Every time I step outside, the first thing on my mind is my forehead’: the women getting hair transplants
A growing wave of women are turning to what was once seen as a surgery for men, hoping it will cure their self-consciousness about high hairlines and thinning crowns. But with treatments costing thousands and bodge jobs common, is it suitable – or even safe?
Aria, 27, first noticed her hair falling out after she had Covid in 2021. “It started receding at the temples,” she says, adding that, after two further bouts of Covid, the hair on the side of her head is now fluffy and sparse. A part-time nanny studying for a master’s in speech therapy, she hides the problem with a fringe. When she goes out, she wears a cap or headband to anchor it down, but activities such as walking in the wind or swimming feel impossible. “Even a fringe is not protective enough because at any minute someone could flick it up,” she says. “It makes me feel so vulnerable.”
Aria started watching YouTube and TikTok videos of hair transplants two years ago. Now she has decided to take the plunge herself, and in a few days’ time she will check into at a clinic in Portsmouth, Hampshire, for a procedure that will cost £5,500.
Hair transplants have been available since 1952, when the dermatologist Norman Orentreich performed the first one, in New York. In 2022, more than 735,000 men worldwide had the procedure, many encouraged by celebrities including footballer and manager Wayne Rooney and actor James Nesbitt openly discussing their experiences. Turkey has become a global hub for hair transplants, due to its lower costs. Some even refer to the national airline as “Turkish Hairlines” as so many men, particularly from the UK, return from Turkey with bandaged heads after receiving hair transplants.
Now more women are having them, too – a global increase of 16.5% between 2021 and 2024, according to the International Society of Hair Restoration Surgery. It is still a male-dominated field – men account for 87% of the market – but the focus is shifting. Transplant surgeon Dr Edward Maitland Ball operated on one woman (and 83 men) in 2016, the year he founded the Maitland Clinic in Portsmouth; last year, 15 women (and 148 men).
But hair loss has troubling resonances for women, and going public about a transplant is rare for a woman. “Women are supposed to be so many things. Thin, but fertile. Successful, but homemakers. And hair is not something women are supposed to lose,” one woman who underwent a transplant tells me. This, then, is a story about hair loss and femininity, of bald spots and shame, and why, among younger women in particular, hair transplants are on the rise. Ultimately, it’s a tale not only about the behaviour of women, but also about the standards and values imposed on them.
About eight million women in the UK experience hair loss at some time in their lives. In men, it usually begins above the temples, the receding hairline eventually forming a characteristic M shape. Hair at the top of the head also thins. Women, on the other hand, will generally retain the hairline and thin out behind it. “It’s more of an overall, diffuse volume reduction,” says consultant trichologist Anabel Kingsley.
There are three typical stages in female pattern hair loss. Stage one is thinning at the crown and central parting, leaving a forest of hair on either side. By stage two, the hair is in retreat from the centre, exposing the scalp in what’s known as a “Christmas tree pattern”. By stage three, large areas on top of the head will be hairless. Even so, Kingsley says, “there are huge variations. Some women can have more of a male pattern loss; in others it is more noticeable around the temples. It’s much more complicated than with men.”
Baldness in men is triggered by the release of testosterone, which reacts with an enzyme in the blood to shut certain follicles off rather than turning them on. This leads to hair thinning and falling out. Male pattern baldness is at least 80% heritable. “We used to call hair loss in men and women androgenic alopecia,” Kingsley says, “which basically means it is genetic and due to the presence of androgens – male hormones. But now it’s thought that, in some women, testosterone doesn’t play a role. We call it ‘female pattern hair loss’ because the causes are not understood.”
Historically, clinical drug trials have been done on middle-aged white men, she says, “so it’s no surprise more research is dedicated to male pattern balding, even though hair loss is both a male and female issue”. And the causes, for women, are many. Menopause (many postmenopausal women suffer hair thinning or bald spots); pregnancy; iron deficiency from periods; side-effects of the pill; crash dieting and restrictive eating; and medical conditions such as polycystic ovary syndrome can all affect hair growth. Even hairstyles can play a role. Gymnasts and ballet dancers who wear tight buns or ponytails are at risk of traction alopecia, a type of hair loss that occurs when tension damages or inflames the follicles.
And yet we are surrounded by images of women with artificially bolstered hair. A current trend on the red carpet, on Instagram and TikTok is “long, voluminous, abundant, shiny hair,” says Josh Wood, owner of an eponymous upmarket salon in west London and vice-chair of the British Beauty Council. The “power mane” – sported by the women of Trump world – signifies youth and fertility. It’s a style that might look free and easy, but achieving it is anything but, especially with older hair. “It looks like nothing’s been done, when you’ve virtually had the construction workers in,” Wood says.
Harriet, 69, a retired teaching assistant from Devon, who is married with three children, first noticed her hair thinning at her temples in her late 50s. “At first, you lie to yourself. You say, ‘I think it’s OK.’ Then after a while, because it’s a slow process, you think, ‘No, it’s definitely thinning.’ I could see the hairline gradually moving back.
My husband would say, ‘Oh, it doesn’t matter.’ But it’s how you feel and I was very self-conscious about it. If it was windy, I avoided going out or wore hats.” If she went swimming, she’d try not to get her hair wet. If she was out with friends, she’d sit with her back to the light: “You don’t want the light shining on the front of you as they might notice.” She’d brush her hair forward, lock it in place with hairspray and constantly check her reflection in shop windows as she walked by. “It’s horrible,” she says. “It niggles and niggles.”
Rogaine, the growth stimulant, helped. But it isn’t recommended for use after 65, “so I stopped. Then it started to get noticeably worse. I thought, is this just a part of getting older; can I accept it, like I accept having lines on my face? But this was worse, somehow.”
Harriet decided she had to do something. “I went online and looked at where all the footballers had their transplants done.” But the thought of the long drive from a London clinic back to Devon with a bloody head was too awful to contemplate. Instead, she turned to Ball’s clinic in Portsmouth. He checked if she had enough hair in the donor area at the back of her scalp. She asked him, “Won’t the transplanted hair fall out at my temples, too?” He reassured her that, as the DNA of the transplanted hair was different, it would stay.
A hair transplant costs between £3,000 and £10,000, depending on the number of grafts needed and the quality of the clinic. There are two techniques. Strip Follicular Unit Transplantation (FUT) is where a thin strip of skin is sliced from the back of the scalp, then dissected under microscopes into individual follicular units, or grafts, which are inserted into tiny incisions in the head. One of the main advantages for women is you don’t need to cut your hair for the procedure, which makes getting back to normal life a lot easier. The disadvantage is a scar where the strip was taken.
Alternatively, Follicular Unit Extraction uses a small device to punch out individual hairs from the back or side of the head, one by one. The main disadvantage is that the “donor area” must be shaved down to the skin. On the other hand, there is no scar.
Harriet had FUT and, two years on, she is thrilled. It looks perfectly natural, she says. It’s impossible to say where the original hair ends and the transplanted hair begins. “In terms of confidence and how much happier I feel about myself, it’s huge,” she says. But, apart from her husband, children and hairdresser, no one knows she’s had it done. “It’s personal,” she says. “It’s taboo.”
Perhaps surprisingly, it is no longer just women with extensive hair loss who are having transplants. Dr Roshan Vara, a hair transplant surgeon and co-founder of The Treatment Rooms in London, says his clients fall into two broad camps: women who are peri- or postmenopausal and have hair loss related to hormonal changes, and young women who aren’t losing their hair, but want to correct a hairline they don’t like.
High foreheads are not a beauty ideal trending on social media, he says. Instead there are memes mocking the singer Rihanna’s “fivehead”. Pinterest has 30 hair styles to hide big foreheads “so you never have to hear lame jokes or snide remarks again”. On TikTok, viewers are invited to watch “a hilarious video” of actor Dakota Johnson and others showing off their “big foreheads”.
Another undesirable beauty standard peddled to young women on social media is a “masculine” hairline with deep temples. Never mind that hairlines are neither “masculine or feminine”, Kingsley says. “It’s just societal pressure; another way to make us feel a bit crap about ourselves.”
Wood has noticed this greater focus on hairlines. “Women are on screen, pulling their hair back, wearing it in high ponytails, conscious of how the hairline frames the face.” Moreover, as cosmetic surgery and tweaks reset our standards of beauty, a natural hairline can start to appear an anomaly. “It doesn’t look right,” he says. Where once we were obsessed with straight teeth, he suggests, now it’s the “perfect hairline”.
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