what is premature genetic balding…?why is my hair falling out at age 14?
Assuming you are male, genetic balding can be seen in the early teens, although it is unusual. There are other causes of hair loss as well. I would have your scalp mapped out for miniaturization to make the diagnosis. See a good dermatologist to get this done. If it is early genetic balding, the drug Propecia may help, but clearly you need a good doctor to manage your hair loss.
- I am 57. Over the last 5 years I have suffered hair loss. I have consulted with three hair-loss experts. Two have said I should be on Propecia, one said at my age it will make no difference. Will it?
- I have four elevated liver counts. I do not drink or smoke, nor have I ever smoked or drank. Will taking Propecia have negative effects on my liver?
The value of Propecia should be determined after you have a diagnosis in hand for the balding process. How much miniaturizationdo you have as compared to balding? Propecia works well if the miniaturization process is well underway, but the hair still should have substantial volumes. With regard to your liver, what is your diagnosis as the cause of your liver problem? Doses of Propecia must be reduced when people have liver disease. I do not like internet medicine, because I like to see and bond with my patients. That is why you need a good doctor first, then a Master Plan to determine what to do next. Propecia may make a difference in the crown hair, even in a 57 year old.
My mother who is 74 is experiencing hair loss. It’s in the range of your grade one that you show on your website. Anyway, she’s in wonderful health so we’ve ruled out any medical conditions that may cause hair loss. She was taking medication for her menopause (primpro) that she’s been off of for approx. 2 years now and isn’t taking any other medications that include hormones of any sort.
My question is..recently her and I went to a company here in Brea, California to see about transplants or any other methods of hair restoration. They told her that because of her age, the doctor wouldn’t even consider giving her transplants cause if the hair wouldn’t grow on the top of her head now naturally, it wouldn’t even if they did do the procedure. Is this true?
Any information would be greatly appreciated!
Hair loss in women needs to be evaluated first, from a medical point of view. If the loss is recent, she may have an underlying medical problem (such as eczema, malnutrition, autoimmune disease, drug reactions, infections, many other problems too numerous to mention). Then she needs to have her hair mapped out for miniaturization so that a diagnosis is made. With all of that in hand, you need to then make decisions. Medical health issues must be addressed first, then the doctor who maps her scalp for miniaturization (often a good ethical hair transplant surgeon or dermatologist) can make a decision about hair transplants. From the little you are telling me, I would guess that hair transplants may not help her. Her age is not the issue, for I have transplanted people as old as 89, but the value of hair transplants must be weighed so that the total picture is the patient, lifestyle, health, etc. The value should not be determined by how much money the surgeon makes, but how much value she would get from doing a hair transplant.
Dr Rassman
I recently had transplant surgery at a reputable office to combat thinning hair on top and a receding hair line. I am 48 years old. I was suprised by what I believe was a fair amount of shock loss around the graft areas given my age. I was not on propecia pre-surgery but began taking it a few days following the procedure after reading your column. Now I believe propecia can also cause shedding in the early months. Could you explain the difference between shedding and shock loss and what you believe I am experiencing. Maybe a combination of both.Thank you
It sounds like you experienced shock loss and if this is in the miniaturized hair, the hair may not come back. Treating thinning with transplants is not something I do often. In many people with miniaturized hair, transplanting into that ‘unhealthy’ hair does little to really increase the fullness. I believe that for most people like you, any benefit you will get in the long term may be lost in the short term, making transplants a poor decision. I would think that Propecia should have been used in advance of your hair transplant procedure just to minimize this risk. The transplants done may offset the hair loss and the Propecia may bring some of the hair back. Only time will tell. Once the glass of milk falls and the milk spills out, it may be impossible to bring it back.
I am 21years old and I am starting to look like my dad. According to your balding classification, my pattern is now like a a Class 4a pattern but my dad is a Class 6 or 7 pattern. I went to a hair transplant doctor and he said I was too young. I already have no hair halfway down my head, Would you transplant me?
First, you must recognize that this process is an important lesson in planning for both you and I. I believe that young men like you can receive surgery, but before that happens, you need to have a Master Plan that takes into account all of those elements that make a 20 year old different than a 26 year old or a 50 year old. These would be my criteria:
I must be sold on taking you on as a patient. I must have faith that you know enough about the process (over time) to appreciate the things I said above. Although I rarely do a hair transplant on someone under the age of 25 (I do some), the concept of your becoming a Class 7 balding man is the worst case for both of us. You do not have to become bald to get hair as that would be unreasonable on my part. Are you prepared to manage the worst case in a cooperative manner with me?
To state emphatically that you are not a candidate for a hair transplant is an unduly hard position. Each and every patient needs to be assessed individually, weighing all of the elements above (and everything else that is relevant) before any decisions are made. I try not make decisions about any of my patients on any one issue, including age. I want to get to know the person inside the head, well beyond what is evolving on top of the head.
I am 23 years old and have visible white hair. i know that this is an aging process and that scares me. i am a very physical athlete and i am worried if this aging is going to effect the way i compete. is this transformation independent from my bodies aging or am i doomed physically as well?
Graying hair is just a change in the way your hair cells manage pigment. This does not mean that you are going to get old sooner, that is, unless you see your body aging as well. Don’t worry, be happy!
Dr. Rassman, what approach do you take with young men who are not able to take Propecia. Do you never do transplants in them? Do you sometimes do transplants? I am a norwood 2 going on a norwood 3. I am considering getting small transplants to keep up with my hairloss starting in about a year when I will be 23 years old. Is is a bad idea? Going bald is not an option for me, so its either transplants or a system.
I hope you read the blog entry from last week where a patient whom I did not recommend getting a hair transplant was not happy with my recommendation and got a hair transplant from another doctor. Now he is worse off and more bald because he lost more hair due to shock loss.
I would not normally recommend a hair transplant to a Norwood class 2/3, but every patient is different and it would be impossible for me to give you personal medical advice without a person to person consult. You may be a Norwood 2/3 now but without a good exam and a good medical history, there is no way of knowing what Norwood class you would be at the age of 50 (this is where the Master Plan comes in). If you have miniaturization in the areas behind the frontal corners (like the top and crown of your head), then it would be suggestive that you are in for a lot of balding in your future and fixing a Class 2 pattern may not be good timing just now. Alternatively, if there is no miniaturization in the rest of your head and your family history does not show advanced balding, then maybe with the right doctor / patient relationship, a hair transplant could be considered. I am not excited about the idea of doing a hair transplant on someone with such a pattern and at your age, because the pattern of your future hair loss is not going to show up for another few years.
I would also question why you are not able to take Propecia.
Dear Dr. Rassman,
Im 17 an i have been noticing when i shampoo im losing quite a bit of strands, i know its common to loss up to 100 strands but i ask my friends if they lose any strands of hair in the shower an they all say no. Also none of my family members have ever gone bald, so does this mean that i can or cant go bald?
You are correct in that 100 (and even as many as 200) hairs a day and is normal to lose. Hair grows in cycles, so sometimes you may notice more hair loss. If your hair loss is within that range, I wouldn’t be worried. Your hair may be in a cycle where it is in its shedding phase, but when we go into a hair loss cycle associated with genetic hair loss, the loss in the shower may be higher. The best way to judge is to:
Hair loss in your genetics can skip generations, so even if you do not see it in your immediate family, it does not necessarily mean that nobody in your family has experienced balding to some degree. And chances are that your friends do lose hair in the shower and it goes down the drain. I couldn’t tell you for sure though — I do not shower with your friends.
My little girl is three and her hair is falling out. When it does it looks and feels like a fur ball from a cat. When she was one she had milk indused anemia. She has been on iron drops since. Her iron levels are now normal, but she is still taking iron drops. Can this have any bearing with the hair loss? Could it be too much iron in her body? She was tested for thyroid, diabetes, and other tests that could cause hair loss – all normal. The way the hair started to fall out was on one side only and now has started to fall from the top of her head. One day at her day care, another girl pulled her hair and a clump of it was sent home to me in an envelope. She is very petite for her age. She is a very nervous little girl. I am a single mother, although she sees her father several times a week and he spends time with her on the weekends. Help me with some answers. Hair loss is not an issue in the family. My hair is red and very thick. With this info please help me?
You need to see a pediatric dermatologist, a specialty in itself. I wouldn’t know how to treat hair loss conditions in a 3 year old over the internet. Sorry.
I am 23 and notice I have a mature hairline. its a 2 on the scale. I dont like my hairline though and would like to get the hair around my temples back. Is there any procedure that can fix this? If so please tell me
I have transplanted the juvenile hairline back in some men, but I do so only under certain conditions:
I have clearly done this more than once, but in my present memory the only ones I have done under 25 years old were professional actors, television soap opera sexy men, or models whose livelihood depends upon that ‘youthful’ look.
Respected Sir,
I am very happy to see the service you are providing. My name is nabeel hussain .My age is 21.5 years. I have started getting bald when I was of eighteen. Now on THE NORWOOD/HAMILTON SCALE I am at 3V position. I have met a dermatologist he recommended me genesis and minoxil2%. I was told that initially I will lose hair + I have to use these medicines for whole of my life. Sir please answers my following questions I will be highly thankful to you.
- I don’t want to do this hectic and frustrating job of using medicines. As it is temporary and as I will stop using them my hair will lose more rapidly. Apart from that they have side effects also. Am I right? Will medicines have some negative effect on my donor area?
- I want to go for hair transplantation. but one doctor told me that doing so at an early age of 21.5 is not a good option because I will continue losing my hair and I will be again bald at a age of 30.and the previous transplantation will become fruitless. Is it right?
- I want to transplant hair because I have a concern about my donor area that it might not diminish if I postponed my transplantation. Is it could be the case?
- Can we take hair from the side of our head as donor hairs?
- What is period of complete bed rest after transplantation?
- At what age should I go for transplantation?
I have asked you a lot of questions but I hope and am certain that you will answer them all as you are very co operative.
Kindly recommend a better solution for me.
You are asking good questions. Take the advice of the good doctor you have already seen.
Dr. Rassman,
- 18 Year old male
- Hair loss started around the age of 13
- This was when i first started geling my hair
- This occured with dandruff
- After a while this stopped, although hair remained very thin and became see through when wet
- About 1 month ago, started to loose about 20 to 30 hairs every time i shampooed or brushed my hair (no dandruff)
- Individual hairs can be pulled out fairly easily
- Started using a new hair gel a few weeks before the problem started
- During the period between my previous hair loss and now, i used gel in small amounts but these did not have any effect
- My hair gets very oily and weak when my nails grow for more than a week without trimming
- I had a blood test done and this only showed a very mild iron deficiency which the doctor said was not enough to make the hair fall out
- I had a very high fever about 4 months ago (New Year’s Eve)
- No history of hair loss in the family
Can you think of any reason why this is occuring and if so, is it treatable?
If you had a complete medical workup and you are still concerned about hair loss, you should make an appointment with a hair doctor (a good dermatologist) to map your scalp hair with a densitometer to look for miniaturization and pattern of hair loss.
I just turned 21 and I am losing my hair. I wasn’t born with a very good hair line and I would like to improve what I already have. Also I need to prevent it from falling out more. I tried using propecia but I couldn’t keep up taking all of the pills, I am really forgetful. Something like that would never work for me. I have a digital camera and would like to send pictures to see what your opinion is regarding my hair.
Sounds like: if you can’t remember to take the single pill each morning, the drug won’t be of a benefit to you. At 21, from what you are saying here, you might not have genetic balding. Maybe you are evolving with a mature male hairline, which is usually about 2/3 inch higher than your child hairline. You need a diagnosis as I have said many times here. You can also send photos to the address on the contact page. Please reference this post when you send the photos.
Is it true that by the age of around 33, if no genetic balding pattern has shown much of a sign of appearing it is unlikely that it will appear in a way that will result in major hairloss?
Although this is largely true, it is not a hard fast rule 100% of the time. Sean Connery had a perfect hairline (see update below) in the first of the James Bond movies (when he was in his early 30’s), yet today, his hair loss is quite advanced. His genes kicked in late enough for him to have developed that frame to his face which women find sexy. All of the James Bonds have that perfect, youthful hairline that set many standards for the sexy male image in Hollywood for years.
You need to find out what you have in terms of miniaturization. It would be unlikely that you would bald significantly if: (1) there was no miniaturization of the hair in the front, top or crown at 33, and (2) no one in your family started to bald later than 33. You can check your scalp for miniaturization by mapping it out. If none exists, the probability is that you may never bald, but nothing is ever certain, even for James Bond.
Update: A reader pointed out something I was oblivious to. Sean Connery was bald in his 20s.
From NNDB: “With an especially bad case of male pattern baldness, Connery began losing his hair at the age of 21. Without his toupee, he has been thoroughly bald for decades, except for a small ring of now-gray and thin hair above his ears”
Oops.
hi. right now, i have a perm from curly to straight. i am 13 yrs old girl and if would be cery nice of you if you would pleeeease help me. i went on a winter vacation with my family for 3 days. the second day i went to the pool with out a cap. after a while i went up to my hotel room by myself, then i blew dry my hair. after the vacation was over i went home to wash the chlorine out of my hair which were V05 conditioner and shampoo. after i washed it, i blew dry my hair some more. later in about a few weeks, every time i comb my hair a whole chunk of hair came out every single day for 3 weeks. it came from the back of my head. i just noticed when my hair dresser said it looked like a short boys hair cut and i started to cry for weeks. i did not want to go out in puplic expecially in school where my friends had good looking then i did. i felt jealous and lonley because a few had longer hair than me, straight with out a perm. and i don’t really want to show my natural hair because it’s crazy looking. so if you would pleeeeease help to grow it back faster i’ll feel much better again and take better care of a perm. thank you so much
You sound very emotional, and that is understandable seeing as how you are a young teenager. When my daughter was your age, I saw these range of emotions firsthand. Please know that losing hair is normal (average person loses about 100-150 hairs per day) so that if you are seeing such numbers of hairs being lost, you are just seeing something that you may not have noticed before. If you are healthy and have no medical problems, then there is no reason for significant hair loss. First, you need to talk with your parents and tell them what you are experiencing. Then they may take you to a good dermatologist who can evaluate your hair to find out if the loss you are experiencing is above the normal daily loss for an adult. The best advice I can give you is to reach out and ask those who love you to help you through this experience.