Hair Loss Questions? This Hair Restoration Surgeon Has the Answers

“In my practice, the most common cause I see in women is androgenetic alopecia—also known as female pattern hair loss. It’s a progressive thinning that usually starts at the part line or the crown, and it’s largely driven by genetics and hormonal factors. But it’s far from the only cause,” says Dr. Kopelman.

“I also treat a lot of women with telogen effluvium, which is a form of temporary shedding that happens after stress, illness, pregnancy, surgery or major life changes,” he says. Then there’s traction alopecia, which is caused by tight hairstyles or chronic tension on the scalp, especially from braids, ponytails or extensions.”

“Autoimmune conditions like alopecia areata and underlying medical issues like thyroid disease or iron deficiency are also fairly common culprits,” adds Dr. Kopelman. “That’s why a detailed evaluation is so important—we have to identify the root cause before jumping into treatment.”

“The first thing I always tell my patients is: don’t panic, but don’t wait. Hair loss can be easier to treat when we catch it early, advises Dr. Kopelman. “If you’re seeing more shedding than usual, a widening part or just feel like your ponytail is thinner, that’s the time to act.”

“Book a consultation with a specialist who has experience treating hair loss,” he suggests. “In my office, we’ll sit down together, go over your history, take high-resolution scalp photos and often order lab work to rule out things like vitamin deficiencies or hormonal imbalances. From there, we can create a personalized plan that gives you the best shot at stabilizing the loss—and in many cases, regrowing hair.”

“The most obvious signs are shedding—like hair all over the shower drain or your brush—and visible thinning at the part or temples,” explains Dr. Kopelman. “But there are subtler signs I notice all the time. One is loss of volume—your hair may not look bald, but it doesn’t hold styles the way it used to or feels limp and lifeless.”

“Some of my patients realize something’s off when their ponytail feels noticeably thinner,” he says. “I also see patients who experience a sensitive or itchy scalp before the shedding really kicks in. That inflammation can be a sign the follicles are under stress, which isn’t always talked about.”

“It depends on the type and how early we catch it. With something like telogen effluvium, the hair usually regrows once the underlying issue is resolved, so that’s very treatable. Autoimmune hair loss like alopecia areata can also be reversed, especially with newer treatments like JAK [Janus kinase] inhibitors,” says Dr. Kopelman.

“But when it comes to androgenetic alopecia, which is the most common, we usually talk about slowing or stopping the progression and stimulating regrowth—not completely reversing it,” he notes. “That said, I’ve seen great results in many of my patients with consistent treatment, and some of them even regain significant density. The earlier you start, the more we can do.”

“I tailor treatment to each patient, but there are a few go-tos I reach for again and again. For female pattern hair loss, low-dose oral minoxidil has been a game-changer—it’s well-tolerated and really helps improve density,” says Dr. Kopelman. “I often pair it with topical minoxidil and PRP therapy, where we use your own platelet-rich plasma to stimulate the follicles. For women dealing with hormonal imbalances, I might add spironolactone, which helps block androgens that contribute to hair thinning.”

“For telogen effluvium, we focus on correcting the trigger—whether it’s stress, low iron or a thyroid issue,” he notes. And “With alopecia areata, I’ve had success with corticosteroid injections and, in more severe cases, systemic medications. Red light therapy is another tool I love—it’s safe, non-invasive and can be used alongside other treatments to boost results.”

The most common by far is androgenetic alopecia, or female pattern thinning. It’s gradual, chronic, and tends to run in families. Telogen effluvium is another frequent one I see—it’s more of a reactive shedding and is usually temporary,” says Dr. Kopelman.

“Then there’s alopecia areata, an autoimmune condition that causes sudden, patchy hair loss,” he says. “I’ve also been seeing more cases of frontal fibrosing alopecia, especially in postmenopausal women—it’s a type of scarring alopecia that affects the hairline. And traction alopecia is still a big concern, particularly for women who wear styles that pull tightly on the scalp over time.”

“Prevention is really about being proactive. If you have a family history of hair loss, I often recommend starting topical or oral minoxidil even before major thinning begins,” recommends Dr. Kopelman. “Keeping your scalp healthy is also key—avoid tight hairstyles, excessive heat or harsh chemical treatments that can stress the follicles.”

“Nutrition plays a big role too,” he adds. “I always look at iron levels, vitamin D, zinc and protein intake in my patients. And of course, managing stress—easier said than done, I know—is incredibly important. Chronic stress can absolutely trigger shedding, so lifestyle support matters just as much as medication.”

“Hair transplants work best for women with androgenetic alopecia who’ve stabilized their hair loss and have a healthy donor area—usually the back or sides of the scalp. It’s not the first treatment I reach for, but when the timing is right, it can be life-changing,” notes Dr. Kopelman.

“The procedure involves taking individual follicular units from the donor area and transplanting them into the thinning zones. These transplanted hairs are genetically resistant to the hormone DHT, which means they’re permanent,” he explains. “I use a very meticulous approach to angle and place the hairs so they blend naturally with your existing hair. It’s a great option when medical therapies have plateaued or when we’re looking to restore density in specific areas like the temples or hairline.”

“There are so many! One I hear constantly is that shampooing too often causes hair loss—that’s just not true. You’re seeing hair that was already going to shed,” states Dr. Kopelman. “Another big myth is that trimming your hair makes it grow faster. Hair growth starts at the follicle, not the ends.”

“I also hear people say that stress alone causes baldness overnight—not quite. Chronic stress can lead to shedding, but it’s rarely the only factor,” says Dr. Kopelman. “And maybe the most frustrating myth? That hair oils alone can regrow hair. Oils can be great for scalp health, but they’re not going to treat hormonal or genetic hair loss without other support.”

“I really like rosemary oil—it’s shown some promising results in improving circulation to the scalp and supporting hair growth, and some small studies have even compared it favorably to minoxidil,” says Dr. Kopelman.

“Pumpkin seed oil is another favorite, especially for its potential to block DHT. I’ll sometimes recommend peppermint oil too—it gives a nice tingling effect that improves blood flow and soothes inflammation,” he says. “That said, I always remind my patients: essential oils should be diluted in a carrier like jojoba or coconut oil and used as part of a broader treatment plan. They’re great for scalp health, but not a standalone solution for most people.”

“I get asked this all the time. The truth is, for most women, it’s not about going completely bald—it’s about progressive thinning. And that can be just as distressing,” assures Dr. Kopelman.

Additionally, Dr. Kopelman notes that he hears a lot of emotional questions—women asking if they did something wrong, if it’s their fault. “The answer is no. Hair loss is incredibly common and often out of our control,” he assures. “The good news is we have more tools than ever to treat it. I always say: this is not something you have to live with silently. There are real, effective options, and the earlier we start, the more empowered you’ll feel.”