What age were you when you first noticed hair loss?*
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What age were you when you first noticed hair loss?*
19 years old or younger
20-30 years old
30-40 years old
40-50 years old
51 years old or older
How many years has hair loss been bothering you?*
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How many years has hair loss been bothering you?*
0-2 years
3-5 years
6-9 years
10+ years
Is your hair loss ongoing or has it stabilized?*
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Is your hair loss ongoing or has it stabilized?*
Ongoing
Stabilized
Which type of hair loss best describes you?*
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Which type of hair loss best describes you?*
Gradual thinning on top of the head that may resemble an M in men or a broadened part in women.
Circular or patchy bald spots. In some cases your skin may become itchy or painful before the hair falls out.
Sudden loss of hair. Clumps fall out easily, overall hair is thinning, but no bald patches.
Full-body hair loss. This type of loss is usually caused by medical treatments such as chemotherapy.
Patches of scaling that spread over the scalp. This may be a sign of a curable infection such as ringworm.
Which type of hair loss best describes your mother's father?*
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Which type of hair loss best describes your mother's father?*
Gradual thinning on top of the head that may resemble an M in men or a broadened part in women.
Circular or patchy bald spots. In some cases your skin may become itchy or painful before the hair falls out.
Sudden loss of hair. Clumps fall out easily, overall hair is thinning, but no bald patches.
Full-body hair loss. This type of loss is usually caused by medical treatments such as chemotherapy.
Patches of scaling that spread over the scalp. This may be a sign of a curable infection such as ringworm.
What drew your attention to your hair loss?*
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What drew your attention to your hair loss?*
Seeing pictures of yourself
Friends/family comments
Abnormal hair loss in the shower
Styling your hair in the mirror
What bothers you most about losing hair?*
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What bothers you most about losing hair?*
It makes me look older
I feel less attractive
It makes me feel insecure
Losing the ability to style your hair the way you like
What concerns you about the hair restoration procedure?*
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What concerns you about the hair restoration procedure?*
Pain
Scarring
Cost
Other
None of these
Which of these hair restoration options have you tried?*
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Which of these hair restoration options have you tried?*
Rogaine
Propecia
Wigs or extensions
Hair transplants
None of these
How soon are you looking to have a hair restoration procedure?*
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How soon are you looking to have a hair restoration procedure?*
1 month or sooner
1-3 months
4-8 months
9-12 months
1 year or later
Tell us about your haircare routine:
