Determining Future Hair Loss

Hi Dr. Rassman. I am 22 years old but have been experiencing hair loss since I was 13. I have already tried Minoxidil (1 year) and Propecia (1 year) when I was 14-16 without stopping or slowing hairloss. I haven’t really lost much confidence due to my hairloss but it is very notorious now and would definitely like to do something about it. From what I can tell baldness comes from my dad’s side of the family (grandfather and father plus many of my dad’s cousins went bald) but no one has gone bald as young as I have. I think I am a class 3A Norwood and have been thinking about getting hair transplant surgery but I am worried if I will have enough of a donor area to cover the bald spot once the balding process stops, especially if I bald like my grandfather but so far it doesn’t seem to be the case. I was just wondering if at this advanced stage it was possible for a doctor to determine how much hair I will have left.

You need to have a good doctor define what is going on with your hair. Hair loss at 13 is rare, but can occur. If genetic balding has started that early, it would have been good to get a base line on the degree of miniaturization and the change over time. You must have that done now, before you get worse, or you will not know where your hair loss is going. With your history, a densitometry examination with quantification of the miniaturization in each area of your head will point to the long term pattern of your genetic hair loss (assuming that this is the correct diagnosis). There are other conditions as well, so it would be of great value to you to have a consult with someone like me, who is familiar with the causes of hair loss.

Transplantation in a person with certain conditions could be contraindicated. You need to be evaluated by a professional and even sending photographs will not give me the detailed microscopic examination I need. Please do not become your own doctor. This is not a game, but your future look we are talking about.