Author: Dr. William Rassman

Fortunately, you supplied just barely enough of a view of your hair in the two most important areas (front and crown) to show that you have thinning in both areas. You have a strong forelock in the center of your thinning frontal area and this forelock may stay even if the hair around it disappears. The best treatment at your age with this condition is the drug finasteride which may reverse it at your age. Also look at this post for more direction: https://baldingblog.com/haircheck-test-how-it-is-done-video/

I’m 21 years old, and I fear I may be losing hair. About a year and a half ago I noticed that my temples were a little thinner in the corners. Now my hair is getting longer, and there are thinner hairs that hang down at my temples. Also, the shallow edge of the scalp is visible. Am I definitely balding? Is there anything I could do about that, and should I even worry? I checked with that chart, and my hairline looks like an NW2, but even with it getting longer, the temples are somewhat visible. I know people way older than me with a
hairline like this, but if I’m already noticing at 21 (almost 22) that seems like a bad sign right?

Genetic Male Pattern Balding (MPB) can start in the teenage years after puberty. Norwood 2 is not really balding, but if you are noticing other patterns of hair loss, then it may be an early sign. Without an examination, anything is possible.

Probably not. What I see is that you appear in the front to be transitioning into a male mature hairline as the widow’s peak is a remnant to where your hairline receded as it is moving to a mature hairline. Some men retain this widow’s peak unless they undergo genetic balding in which case they may lose the widow’s peak and the entire hairline as well. It appears that your left side is maturing faster than your right side.

Normally, I tell my patients that finasteride is a lifetime commitment. It takes about a year to see the benefits. Some see it earlier and a few see it later. Most people will find that it slows or stops the hair loss as opposed to reversing it. The younger you are when you start it, the better is the result so men who start it in their late teens probably see less long term balding than men who start it in their late 20s.

I and hundreds of thousands of young men like me got PFS from a single pill, doctor – from the first pill. How would your self-rationalization deal with that inconveninient truth? Oh, I know how:

Denial.

If that is true, I can’t understand the physiology of it. If there were hundreds of thousands of men suffering from PFS from a single pill, I would have seen it in my practice. A single pill? What is the mechanism for it? I am a clinical scientist and I look to science for answers to questions.

A physician wrote: “I have personally been taking finasteride for 14 years and will be taking it for the rest of my life. I have never had a patient in my practice have long term side effects from finasteride [he has prescribed it to thousands of men]. I have only seen a positive psychological influence on my patients’ lives since they realize they are slowing a progressive aging process. I would bet my retirement that there is a lowering depression/suicide rate for patients on finasteride compared to their peer group not on finasteride with similar Norwood pattern hair loss (if this study could ever be performed since there are so many confounding variables).”

All the doctors in my field are struggling with the PFS problem as you told us here. In my practice I have not seen PFS in my patients except one man who reported impotence within 2 hours of taking the first dose and I told him to stop it. Like the doctor I quoted above, I too have been taking finasteride for years with no ED or libido problems. What is in it for me to prescribe it if it didn’t help my patient?

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So I am 20, soon turning 21 and I have recently been more and more adamant that a transplant would be the best thing for me. I never did have a perfect hairline since a kid and having a Dad who went bald probably about 30 it was going to happen. But I probably started noticing around 16/17. Then about a year and a bit ago it got really bad. Now I am a constant hat wearer. So my hairs receeded a fair bit at the temples as well as my hairline.

I have looked into transplants and come across various reviews of Turkey. Being a student the cheaper price there sells it immediately. I was wondering if anyone had any advice etc on it and could maybe point me in the direction of well reviewed trust worthy clinics. I have come across this https://www.medaway.co.uk/hair-transplant-turkey/ but just seems bit fishy even with over 3000+ successful transplants???Any advice or guidance would be much appreciated

Yes, don’t do it, not at 20 and not in Turkey. See this blog post here: https://baldingblog.com/22-year-old-received-a-hair-transplant-of-2800-grafts-from-reddit/ This explains the many reasons why you shouldn’t do it now. Get a good doctor who can work with you on a Personalized Master Plan that will insure that you will keep your hair, one way or another, through your entire life. I have had many patients who I worked with (see here for a couple of examples with photos:https://baldingblog.com/difference-between-norwood-class-7-patients-with-photos/ ). Be smart about your hair, please don’t dive into hair transplants now for your own sake.

If you have a tendency to Hypochondriac thinking, then the nocebo effect is clearly something that could impact you. You have to work it out in your own head first, otherwise, sexual side effects will hit you.

There is no such things as a little hair transplant. A hair transplant requires local anesthesia which can be the beginning of a cascade of hair loss in a 25-year-old not on finasteride. See this link: https://baldingblog.com/need-master-plan-think-hair-transplants-photos/ as this could be you. Whatever hair you use now should be part of a Personalized Master Plan that will follow your hair loss as it occurs. Even the man in the link, with a Personalized Master Plan, could have hair for his life.

You have a Class 3A or 4 pattern of balding. At your age, you are an ideal candidate for a hair transplant. The frontal area with a normal hairline will make the man in the mirror look like he did 10-15 years ago.