GLOBAL STUDY

Hair Transplant Study (2021)

Medically reviewed by Dr. Sternberg Written by David Stelzer on 9 Feb 2021

Nowadays, more than 80% of men and 25% of women suffer from genetic hair loss. The number of people affected is increasing from generation to generation. Therefore, more and more people are looking for effective and sustainable treatments. One of the few effective treatments is the hair transplantation, which is becoming increasingly popular.

Medihair is one of the leading platforms for medical proven hair loss treatments. Because of our large user base we have access to one of the most representative data sets on hair loss and hair transplants. In the following we will present the findings of our annual hair transplant study.

We have gathered data regarding various factors of hair loss, medication for treating hair loss and hair transplants. We analyzed how age, degree of hair loss, cost, and emotional impact are affected by or can affect a hair transplant. We also examine the rising topic of medical tourism and hair transplants abroad.

Most Important Findings

Use of hair loss medication 15,6%
Average Age before HT 37
Average NW type NW4
Willingness to travel for HT 45,81%
Most important criterion Quality & Service

Study Design

We have the most objective, comprehensive data regarding hair transplant and hair loss patients using the information we gathered directly from our users and partner clinics. We collected our data using the answers of users to evaluate their hair loss and match them with suitable hair transplant clinic. There are over 1,000 individuals included in our data set (n = 1,063). This is much larger than data samples used in medical societies reports as they only take the information from their members (e.g. ISHRS: n = 200). Furthermore, our data is more non-biased than data collected by hair transplant or restoration societies as we gather information from patients directly rather than from clinics representing their patients. Nevertheless, we enriched our data set with the samples of the societies to get an even more holistic view.

Hair Loss

It is normal for individuals to lose anywhere from fifty to one hundred hairs in a single day without there being a cause for concern. This amount isn’t a noticeable loss as there are over one hundred thousand hairs on the head for most people. Generally new hair will grow back to replace the lost hairs however, this is not always the case.

The vast majority of individuals will suffer from hair loss (e.g. male pattern hair loss) at some point in their lives, although the causes may differ. As someone ages they become at greater risk for suffering from hereditary hair loss. Two thirds of men over the age of 35 experiencing some form of hair loss and by the age of 50, 85% of men will experience significant thinning of their hair. By the age of 65 more than 50% of women have experienced noticeable hair thinning, particularly along the part of their hair.

Hair transplant age and gender

Women unfortunately aren’t as likely to be candidates for hair transplants as men due to the kind of hair loss they experience. Rather than balding women’s hair thins all over, this reduces their donor area. Transplanted hair for women will continue to fall out as the hair is not resistant to DHT. As this graphic displays, there are significantly fewer females who seek out hair transplants as a result of hair loss.

Hair transplant by gender

Men on the other hand experience more obvious signs of hair loss. Hair loss in men typically begins with a receding hairline and thinning at the top of the head. The back of the head will then develop a bald spot at the vertex of the crown. The path of hair loss varies by individual though and these stages are not the same for each person.

Hair loss symptoms

The most common cause for hair loss is pattern baldness, or androgenetic alopecia. Also known as hereditary or hormonal hair loss, it usually begins and progresses gradually however, it can also develop very quickly. The predisposition for pattern baldness comes from both sides of the family although, the maternal side can have a slightly stronger effect. This predisposition leads to a hypersensitivity to the hormone dihydrotestosterone (DHT), which causes a weakening and breakdown of hair follicles on top of the head.

Hair Loss in the Family (Androgenetic Alopecia)

Combined with a family history of hair loss, progressive hair loss for more than five years is a good indicator of androgenetic alopecia. In fact, our data study found that 70.5% of our clients reported a history of hair loss in the family. Additionally, 74.3% of patients included in our data set reported suffering from hair loss for more than five years.

How many years ago did the hair loss start

The International Society of Hair Restoration Surgery (ISHRS) released its own data summarizing the causes of hair loss. They found that 77.6% of patients seeking hair transplant surgeries suffered from genetic hair loss. This is similar to our findings that the vast majority of hair transplant patients suffer from pattern baldness.

Hair Loss Treatments

Hair implants should be viewed as a last resort for hair loss treatment. Patients should attempt to use medication to stop their hair loss before pursuing a hair transplant. It is important to stop the progression of hair loss before getting a transplant in order to obtain long-lasting results.  Younger patients who are likely to have extensive future hair loss especially need to use medication to stop the progression of hair loss. The donor area is difficult to identify as the path of future hair loss is not always clear to the surgeon when treating young patients. The donor area is often the section of hair at the back of the head that will not fall out with age as the hair follicles are resistant to DHT. If the donor area is not properly selected then transplanted hair is at risk for falling out later as it may not be resistant to DHT.

Men suffering from male pattern baldness should try taking finasteride. Finasteride blocks the conversion of testosterone to dihydrotestosterone (DHT) by inhibiting the enzyme reductase of 5α- DHT. The hormone DHT binds to the hair follicles and weakens them until they eventually die and fall out. When used for hair loss, finasteride is taken daily as a pill with a glass of water. The medication is not safe for women to take. Women who want to stop their hair loss should use the drug minoxidil instead.

For hereditary hair loss, minoxidil it is applied to the scalp in the form of a foam solution commonly known as Rogaine or Regaine twice a day. As an antihypertensive drug, it dilates the blood vessels under the scalp, optimizing the supply of blood and nutrients to the hair. This process will help stop the progression of hair loss. It is advised a patient starts the medication as soon as the thinning of hair is noticed for the best results.

These medications cannot regrow lost hair, they only stop the future progression of hair loss. They can however, encourage hair growth in regions where the hair has begun thinning. They should be used in conjunction with a hair transplant to obtain optimal, long-lasting results.

Hair loss treated with Finasteride or Minoxidil

We found that only 15.6% of our clients had tried medication before seeking out a hair transplant. This is a much lower percentage of clients than there should be. Nearly 100% of our clients should have tried the medication for at least several months before turning to surgery options. Clients who pursue a hair transplant without stopping their hair loss with medication will create the need for future transplant procedures as they will not be satisfied with their transplant.

Hair Transplant

With hair transplantation, a patient’s hair is removed from one part of the body and re-inserted in the bald area. New hair is not grown with transplantation, but existing hair is distributed more evenly over the scalp to cover bald or thinning areas.

Different methods have been developed to perform hair transplantations, but they all compromise of the same three phases; extraction, storage and implantation. The storage and implantation phases are virtually identical regardless of the method, with the hair grafts being stored in a sterile, cooling solution before being individually inserted into the bald area.

The most popular modern-day method of hair restoration is known as the follicular unit extraction (FUE) method. This method uses a thin, hollow needle to extract the hair grafts from the donor area in natural groupings of one to four follicular units. This minimally-invasive technique leaves behind small white scars peppered around the donor area which are unnoticeable even with shorter hairstyles.

The other common method of hair transplantation is follicular unit transplantation (FUT), this method is slightly more invasive than the FUE method. The FUT method involves removing a strip of skin from the donor area at the back of the head. The strip of skin which is full of thick, dense hair is dissected into individual follicular units for implantation.

Most common hair transplant method

The best method for hair implant depends on the degree of hair loss, age of the patient and the surgeon. Every hair surgeon has his or her preferred method. Many hair surgeons only know the FUE method and few know both the FUE and FUT methods. Whether the FUE of FUT method is used there are excellent results.

Hair Transplant Cost

By reviewing over 90 clinics and doctors across 11 countries our experts have compiled the largest, most comprehensive hair transplant cost study in the world. We have prepared average prices for individual countries in this study as well as compared each country to the global average.

We found the most expensive countries to be Canada and Australia, with respective prices per graft of 7.00 USD and 5.50 USD. On the other hand, hair transplants in Turkey were relatively cheap with an average price of 1.07 USD. The average global price per graft is 2.98 USD for comparison.

Hair transplant cost per country

We used information from the ISHRS 2020 Census to calculate the average cost per graft globally. They had estimated the average total cost of a hair transplant to be 6,208 USD and the average number of grafts used in a single procedure was roughly 2,083.

The ISHRS also estimated a total number of 735,312 hair restoration procedures were performed in 2019, although we believe this number is much smaller than the actual number of hair transplants. The ISHRS underestimated the number of hair restoration procedures performed as they underrepresent medical tourism when collecting their data and making extrapolations.

Degree of Hair Loss

The Hamilton-Norwood Scale is used to determine the degree of hair loss a patient suffers from. As the patient’s hair loss worsens, they progress further along the scale. The stages of the Norwood scale can be used to estimate the number of grafts needed to cover the balding or thinning areas of the patient.

Hair loss degree prior to hair transplant

Our data found that 76.9% of patients who suffer from hair loss seek out hair transplantation as a treatment between Norwood scale stage 2 and stage 4, with stage 4 being the most popular stage to seek out hair transplantation. It was extremely rare for patients with advanced stage 6 hair loss to seek out hair transplantation, only 1.1% of our clients with this stage of hair loss sought out hair transplants.

Hair Transplant Age

It is generally recommended that patients wait until they are over the age of 35 to get a hair transplant. By the age of 35 the future path of hair loss progression will be easier for doctors and surgeons to identify. It is important for the path of the hair loss to be identified so the doctor doesn’t take hair grafts from an area that will bald in the future. The strands would not be resistant to the hormone DHT and would fall out after transplantation.

The optimal age for a hair transplant is not always the same for every individual. Other factors such as family history of hair loss, use of hair loss medication and degree of hair loss are necessary to review before deciding if it is the appropriate time for a hair transplant.

Our data found that 24.5% of our patients were younger than 30 years old when they sought out a hair transplantation. Nearly 49.6% of our patients were between the ages of 30 to 45 and the final 25.9% of our patients were above the age of 45 years old when they sought out a hair transplantation.

Age of people interested in a hair transplant

There are several issues with such a large number of patients seeking out hair transplantations before the age of 35. When the path of hair loss is not properly identified then transplanted grafts are at a greater risk for falling out after the surgery. This leads to patients wasting money and needing multiple treatments to achieve lasting results.

The ISHRS had similar findings to our data, they reported nearly half of their patients receiving hair transplants before the age of 35. This extreme variation in the optimal age for hair transplantation and the actual age of patients means there are many inappropriate hair transplantations being performed. Many of these patients will have to seek out further treatment to stop their hair loss.

Past Hair Transplants

Despite the promise of long-lasting results from hair transplants, this is not always the case and follow-up procedures are sometimes necessary.

The main issue leading to the need for a secondary hair transplant is the loss of transplanted hair. As previously mentioned, this can be an effect of premature hair transplants being performed. When the patient is young their hair loss hasn’t fully progressed and the donor area is difficult for the surgeon to identify. If the surgeon transplants hair from an area that will eventually fall out then they will not permanently grow after they are transplanted.

Patients, especially younger patients, should seek to stop their hair loss before a transplant using medication. This will allow them to prevent the loss of transplanted hair. If patients can prove they have been able to stop the progression of hair loss using medication they become viable candidates for a hair transplant. The medication should not be stopped after the transplant, it should be used in conjunction with the transplant to create the best results.

Number of previous hair transplants

Our data found that 7% of our clients had previously sought out a hair transplant, this is a relatively small amount in comparison to the ISHRS findings. The ISHRS found that 33.1% of patients required two procedures, and an additional 9.6% required three or more surgeries. If medication is properly used to stop the progression of hair loss and paired with a hair transplant the need for further procedures should be diminished.

Hair Transplant Emotional Impact

A thick, full head of hair is seen as a symbol of beauty and youth in modern society, while balding and thinning represent illness and aging. Therefore, the negative emotional impact of hair loss can be quite significant. Hair loss can affect someone’s self-confidence in the workforce, relationships and social life. People suffering from hair loss feel a sense of shame, vulnerability and embarrassment.

These negative feelings can greatly influence an individual’s desire to seek out a hair transplant or other form of treatment to conceal the effects of hair loss. We have found that 95.2% of hair transplant patients experienced a positive emotional impact from receiving a hair transplant.

Emotional impact of a hair transplant on a patient

We found that 41.5% of patients wanted to get a hair transplant as soon as possible, which is indicative of the emotional impact of hair loss as well. This is an expensive, elective surgery that will take time away from work and normal activities but many patients want to pursue a hair transplant with haste. An additional 36.5% of our clients wanted to get a hair transplant within 6 months of requesting information about transplantations. The vast majority of our clients wish to seek action against their hair loss suffering quickly to help improve their emotional state.

Desired time of the hair transplant

In addition, 71.7% of respondents hope to achieve more success in career and dating through hair transplantation.

Reasons for a hair transplant

Hair Transplant Abroad

The expense of cosmetic surgeries in the western world has led to an increasing trend of medical tourism. It has become more and more worthwhile for patients in Europe, the US and Canada to travel to clinics abroad which offer significantly lower prices for cosmetic procedures like hair transplants.

Clinics in countries like Turkey, India and Mexico have even started offering all-inclusive package deals for operations to increase medical tourism. Our cost study found that a hair transplant in Turkey is more than 3,500 USD cheaper than the global average price for hair transplants. Patients from the UK or other countries in Europe could save thousands by travelling to Turkey instead of staying in their home country for hair transplants.

Willingness to travel abroad for the hair transplant

Our data showed that 45,81% of our clients were willing to travel abroad for a hair transplant. With the expanding hair transplant industry, it has become even easier to find a high-quality clinic for an inexpensive price.

Most important criterion for the selection of the hair transplant clinic

In addition, price was the second most important factor our clients looked for in a hair transplant with 30.8% of our clients rating it as their priority. It is easy for patients to save money through medical tourism.

Conclusion

The data we have gathered for our hair transplant study is more objective than data included in studies from restoration societies. Our data comes directly from our clients rather than collecting data from clinics. This reduces possible bias in the data collected by hair restoration societies as clinics have a chance to manipulate the data they give. They may also place more importance on certain kinds of data and overlook other factors like the draw of medical tourism leading to them underestimating the number of transplant procedures performed worldwide. The studies from medical societies also create bias because they cater to their member clinics and doctors with their data. They don’t publish prices for individual countries in their studies as a way of fostering cost transparency in the market.

Frequently Asked Questions

How many people are using finasteride or minoxidil?

What is the most common hair loss degree?

How old are most people when they have a hair transplant?

Sources

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