Hair Restoration in Numbers: What the ISHRS Practice Census Shows

How many people have hair transplant surgery, who are they, and which techniques do surgeons use? The most widely cited source is the Practice Census of the International Society of Hair Restoration Surgery (ISHRS), a non-profit medical society of hair restoration physicians. This guide summarises its figures and explains what they can and cannot tell you.

Key facts

• ISHRS estimated 703,183 surgical hair restoration procedures worldwide in 2021, compared with 279,381 in 2010.
• In 2021, 87.3% of surgical patients were men and 12.7% were women.
• FUE was used in 75.4% of procedures on men and 57.0% of procedures on women in 2021.
• In the 2025 census, 95% of first-time patients started surgery between the ages of 20 and 35.
• 59% of ISHRS members reported illegal “black market” clinics in their city in 2024, up from 51% in 2021.

What the ISHRS Practice Census measures

The census is a survey of ISHRS physician members. For the 2022 report, which describes the year 2021, 197 physicians answered out of 822 valid invitations, a response rate of 24%. ISHRS then extrapolated the answers to estimate worldwide totals. The most recent census, published in May 2025, describes the year 2024 and reports a margin of error of ±5.4% at the 95% confidence level.

Because the figures come from a member survey, they are best read as estimates and trends, not as an official count of every procedure performed.

Procedures have more than doubled since 2010

ISHRS estimated 279,381 surgical hair restoration procedures worldwide in 2010 and 703,183 in 2021. The highest figure in the series was 735,312 in 2019. The 2021 survey year was the first census year after the start of the COVID-19 pandemic.

Year	Procedures
2010	279,381
2012	310,624
2014	397,048
2016	635,189
2019	735,312
2021	703,183

Source: ISHRS 2022 Practice Census

Where procedures take place

In 2021, the census attributed the largest number of procedures to Asia and Australia, followed by the United States and Canada, the Middle East and Africa, and Europe. The report notes that the estimates for Mexico, Central and South America and for the Middle East and Africa are based on fewer than 30 respondents, so they are less reliable. Turkey is not reported as a separate country.

Region	Procedures
Asia and Australia	256,835
United States and Canada	149,254
Middle East and Africa	124,475
Europe	112,742
Mexico, Central and South America	59,877

Estimates for the Middle East and Africa and for Mexico, Central and South America are based on fewer than 30 respondents.

Source: ISHRS 2022 Practice Census

Who has hair transplant surgery

Most surgical patients are men: 87.3% in 2021, compared with 12.7% women. Among patients treated without surgery, the share of women was much higher, at 37.5%.

Patients are often younger than people expect. In 2021, 57.2% of male and 54.8% of female surgical patients were aged 30 to 49. In the 2025 census, ISHRS reported that 95% of first-time patients started hair restoration surgery between the ages of 20 and 35, and that the number of female surgical patients rose by 16.5% between 2021 and 2024.

Younger patients matter for planning. Hair loss usually continues over time, so a surgeon has to think about how a hairline will look in ten or twenty years, not only next year.

Techniques: FUE and strip surgery

Follicular unit excision (FUE) removes individual follicular units from the donor area. Strip surgery, also called FUT, removes a thin strip of scalp that is then divided into grafts. In 2021, FUE was used in 75.4% of procedures on men and 57.0% of procedures on women. Strip surgery remained more common in women than in men.

Technique	Men	Women
FUE	75.4%	57%
Strip (FUT)	21.3%	41.7%
Strip and FUE combined	3.3%	1.4%

Source: ISHRS 2022 Practice Census

DHI is not listed separately in the census. It describes a way of implanting grafts with an implanter pen, and the grafts themselves are usually extracted with FUE. Read more on our DHI hair transplant page.

Beyond the scalp: beard and eyebrow transplants

Most procedures are still on the scalp, but the share of other areas is growing. In 2024, 18% of procedures on men and 21% on women were outside the scalp, up from 13% and 17% in 2021. After the scalp, the most common area was the moustache and beard for men (5%) and the eyebrows for women (12%).

Medication alongside surgery

Surgery moves existing hair. It does not stop hair loss elsewhere on the scalp, which is why many surgeons also discuss medication. In 2021, ISHRS members said they always or often recommended these treatments:

Treatment	Members
Finasteride 1 mg	69.1%
Minoxidil solution (2% or 5%)	53%
Minoxidil foam 5%	53%
Platelet-rich plasma (PRP)	48.4%

Based on 157 responding members.

Source: ISHRS 2022 Practice Census

Whether any medication suits you is a medical decision that depends on your health, your hair loss and your preferences.

The growth of illegal clinics

ISHRS uses the term “black market” for illegal clinics where surgery is not performed under proper medical supervision. In the 2025 census, 59% of members said such clinics operate in their city, up from 51% in 2021. Repairs of procedures done elsewhere made up 10% of members’ cases on average in 2024, up from 6% in 2021.

Measure	2021	2024
Members reporting such clinics in their city	51%	59%
Repair cases as a share of members’ cases	6%	10%

Source: ISHRS 2025 Practice Census press release

This is why we encourage every patient to ask who examines them, who designs the hairline and who performs each surgical step, wherever they choose to have treatment. You can see who leads treatment at Hair in Istanbul on our doctors page.

What the data cannot tell you

• It is a survey of ISHRS members, not of all clinics. Clinics outside the society are not counted directly.
• Regional figures with few respondents can change a lot between surveys.
• The census does not measure the results or patient satisfaction of any individual clinic.
• Your own plan depends on an examination of your hair, scalp and donor area.