Author: Dr. William Rassman

Hi, I’m a 20 year old Caucasian male, and for the last few months I’ve been concerned about my hairline. I had never paid much attention to it before, as I’ve always had thick wavy long hair that mostly hid it, but after getting it cut short I realized that the corners extended a little bit higher than I’d like them to. The left only extends a little bit above my juvenile hairline, but the right corner is a little bit higher than the left. In both corners above the juvenile hairline mark I have short dark vellum hair.

I’m worried because I have more of this hair on the left than the right. The left almost hits my juvenile hairline while the right does not… Any advice you can give me would be much appreciated.

I give all permission to use these photos.

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You shouldn’t worry about having more hair or less hair on left or right corners of the hairline. Many people have asymmetry, so what you’re seeing isn’t uncommon. With respect to hair loss, I cannot give you a diagnosis at this stage since you’re only 20 years old and anything is possible. This could just be a case of the hairline maturing, but honestly, it is impossible to tell how/if your hair loss will progress just based on looking at photos. There needs to be more hands-on examinations of the hair.

My advice is that if you are concerned about hair loss, see a doctor. First, get an objective measurement — miniaturization studies and bulk analysis of hair on different parts of the scalp). Then get a diagnosis and a suitable Master Plan that will follow you for the years to come.

What do I do, How do I start?

You need a good doctor and anything short of an experienced doctor to help you manage your hair loss is a mistake you will take with you every year you get older. Regrets are when you don’t do the right thing and lose your hairy look when maybe you don’t have to. At your age, your’e in trouble as anyone can see. With this much hair loss at your age, you may be heading to a very bald man. Have you thought about it?

I’ve currently been on Finasteride for 3 months now, and Minoxidil for 5. My hairline is starting to regrow extremely slowly, but at the same time i’m not sure it will come back. I also would like to see if it would be possible to lower my hairline with FUE procedure as well as filling in a bit of the horshoe pattern as well that is receding. I contacted a facility in Miami, FL on Saturday I believe and was wondering how long it usually takes to schedule a consultation etc etc… I do realize i’ll probably have to get 1-2 or even 3 more hair transplants by the time i’m 40 but right now at age 20 my only fear is that when I go to college started this year, i’ll have missed out on my college social life due to my insecurity of my high and receding hairline.

At 20, you shouldn’t get a hair transplant. Medication is better. The reason is simple, you are very early in a progressive process and if you start now, you may end up chasing the balding. Any doctor who does surgery on a 20 year-old male is after the money and not the welfare of the patient.

The answer is no, you cannot have a hair transplant. I also always perform bulk measurements with an instrument called HAIR CHECK which is a good way to determine just how much thinning you have that you cannot see. Once this test is done and you have gone a year, I often repeat the test as it gives an excellent measurement on what happened to your hair over the year. If it got better and some of the thinning reversed, maybe you won’t need a transplant and that is the goal that you should look to do. Of course, a good doctor is critical to this course.

I’m basically at Norwood 3 and I don’t want to lose my f***ing youth. Going isn’t an option like for many here since I have moles on my head and can’t grow a beard anyway. I also got depression because of my hairloss, and it’s literally the only thing that bothers me in terms of my body.

However, most information online says you have to be at least 25 to do one. I can’t really wait 25 years and suffer like this. Is it really a bad idea to do it now, and is it even possible? I’ve got around 14k€ saved up, so money shouldn’t be an issue.

It is never a good idea to do a hair transplant at 20 years of age because you don’t know where your balding pattern will end up, and you can use up all of your donor hair before you get to the final pattern. Some bad doctors are unfortunately motivated to make a lot of money by doing more and more grafts on each patient, and that leaves you with possibly nothing left for future hair loss. Send me photos to wrassman@newhair.com

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….?

You are correct to wait until you are older to be sure where your balding pattern will show up so you will know what you are in store for. Your family history might indicate where your balding may be going. Look at your brothers, uncles, father and grandparents on both sides of the family to see what they hair loss pattern is/was, Usually by the age of 25, you will know and you can then build a Master Plan with your doctor.

Hello, I am not sure what to do now.

I am a 20-year-old male currently suffering with AGA. I have frontal and crown diffuse thinning. I was on (brand name) Finasteride for about a year, but my hair loss continued. I then switched to (brand name) Dutasteride. No sides and am currently on 1 gram a day rather than 0.5mg. Been on it for nearly 10 months.

All this, yet my hair continues to fall. I can’t use Minoxidil because I am required to look very tidy every day for work related matters. Minox causes a lot of dandruff and makes what’s left of my hair feel coarse and dry.

What can I do? I have been reading up on a famous hair transplant doctor and he mentions how he prescribed a very low dose of around 2.5 – 5mg of Loniten to his patients, and it apparently was very successful. I know of the dangers that come with this drug, though I am prepared to test the waters for a trial with a low dose of around 2mg. This is all I know of that can help. If you know anything else to help I would appreciate it!

You could use topical Minoxidil at night only after a shower, and then shower it off during the daytime. That is as effective as twice a day use. Oral Minoxidil as you suggest might also work, and in many countries it is the drug of choice.