Pattern Hair Loss at 18 - Options for Early Diagnosis, and Stopping Hair Loss While Young

Author: Amiya Prasad, M.D.

Thank you for your question. You submitted a single photo and you stated in your question that you are 18-years-old and you are inquiring on whether or not it appears that your hair is thinning and you state that the photo was taken with your hair wet. You are asking about hormonal imbalance being a possible cause. You described some family history and it’s basically, you’re looking for guidance as to first to diagnosis and then of course the management.

Well, I can certainly give you my some guidance from my practice. I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years.

Hair loss treatment has been a significant part of my practice and in fact I am the founder of TrichoStem™ Hair Regeneration Centers. This is a technology we developed to treat men and women with hair thinning using an injection, a non-surgical alternative to hair transplant as well as what’s becoming a significant alternative to taking oral drugs such as finasteride. Now, I’ll go into the details a little bit further, a little bit later. So to begin with, I think that you are probably becoming aware of some recession and thinning of your hair. What is important is to first answer the questions that come into your mind. And of course yes, hormone imbalance may be an issue but in my experience, for men with your young onset hair loss, it basically falls under the category called androgenetic alopecia or genetic pattern loss, something that runs in families.

Common myths that it runs from the maternal uncle side or maternal grandfather but in reality is there are multiple genes that are associated with hair loss and therefore even if its siblings or other family members, you can’t figure out how this occurred, it is in the genetics. And of course, when we do an evaluation for someone like yourself, we take photos with the microscopy, we take standardized photos, we review your medical history, medications and details and if there is any question or concern, we refer you for endocrinology evaluation or if there is any question of the diagnosis from a tissue perspective or what exactly is going in, whether it is male pattern or something else, now we do biopsies. That means taking a piece of the skin with the hair to diagnose what is going on from a microscopic point of view.

Pattern Hair Loss at 18 - Options for Early Diagnosis, and Stopping Hair Loss While Young

However, I would share with you that the overwhelming majority of hair loss, 95% for both men and women, the most common diagnosis at 95% is androgenetic alopecia. So the question becomes what do you do moving forward? Well, when we started doing this treatment Hair Regeneration and briefly Hair Regeneration evolved from our application of wound healing technology using this material called Acellular matrix that recruits adult stem cell activity to further improve the wound healing of hair grafts as well as the donor area of hair transplants. We were able to find that thinning hair got thicker. From this, I developed a process called Hair Regeneration and what we do is for men and women at almost any age and our youngest male patient is 17, we are able to successfully with a single injection treatment, stop progression, restore the growth of hair that hasn’t been growing, as well as induce the shed of thinning hairs so that thicker hairs grow in. You have to understand that hair thinning is a combination of the cessation or stopping of hair growth and the progressive miniaturization or slow progressive thinning of hair. And for men, there is a strong association with something called DHT or dihydrotestosterone. So you’re kind of on the right track in terms of hormone-related issue but what happens is with puberty, the testosterone levels goes very high and that means that also the dihydrotestosterone increases.

So, people who have DHT sensitive hair can also be treated with a drug called finasteride. Unfortunately, a lot of people don’t want to take finasteride because of current fears about long-term sexual side-effects. Once we were starting to pick up a lot momentum with the Hair Regeneration treatment and we have patients who come from all over the world to come for this injection treatment which currently stands at 5 years out, no evidence of regression for the vast majority of patients which means with one injection treatment. And in some cases in the past couple of years, we started treating more and more people and we saw some situations where we wanted to experiment with additional injections, an injection at about 15 months, continues to be extremely successful in helping people treat their hair loss without any other drugs or other intervention. We found younger and younger people coming and there were often times when I had to really question whether or not it was the appropriate thing to do to help someone as young as 18. The point is that the onset of this type of hair loss at a young age is unfortunately associated with a certain rate of progression that doesn’t make you the best candidate for a procedure like a hair transplant. So, understanding that you now have drugs on one end like Propecia which people are afraid to take and your are not a good candidate for hair transplant, it is of value for you to learn about an alternative like Hair Regeneration because this is using your own blood, your platelet-rich plasma (PRP) which is the concentration of growth factors but unlike platelet-rich plasma (PRP) on its own, we have combined successfully an algorithm and a dosing process and a delivery technique with Acellular matrix to successfully treat men and women of a wide range of ages with progressive hair loss. So, certainly discuss this with your physician.

Discuss this with the people in your family who can assist in finding the information and do some consultations. Learn about what options you have so that you feel comfortable with any decision you make and I think this is something that will help you also think about the different options and there are not that many so timing is important. I stress this very much when it comes to Hair Regeneration treatment. We have situations where people start losing hair by 18 and be bald by the time they are 22. It is a very aggressive progression. So the earlier we catch someone, the better it is and this has been a very strong message that we have developed for our patients, for people who are learning about this that the inventory of hair is the limiting factor, the inventory of salvageable hair follicles. So the earlier we catch someone, the better it is. So, learn more about your options, start doing some consultations, try to get into doing something early so you can save the hair before it’s too late.

So I hope that was helpful, I wish you the best of luck and thank you for your question.

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