Baldness at 21

[Russian Boy]

Hello everyone. I am 21 years old, I started to go bald from 18-19, although there is not a single bald person in the family at all! 

I went to the trichologists, at the moment I take minoxidil 1 time a day. I can not accept baldness, there are many complexes, because I am still young (I do not mind going bald at least after 30, but not in 20 years...). It is noticeable that the situation is getting worse every year, and seriously thought about hair transplantation. What do you say? Do I have a normal donor zone, and how many grafts do you think will be required?

I recently passed tests for hormones, the value of dihydrotesterone is 979 (normal values: 250-990). I do not want to take drugs like finasteride, I am young and I am afraid that they will have a bad effect on my health. Does it make sense to transplant hair?

I'm sorry, my English is bad. The photo below after I washed my hair, dried it with a hair dryer (if I do not wash my head, do not put a hair dryer or cut my hair short, it will look much worse)

[Coady]

get on finasteride asap you still have a good amount of hair to save, trust me on this. then get a transplant in a year or two.

[Westview]

Get on topical FIN if you want to limit side-effects

[Huncholini]

I'm sorry to see what you're going through. You are similar to me, only a few years younger. I started balding at 17, it's a horrible experience.

You should get advice from a well respected, ethical hair surgeon. A lot of the well known/world class hair surgeons offer online consultations, all of the consultations I have had have been cost free.

I would be wary about taking advice from people on this forum who may be unqualified to prescribe you drugs, especially those that have the potential to cause side effects far worse than balding (I personally have had side effects from both topical fin and fin in tablet form). This is not meant to scare you from taking Finasteride, but offer another perspective to the folks who are telling you to jump on Finasteride as if it's the same as eating a tic-tac.

[Britanium]

Consult with some top/elite type clinics. They may only be willing to consider you for a ht after you reached the age of 25. Having hair loss at a young age means it’s going to be aggressive. I’m not telling you to jump on fin, but it can be considered after talking with some clinics and also your own Dr. It’s going to be the only med that can help you retain. These days you can opt for the topical version which has less chance of sides. Whats likely is that fin will be mentioned during your consults. 

[Mike2098]

I was also quite young, when I started losing my hair. Like others have mentioned hair loss at a young age is usually more aggressive and without meds, you might not have enough donor grafts if you progress to NW 6 or 7. First thing you should do is consult with a hair transplant surgeon and get their advice. Also just curious, did you get a biopsy done? Hairloss can sometimes be caused by lichen planopilaris or other forms of scarring alopecia, so if you don't have any family history it might be worth it to get one done by a dermatologist. 

[Kharmacoma]

Go on finasteride. You may solve your problem completely. You are way too young for hair transplant. 

[Russian Boy]

3 hours ago, Mike2098 said:

Я тоже был довольно молод, когда у меня начали выпадать волосы. Как и другие упоминали, выпадение волос в молодом возрасте обычно более агрессивно, и без лекарств у вас может не хватить донорских трансплантатов, если вы перейдете к NW 6 или 7. Первое, что вам нужно сделать, это проконсультироваться с хирургом по пересадке волос и получить его совет. . Также просто любопытно, тебе сделали биопсию? Облысение иногда может быть вызвано плоским лишайником или другими формами рубцовой алопеции, поэтому, если у вас нет семейного анамнеза, возможно, стоит обратиться к дерматологу. 

I went to the trichologist, he checked my head and said that I have androgenetic alopecia. I didn't get a biopsy.

[Gatsby]

I began to lose my hair at the age of 18 and it nearly destroyed me at the time. I had a hair transplant and it was the worst decision I could have made. As JohnAC71 has stated you will find that a good hair transplant surgeon will suggest you commence finasteride. An 'excellent' hair transplant surgeon will not touch you until 25 so you don't end up like I did. Continual hair loss and lots of ugly scars. The point about finasteride is that it will likely strengthen your hair (including your donor) and help stabilize your MPB. In this way you will then be in a position in the future to start a game plan in the future for surgery. You may even regain a lot of the loss from finasteride, especially in the crown.

[Raphael84]

@Gatsbyhas given some great advice.

I also experienced hair loss at a young age and completely relate in terms of the emotional impact and no young guy beginning their adult life should have to experience this. Unfortunately this is the reality for many young men. What is important is to be honest and realistic regarding your hair loss situation, and if it is an absolute priority for you, then seriously research and consider any options that are available to you. At this point, hair restoration surgery is not a good option. At 21, with progressive loss, and with a visible decline in density and hair quality from hairline to lower crown, with what would appear to be signs of retrograde alopecia, your native hair is not stable. 

The options available to you at this stage are hair loss preventative medication in the form of finasteride and minoxidil. Many guys do not want to consider committing long term to medication, and it is sensible of them to question and research this to make the appropriate decision for their own situation considering all factors. Without medication, your hair loss will progress in the next years. Many guys initially reject the idea of medication for other more natural options, but find further down the line when more hair is lost, that such options have not been effective and they decide to begin medication, but any hair lost in this interim period could have potentially have been strengthened or retained if earlier action was taken.

Your question - does it make sense to have a hair transplant? Currently, it does not make sense. From the photos the quality of your hair is weaker. Surgery itself could result in significant shock loss that your follicles may not have the strength to return from.

Your pattern of loss appears to be classic andoagenetic alopecia as confirmed by your trichologist. Your photos show no reason why you should be considering a biopsy.

 

[Russian Boy]

thank you all very much for your answers!

[Russian Boy]

I am haunted by the fact that in my family, on my father's and mother's side, there is not a single bald person. Is it often the case that I start to go bald first in the family? I can't understand why this is happening to me...

And yet, if I start taking finasteride, and at the same time start exercising, eating right, will it be possible to reduce the side effects in the form of a decrease in libido? or it won't affect

[Britanium]

18 minutes ago, Russian Boy said:

thank you all very much for your answers!

Your welcome 🙏 

[Melvin- Admin]

43 minutes ago, Russian Boy said:

I am haunted by the fact that in my family, on my father's and mother's side, there is not a single bald person. Is it often the case that I start to go bald first in the family? I can't understand why this is happening to me...

And yet, if I start taking finasteride, and at the same time start exercising, eating right, will it be possible to reduce the side effects in the form of a decrease in libido? or it won't affect

Genetics can be cruel, my father is 63 not bald, my brother 44 not bald. I went bald before 30. Stay on fin and consider getting on oral minoxidil, give it a few years, it’s possible to reverse a lot of your hair loss.

[Richie888]

50 minutes ago, Russian Boy said:

I am haunted by the fact that in my family, on my father's and mother's side, there is not a single bald person. Is it often the case that I start to go bald first in the family? I can't understand why this is happening to me...

And yet, if I start taking finasteride, and at the same time start exercising, eating right, will it be possible to reduce the side effects in the form of a decrease in libido? or it won't affect

You certainly won't do yourself any harm eating right and exercising. I believe regular exercise plays a big role in balancing hormones - it certainly does for me. Have you had an overall health check? Blood pressure etc which can all play a part. At the end of the day if you eat rubbish you feel rubbish. At least if you improve your health and try fin and still get sides you will know then you tried everything possible to make it work. Topical Fin would be the best starting point if you can get it in your country. There's some great threads on here about the efficiency of topical fin plus oral min which you are already taking. Just take your time and look over your options, you're at a great age to turn it around. 

[Russian Boy]

22 hours ago, Melvin-Moderator said:

Генетика может быть жестокой, моему отцу 63 года не лысый, моему брату 44 года не лысый. Я облысел до 30 лет. Оставайся на плавнике и подумай о том, чтобы принять миноксидил перорально, подождав несколько лет, можно полностью обратить вспять выпадение волос.

Did I understand correctly that if I start taking finasteride, and there is a good effect, then after the withdrawal of finasteride, the hair will continue to fall out? some write that finasteride can stop baldness, even after you stop using it.

[Russian Boy]

Friends, I have a desire to pass tests for male hormones, pass a spermogram, and then start taking local finasteride. let's see how they will change my test results after the use of finasteride. this will be useful to me and to others.

[Raphael84]

Finasteride can only be effective whilst you take the medication. Discontinuing the medication will mean your system will revert to its genetic predisposition of DHT production and hair loss will continue. This is why it would be a long term commitment for as long as you wanted to maintain native hair.

[Britanium]

9 minutes ago, Russian Boy said:

Friends, I have a desire to pass tests for male hormones, pass a spermogram, and then start taking local finasteride. let's see how they will change my test results after the use of finasteride. this will be useful to me and to others.

Very good and sensible approach 👌 and yes Fin needs be considered as a long term plan. 

[Russian Boy]

10 minutes ago, Raphael84 said:

Финастерид может быть эффективным только во время приема лекарства. Прекращение приема лекарства будет означать, что ваша система вернется к своей генетической предрасположенности к выработке DHT, и выпадение волос продолжится. Вот почему это будет долгосрочное обязательство до тех пор, пока вы хотите сохранить естественные волосы.

thanks for the reply. I've also read that someone goes bald to a certain extent, and then the bald spot stops and doesn't progress. in my case, it doesn't matter?

and why do many doctors do a transplant after 25 years? I think the younger the guy, the more urgent the problem. I wouldn't be too upset if I was bald after I turned 30.

[Russian Boy]

22 hours ago, Richie888 said:

You certainly won't do yourself any harm eating right and exercising. I believe regular exercise plays a big role in balancing hormones - it certainly does for me. Have you had an overall health check? Blood pressure etc which can all play a part. At the end of the day if you eat rubbish you feel rubbish. At least if you improve your health and try fin and still get sides you will know then you tried everything possible to make it work. Topical Fin would be the best starting point if you can get it in your country. There's some great threads on here about the efficiency of topical fin plus oral min which you are already taking. Just take your time and look over your options, you're at a great age to turn it around. 

No, I didn't check my blood pressure or my heart. but I have a desire to check my entire body to make sure that everything is fine with it.

[Melvin- Admin]

1 hour ago, Russian Boy said:

Did I understand correctly that if I start taking finasteride, and there is a good effect, then after the withdrawal of finasteride, the hair will continue to fall out? some write that finasteride can stop baldness, even after you stop using it.

No, it’s a medicine not a cure. You have to continue taking it to see the benegit.

[Raphael84]

3 hours ago, Russian Boy said:

thanks for the reply. I've also read that someone goes bald to a certain extent, and then the bald spot stops and doesn't progress. in my case, it doesn't matter?

and why do many doctors do a transplant after 25 years? I think the younger the guy, the more urgent the problem. I wouldn't be too upset if I was bald after I turned 30.

For individuals who are losing hair, especially in a more aggressive pattern at a younger age, further balding with not likely “stop”. 

Hair loss and a decline in strength and quality of hair, with potential dropping of the lower crown and lateral humps  (sides) and even miniaturisation in the donor area can continue to evolve into our later years. For example, you can see many men in their 40s with loss, but having retained some decent amount of native hair. At 60, this hair has gone.

At 21, you have been losing hair since 18, so approximately 3 years. It is safe to say, that with out a regimen of medication, hair will continue to decline for the next 40+ years. 

It is understood that 50% of hair is lost before it becomes noticeable to the human eye. So loss likely begins earlier than most realise. 
Whilst each individual’s pattern and rate of loss is unique, generally the rate of loss is deemed to slow at around 35-40 years. But slow, not stop.

The reason doctors prefer that patients reach a particular age before considering surgery, such as 25 as you mention, is because in a 21 year old patient, it may not be possible to fully understand how their pattern of loss may progress, and to what extent, therefore not knowing how good a candidate they really are. A borderline candidate at 21 (based on loss and hair characteristics, NOT AGE), may not be deemed an acceptable candidate at 30 due to a much larger area of loss, progressed retrograde alopecia and lower crown loss. This means more graft demands but more limited donor areas. Potentially unstable donor.

21 year old patients relate to their 16/18 year old hairline and in most cases want to recreate something similar. Considering that further loss will evolve, having that lower juvenile hairline is not appropriate and will not appear natural when hair is lost behind it, and as you age, you may have nothing but that hairline, which is not a natural balding pattern.

Hair loss is incredibly tough and unfair for the younger guy. But in the eyes of a 30 something that is losing hair, it is no easier for him either, and it is naive to think that at 30, loss would not be an issue. But I completely understand that this is how you feel, just as I did.

Most younger patients with aggressive loss and without the use of medication, do not have the donor supply to constantly chase loss with more procedures. It is not an appropriate, nor ethical approach.

Whilst finances should never be the priority, the need for further surgeries would mean a huge investment financially which most younger guys are not in the position to do, and as a result they may make decisions based on finances and often decide on cheaper clinics, with less ethics, that may offer surgery, but present a larger margin of risk for many factors.