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Severe hair loss (Norwood 6). 23 years old. Options?

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First I am sorry you are dealing with this at such a young age. I started losing my hair very young and very fast and know how painful this is. Second, you can certainly try meds-even a modest gain would probably make you feel a lot better. Third, depending on your donor you might be able to have a HT done to restore the top and front of your scalp. Again, even a modest improvement might do wonders for your state of mind. 


More pics would help. 


Hang in there bro. You are not alone. 

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Think hard about trying the head-shaved look if you haven't already. Its a look that can improve with age as your face matures too. I can say from personal experience that I wasn't crazy about how I looked buzzed down back when I was younger going into the service, but now in my middle years (43) during covid I've been shaving down working from home and not to brag, but my head, face shape is more angular and I can honestly say that I like it and had I known back then I probably would have just stuck with shaving it instead of messing with HTs and meds. I'm considering a procedure to do some scar repair and just do the buzzed look from here on.

Maybe lower your expectations and if you do anything procedure wise, just enough FUE to give you some light coverage and frame your face a little and keep it at a buzz cut length. But again I would just try the shaved look first and consider how you may be able to age more into it too.


The medications, hair transplants, hair transplant scars, and hair loss concealers are major long term commitments, of time and money, and there's worrying about people noticing, etc. And you have a very aggressive hair loss pattern and many more years to potentially lose more even if you respond pretty well to the medications for the foreseeable future -they don't perfectly halt the hairloss just slow it down (hopefully alot of slowdown in the best case scenerio).

If you are still leaning hard towards the hair transplant route I would recommend seeing a reputable HT doctor BEFORE you start the meds - have them do a scalp hair follicle miniaturization analysis, evaluate your donor area, because if you are thinning in your donor already as well, or just don't have much in that area to begin with, then HTs would almost certainly not be something you want to risk.


Sorry for being so negative and cautious, but you are still so very young and have so much loss already. And you have a virgin scalp with no scarring, which probably doesn't sound like much to you now, but that gives you the freedom to just shave it down and face the world as you are without worrying about people staring at your head/scars all the time. There's alot of disappointed guys out there that have tried the hair transplant journey that would give up alot now to somehow go back to having that.


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Oof. MPB doesn’t get much worse than that. Sorry, bro.

Be careful with surgery. It’s hard to think clearly in your situation. Just remember bad choices in cosmetic surgery can be worse than hair loss.

“You may say I’m a dreamer, but I’m not...”

- John Lennon

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Consult with a few top Drs before doing anything. I hope your donor area is still ok. Maybe you have a strong  beard you can tap in too? 

Your going to have to have realistic expectations IF you do get a hair transplant. 

Sorry it’s happened to you so early in life dude. 

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I don’t think finasteride or minoxidil is gonna do much at this point, you should’ve tried that years ago. Are you okay with shaving? If so, try smp, it might be your best bet.

I do not provide medical advice, recommendations, all responses are my opinion.

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Melvin- Associate Publisher and Forum Moderator for the Hair Transplant Network, the Coalition Hair Loss Learning Center, and the Hair Loss Q&A Blog.

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You are tightly shaven and it's difficult to see if there are miniaturized hairs.  Also, please photo the entire head, including the donor.  Hopefully you are not dipping.  If so, you may have some transplant options.  Two things.....

If you do have many miniaturized hairs, given how young you seem to be, I would try the meds. (Propecia, Rogaine, Laser and PRP) and give it a year. Based on the results you can decide if you should continue the regimen.  If you see no results or it's  insignificant, there's your answer.

Have you consulted with a professional? Have them scope you.  Perhaps there is a lot there that can be improved.

What are your goals? Be specific.  If you are considering adding a forelock to frame your face, proceed.  If you are set on having a full set of hair, I would consider SMP and perhaps the meds.  (SMP will give the illusion of hair, but there is none.  If the meds are somewhat successful, the "the look would be that much better). Expectations are huge.

Patience and take it a step at a time.

Family history?

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On 9/8/2020 at 4:28 AM, Andy G said:

Given that I'm already Norwood 6, should I still try Propecia + Rogaine? What options would you recommend?


Obviously you require a transplant procedure. Finasteride can be helpful for the hair.

Official representative of Eugenix Hair Sciences

Dr. Arika Bansal & Dr. Pradeep Sethi



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Hey Andy! I'm glad you found this forum early on in your quest for a solution. A few quick tips/points I would leave you with:

A) Unfortunately, due to your age and the state of your hair loss, your options are fairly limited in regards to getting a full head of hair. There's a small chance that you would be a viable candidate for a hair transplant, but I wouldn't bank on it to be honest. It's hard to get a good grasp of your donor area based on this photo, but that is a lot of area to cover.. And since hair loss is progressive, an ambitious procedure like yours at a very young age is typically not recommended. 

B) That said, the only way to know for sure is to schedule a few consultations with some top surgeons. Use this forum and the list of recommended surgeons as a starting off point. You'll want to compare the opinions of some of the experts in the field and then proceed accordingly. 

C) Manage your expectations. Should you ultimately decide to move forward with a procedure, understand that your final results will be limited compared to what other guys can achieve who have less hair loss. Keep that in mind, and then whatever results you are able to achieve will hopefully be very satisfactory to you. 

D) You can always try Finasteride, but at this point, I'm not sure how much good it would do you. This is something you could discuss with a hair transplant surgeon as well. 

E) Be open to surrendering to the hair loss and shaving it down... OR to SMP if shaving it down isn't an option for you. Work within the parameters of the hand you've been dealt, and I think you'll be really set up to win.

I hope that isn't discouraging - but I want to make sure you don't fall into the false hope of "hair transplants can fix everything" and mentally prepare yourself for whatever options lay before you... Best case scenario, you meet with some top surgeons and they think you're a good candidate and that you have enough donor for them to work some "illusion of density magic". If not, look at some guys with SMP (or even hair systems if that's a route you wanna go) and see if that sounds like a good fit for you. 

I am a patient advocate for Dr. Parsa Mohebi in Los Angeles, CA. My views/opinions are my own and don't necessarily reflect the opinions of Dr. Mohebi and his staff.

Check out my hair loss website for photos

FUE surgery by Dr. Mohebi on 7/31/14
2,001 grafts - Ones: 607; Twos: 925; Threes: 413; Fours: 56

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