The first question is “why is hair being lost?”
Diagnosis before graft counting
Women may experience female-pattern hair loss, telogen effluvium, traction alopecia, alopecia areata, inflammatory or scarring alopecia, medication-related loss, or shedding associated with illness, weight change, childbirth, menopause, thyroid problems, or nutritional deficiencies.
History, scalp examination, hair-pull findings, trichoscopy or densitometry, and selected laboratory tests may be needed. Tests should be chosen by a clinician from the individual history rather than ordered as a generic package.
Surgery is usually considered only when the diagnosis is suitable, loss is sufficiently stable, the donor area is dependable, medical management has been reviewed, and transplantation can create a worthwhile improvement without exhausting future options.