once a month for three months, eventually shifting to every six to nine months.
Lasers and LED Light
FoLix, a fractional laser machine, stimulates blood flow to the scalp that, in turn, delivers nutrients to the hair follicles. Dr. Avram is a believer, but doesn’t think it’s necessarily more effective at encouraging hair growth than an at-home red-light cap. “No one, as far as I know, has done a side-by-side comparison study of them.”
There’s no harm in piling on the treatments. “You could do minoxidil with a laser cap—that would be synergistic,” says Dr. Avram. “Minoxidil with PRP would be synergistic. The key thing is to do one thing regularly, but if you can combine it with two, it’s even more likely to work.”
Supplements
All those hair growth vitamins on TikTok may not be transformative, but they can provide a little extra insurance. “If someone has a disease where nutrition absorption through the GI tract may not be optimal, one of the side effects can be thinning hair,” says Dr. Avram. “Some kind of multivitamin supplement is a good thing to do, especially if you’re taking an Ozempic-like drug. But if you’re in good health with a regular menstrual cycle, no thyroid issues, no iron issues, and your weight is stable, then there’s no evidence that nutritional supplements will help hair growth.”
So far, “Nutrafol is winning the vitamin war,” says Dr. Paul. “The worst vitamin for hair is biotin. There’s so much data that it does nothing.” And it’s been shown to interfere with the detection of thyroid disease and heart attacks.
Shampoos and Serums
Since you’re washing your hair anyway, you might as well use a shampoo designed to create an optimal environment for healthy hair. Small scientific studies report that caffeine and adenosine can stimulate the hair follicles.
The Hårklinikken system from Copenhagen has attracted its share of high-profile fans. It requires a personal evaluation and a dedicated application of products (I received five plus a pouch of supplements). “I’ve had patients on Hårklinikken who’ve stopped and seen [hair] loss,” says Dr. Paul. “So I think their products do help.”
Hair Extensions
I expected the doctors to be against hair extensions, given that they can cause traction and loss of the existing hair. But, if they’re applied correctly—a light sprinkling half an inch from the scalp—Dr. Avram is all for them. Big, heavy extensions can also pull out your existing hair, so step away from the Ariana Grande ponytail.
Hair Transplants
When other medical therapies fail, more and more women are going the surgical route, with Dr. Paul reporting that about 35 percent of his hair transplant patients are women.
It doesn’t require clumsy hair plugs or a trip to Istanbul. “In the old days, people would take big chunks of hair and move them forward, which is not aesthetic,” says Dr. Paul. He and his colleagues have refined their technique, moving individual hairs and clusters to the front of the head and matching their natural growth pattern. I saw Dr. Paul’s before-and-after photos and was tempted to sign up on the spot.
The procedure takes several hours under local anesthesia, followed by about a week of recovery and a year for the hair to grow in completely. The average cost in the U.S. is between $10,000 and $15,000.
Future Drugs
If early studies are to be believed, there may be a breakthrough drug on the horizon. It’s called PP405 and is causing a frenzy of excitement. In two clinical trials, the drug grew hair, even on bald heads. And scientists reported no side effects. “If it works, it will be the first medication that was designed to actually treat female pattern hair loss,” says Dr. Avram. A larger clinical trial will start in 2026 with the hope of FDA approval in, fingers crossed, 2028.
Whoever cracks this code is going to be the Novo Nordisk of the future. Send in the VCs and the private equity bankers, all the better if they’re bald.
Linda Wells is the Editor at Air Mail Look
