20 year old wants a hair transplant

/by William Rassman, M.D./0 /

I am a 20 year old male and I want to discuss about hair transplant. I Started noticing hairloss since around age 19 and since then I have been using rogaine to help me with it(about 7 months now), I have also just started finasteride a month ago. Although I only have a small amount of recession, I want to get a small hair transplant done so that my hairline looks good. I am a model/actor hence I am in front of the camera a lot and I need to keep my hair looking good in order to maintain a few of my upcoming roles. After doing a bit of research I came across the fact that hair transplant is usually done on people above the age of 25. But I am fine with getting it done two or even three times in the next decade as long as I can keep my hair! I also think it is worth mentioning that money is not an issue for me in the sense that having good hair would be an indirect investment into my career. What would you advise me?

Please look at these pictures: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/ and see the need for a Personalized Master Plan that will not include a hair transplant until you are at least 25. This is clear because your balding will change and if you use us your donor hair now, then you might end up without enough to follow your future balding pattern.

Minoxidil producing hair elsewhere

/by William Rassman, M.D./0 /

Recently, i have to start shaving my mustache once every 3 days since the growth is much more noticeable and i have started growing a visible soul patch??? I don’t have a speck of hair for a beard and under my lips, so a soul patch is so off-putting when i saw it in the mirror. Also, i only apply the min on my scalp so its weird seeing growth on places other than the top of my head. I will just take these changes as a good sign!

It means that you are absorbing enough minoxidil in your body though the skin to produce hair elsewhere. When women use it and this happens, they get facial hair and body hair as well.  maybe you are using too high a concentration of minoxidil?

 

I got Brain Fog immediately after taking finasteride

/by William Rassman, M.D./0 /

I get immediate, brain fog-like sides upon taking even a 0.25mg dose of fin. I usually start to notice them about 30 minutes after taking the pill. If I continue to take it for multiple days, the sides compound, seemingly, and get worse.  Why is this? Why is it immediate? Does anyone else get acute side effects?

We don’t know the answer to your questions but when this is reported and if you were my patient, I would have you stop taking finasteride.

Hair Thickness vs Density in a Hair Transplant

/by William Rassman, M.D./0 /

When estimating the number of grafts a person needs, I always want to know the hair thickness of the person. The reasons for this are clearly defined by this graphic I saw on Reddit.  For a visual representation, the graphic artist kept the number of hairs the same (density) and change the thickness of the hair so show the difference in coverage.  This was nicely discussed by Dr. Sharon Keene with actual hairs.  So you see, that if your hair is fine, it will take a lot more hair to get the fullness that a person with a medium weight hair or a coarse hair.  This is why, people with fine hair often get a second hair transplant because the fullness seen is not as good as if the hair shafts were thicker. It is therefore true that that two fine thickness hair transplants with the same number of hairs might be equal to one medium thickness hair transplant.   Then it is also true that two medium thickness hair transplants with the same number of hairs might be equal to one coarse hair transplant.

Male with large forehead (photo)

/by William Rassman, M.D./0 /

With some decent density on the hairline now (only fibers would get me here before) I’m looking at my forehead size and shape. I’d really like it lower, but could use some feedback.

Option 1: Forehead reduction surgery. I know this is hardcore, and usually not recommended for males…. but given my age and recent treatment plan, I’m wondering if it would be less risky (ie. the chance of further rapid recession)

Option 2:Recreating my hair entirely with an HT. Maybe. I’m not sure if would ‘take’ in an area that is completely smooth/shiny area like the upper part of my forehead.

Men should never get a forehead reduction surgery because what caused your large forehead is hairline recession which is likely to continue. If you do it with a forehead reduction surgery, then as you recede, the scar will show. A hair transplant is always the way to go for men. In your pictures, your hairline is already going back further. If you advanced that hairline, it would be thin and would eventually disappear. Women can have the hairline reduction surgery because they don’t recede.

Can I go from a hair system to a hair transplant?

/by William Rassman, M.D./0 /

Question, is it advisable to use hair systems when i have plans to have transplants in the future? will the scalp be damaged? Thank you.

Are you aware that hair systems cause significant hair loss from the glues and attachment clips? This will make the balding worse and increase the size of the hair transplant you may need if there is hair in the area of the hair system.

20 year old with advanced balding (photo)

/by William Rassman, M.D./0 /

Hi I l’ve seen your advise and I was wondering if I could ask for you opinion as you seem to be one of the few in r/tressless who is an expert in hair loss. I’m diffuse thinning and started fin at the end of October. I’m afraid of starting min as well because of the shed. All I’m wondering is do you think min could work for me looking at my hair loss. I’m 20 going bald for about 15 months. This is my hair from last august until this week

That is a lot of balding for a 20 year old. I would add minoxidil to your daily routine, pulling out all stops to hope for some reversal. If I ever saw a man than needs a Personalized Master Plan it is you with a caring competent hair doctor. You are likely going to develop a Norwood Class 7 pattern of balding. Is that what is in your family history?  Dad, Grandfathers, brothers, etc….?

Does finasteride grown hair stay your lifetime?

/by William Rassman, M.D./0 /

Over time (sometimes years or decades), the finasteride MAY become less effective. Everyone is different. It is clear, however, that you must stay on the finasteride if you want to keep your hair as finasteride is a lifetime commitment. Many of my patients in their 60s stayed on finasteride and the few that stopped it, told me that they lost huge volumes of hair within a couple of months so they went back on it. This suggests that the finasteride is working well into a man’s 60s.

 

Hair loss from hair treatment (photo)

/by William Rassman, M.D./0 /

Some background: I’ve gotten perms 1-2 times a year for the last 9 years to try to increase volume for my thin hair. I got a root perm done in November but my scalp felt like it was burning so I decided to stop them altogether.

Now I noticed my scalp has been pink (thought it was a sunburn at first but it’s been 3 weeks and no flaking or changes) and I have this bald spot around my hair part. The hair around it is so thin and sparse if you look close. I changed my hair part to cover it up but I’m worried the hair loss is irreversible. I’ve been noticing also that I lose a lot of hair in the shower.

I ordered a silk pillowcase after a friend recommended it, and I currently use sulfate and paraben free moisturizing shampoo from Costco, OGX biotin & collagen conditioner and Aveda invati advanced scalp revitalizer spray but I’m not sure if it’s helping.

I thought initially it was from stress but this is way worse than anything I’ve experienced before. Any input or recommendations would be appreciated. I’m wondering if I should go to a dermatologist or change any of my hair products.

Hair treatments used to color hair can cause chemical burns to the scalp and kill off hair. If that happened to you, it will not get better. The best treatment for a permanent loss like is shown here: https://scalpmicropigmentation.com/gallery/smp-for-women/ Permanent burns can happen with a variety of hair treatments, using any bleaching agent in particular.