23 year old with aggressive hair loss

[silvertaurus]

Hi!

I am 23 year old male with aggressive hair loss. It started at 18 now it has gotten way worse. My scalp is visible in light . I have been taking minoxidil 2-3 years but it is not having significant effect. Here is my current pic.

It looks way thinner when in bright light . I have a weird head shape too So I am not comfortable with shaving my head. Kindly, suggest when should I get hair transplant and how much grafts I would need to cover up.

[BurnieBurns]

Mate before you even think about a transplant you need to focus on stopping your loss. Topical Minoxidil alone hardly regrows hair on anyone. With this extent at your age you might become a Norwood 7 which would be severely limit your hair transplant options. Even if your hair loss never got worse you'd be needing a few thousand grafts at least depending on your expectations.

You need to try finasteride or dutasteride. Combined with minoxidil (even oral) this may provide some recovery.

Alternatively, I'd seriously consider looking into hair systems as well.

[Gatsby]

As has been said you need to stabilize your hair loss before even thinking about surgery because will just make things worse in the long run. Looking at your hair loss pattern now you need to try finasteride in consultation with your doctor. Give it at least a year. I know this is not what you want to hear. The other alternative as has been mentioned is to consider a hair piece. All the best!

[silvertaurus]

2 hours ago, Gatsby said:

As has been said you need to stabilize your hair loss before even thinking about surgery because will just make things worse in the long run. Looking at your hair loss pattern now you need to try finasteride in consultation with your doctor. Give it at least a year. I know this is not what you want to hear. The other alternative as has been mentioned is to consider a hair piece. All the best!

I wanted to ask why are suggesting finasteride,from what I gathered is that finasteride only stops the hair loss as long as you keep taking it. My hair loss pattern is only affecting the top of my head. The  donor area at the back of head and both sides is as thick as when I was a teenager. That is my only confusion.

[silvertaurus]

@Gatsby This is my donor area

 

 

[drawdownfx]

The medication is to stop further loss so when it does come to a transplant eventually you will keep a good look. If you get a transplant now and then the native hairs continue to fall you will look worse and at that point even shaving it won't be an option. You have to stop the current loss or halt it down as much as you can. By taking finasteride/dutasteride + (oral) minoxidil you give yourself best chance to halt+ even recover some. At which point you will be a good candidate for a hair transplant.

[mister_25]

Before you even think about having a transplant, you need to stabilise your hair loss. If you go 1 year on finasteride/dutasteride and you notice further hair loss has halted then you are much more of a candidate.

Minoxidil isn’t strong enough on its own.

[Al - Moderator]

1 hour ago, silvertaurus said:

I wanted to ask why are suggesting finasteride,from what I gathered is that finasteride only stops the hair loss as long as you keep taking it. My hair loss pattern is only affecting the top of my head. The  donor area at the back of head and both sides is as thick as when I was a teenager. That is my only confusion.

 

Don't assume the pattern is going to stop at the point you are at now. The area can expand to the sides and down the back of your crown. You still have a lot of hair in the crown area that is thinning. It would be best to keep that if you can.

 

Edited December 30, 2022 by BeHappy

[silvertaurus]

12 minutes ago, BeHappy said:

 

Don't assume the pattern is going to stop at the point you are at now. The area can expand to the sides and down the back of your crown. You still have a lot of hair in the crown area that is thinning. It would be best to keep that if you can.

 

Can a doctor check the extent of hair loss possible should I get a check up?

[silvertaurus]

52 minutes ago, mister_25 said:

Before you even think about having a transplant, you need to stabilise your hair loss. If you go 1 year on finasteride/dutasteride and you notice further hair loss has halted then you are much more of a candidate.

Minoxidil isn’t strong enough on its own.

What about the possible side effects of finasterid. That is the only reason I don't take it.

[Rahal Hair Transplant]

@silvertaurus,

At 23 years of age with aggressive hair loss, the first thing that you should really be doing is getting on nonsurgical treatments such as finasteride and minoxidil if you’re not already. Finasteride does a pretty good job at slowing down, stopping and even sometimes reversing the effects of male pattern baldness. Minoxidil may help thicken existing thinning hair.

But to undergo hair transplant surgery at this early stage without at least attempting nonsurgical treatments wouldn’t be prudent. Sure there are doctors who would be willing to take your money but in my opinion, these are the first things you should try.

After a year or two of aggressive non-surgical treatment, your situation can be reassessed for the possibility of proceeding with surgical hair restoration.

Frankly, without any medical intervening, it looks like you are headed towards a Norwood class 5A at the very least, possibly a Norwood 6 or even further.  As a result, unless things can be reversed or at least halted at this stage, you’re going to have to establish very realistic expectations as to what can be accomplished with hair transplant surgery. Surgical hair transplantation cannot restore a full head of hair as donor hair is limited and must be used wisely. This is why nonsurgical treatment is vital at this stage.

I hope this helps.

Rahal Hair Transplqnt

Edited December 30, 2022 by Rahal Hair Transplant

[mister_25]

5 hours ago, silvertaurus said:

What about the possible side effects of finasterid. That is the only reason I don't take it.

Taking Finasteride is a risk on its own, some people experience temporary side effects and very rare claim to have PFS. It’s ultimately your choice, but you should know that many surgeons refuse those that are not medicated, especially those under the age of 25-30. 

You should know the risk of the drug and think to yourself “does hair matter to me this much”. In my case yes and I started taking the drug at 20 years old with no side effects ever and got regrowth and stabilisation. 
 

If you went for a hair transplant now, without medication, your setting yourself up for failure in the future. You might get a good result but you would only be able to enjoy that for a year or two because you will continue to thin and will be chasing transplants until your donor is exhausted and inadequately used for a high Norwood case.

since you are a aggressive balder you should know that the likely hood that it will get worse is high.

[gillenator]

13 hours ago, silvertaurus said:

Can a doctor check the extent of hair loss possible should I get a check up?

Based on the information you already supplied to us, unless you can drastically reduce the progression of loss with effective medication, you are eventually headed for class 7…there is also evidence of retrograde alopecia…look at the much older men in both the maternal and paternal sides of your family history…without meds, that is undoubtedly where you are headed.