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Hair Loss in Men
Under 21
1) Is Hair
Transplantation the
Answer?
2) What should a
young man do if he
begins to
lose hair
before age 21?
3)What treatment is
a physician hair
restoration
specialist likely to
recommend?
1) Is Hair
Transplantation the
Answer?
Hair Loss is
commonly thought of
as something that
occurs only in older
men. But it happens
in younger men,
too—those who are
not yet 21 years
old. Because hair
loss is generally
unexpected before
age 21 it can be a
shock for a young
man 15 to 20 years
old to discover he
is losing hair. The
first hair sign
likely to occur is
thinning in the
temporal area of the
frontal hairline,
above the eyebrows
on either side of
the “widow’s peak”.
This can result in
the appearance of a
high forehead. The
young man may also
begin to notice
excess shedding when
he combs, brushes,
showers or shampoos
his hair.
If the young man’s
father, mother,
uncles or older
brothers have
pattern hair loss he
may not be surprised
to see that the
family “baldness
trait” has been
passed along to him.
Nevertheless, he
most definitely will
not be pleased to
see the inherited
trait appear so
early. Hair loss
before age 21 can be
very disturbing for
a young man, even if
he expects to
eventually undergo
hair loss similar to
other male members
of his family. Loss
of hair at this
psychologically and
emotionally
vulnerable time in
his life can leave
him feeling
disfigured, less
attractive socially,
and hindered in the
job market. He can
be an easy target
for expensive but
ineffective “miracle
cures” advertised in
print media, on TV
and on the Internet.
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2) What should a
young man do if he
begins to
lose hair
before age 21?
A good first step is
consultation with a
physician hair
restoration
specialist who is a
member of the
International
Society of Hair
Restoration Surgery
(ISHRS). A physician
member of ISHRS is
skilled and
experienced, and
importantly, follows
ethical guidelines
that make the needs
of the patient the
physician’s primary
concern. Ethical
considerations are
especially important
when the patient is
vulnerable,
distressed, and not
yet an adult. The
minor with hair loss
should not be
“pushed” into any
decisions regarding
hair restoration,
especially surgery,
and should be
educated and
counseled against
making any hasty
decisions that may
not be in his best
interest.
The first advice a
physician hair
restoration
specialist might
give a minor with
hair loss is: “Don’t
panic. I understand.
Male pattern hair
loss is a common,
inherited condition
and it is normal to
be bothered by it.
We can almost
certainly find a way
to manage it by
making decisions
tailored to your
individual needs.”
When the patient is
a minor, the
physician hair
restoration
specialist must
insist that a parent
or legal guardian be
involved in the
decision-making.
Inclusion of a
parent or legal
guardian resolves
questions of legal
responsibility and
gives the patient
support in making
informed decisions.
Close parental
support is important
in the success of
any treatment
recommended to a
minor. No
recommendations for
treatment will be
made until the
physician hair
restoration
specialist has
determined the cause
of hair loss. While
male pattern hair
loss is the most
common reason for
hair loss in men
there are many other
causes that need to
be considered and
ruled out. Hasty
treatment before a
diagnosis is
established may be
ineffective and
could be
counter-productive.
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3) What treatment is
a physician hair
restoration
specialist likely to
recommend?
The physician’s
first goal is to
educate the patient
with regard to the
cause, progression
and long-term
ramifications of
hair loss as well as
any treatment for
hair loss. Because
hair transplantation
has high public
acceptance as a
successful method of
hair restoration,
the young man may
consider it his
first option for
treatment. However,
most leading
physician hair
restoration
specialists do not
consider hair
transplantation a
good option for most
men under age 21.
Hair transplantation
may rarely be an
option for
individual young men
under age 21 when
indicated by
individual patient
characteristics.
Hair transplantation
may not be a good
hair restoration
option for young men
because, among other
reasons:
A)
The pattern and
progression of hair
loss has usually not
been fully revealed
at this early age
B)
Hair transplantation
performed this early
may be less than
desirable later in
life when the
pattern and
progression of hair
loss has been more
fully revealed
C)
It is difficult to
design a surgical
procedure that will
look natural and
appropriate for the
rest of the
patient’s life
D)
Once hair
transplantation is
begun, future
surgeries are
required to maintain
a natural appearance
E)
Unfortunate results
of hair
transplantation
performed too early
may have to be
surgically corrected
later
F)
Even with parental
guidance, it is
difficult for a
minor to make
informed adult
decisions regarding
elective surgery.
Hair transplantation
may eventually be
the best approach to
treatment of the
patient’s hair loss.
An interim option
often recommended by
leading physician
hair restoration
specialists is
non-surgical
treatment with
minoxidil (Rogaine®)
and finasteride (Propecia®)—the
only hair
restoration
medications approved
by the U.S. Food and
Drug Administration
and scientifically
proven to
successfully treat
hair loss. Treatment
with minoxidil and
finasteride can slow
hair loss and give
the appearance of
more hair by adding
density to
miniaturized hair
follicles.. Slowing
the progression of
hair loss before and
after age 21
improves the
opportunity for
successful hair
transplantation
later.
In selected cases a
physician hair
restoration
specialist may
perform a small
“forelock”
transplant to
provide immediate
improvement in the
patient’s temporal
frontal hairline. In
only very rare cases
would a physician
hair restoration
suggest aggressive
treatment with hair
transplantation. The
cost of consulting a
physician hair
restoration
specialist may be
less than the cost
of multiple
ineffective “miracle
cures” purchased
from vendors
advertising on the
Internet, TV, radio,
or in print media.
The professional
advice and support
of a physician
member of the ISHRS
will be invaluable
to a young man who
feels devastated by
the early loss of
hair.
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