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I’m a Teen Worried About Hair Loss — What Should I Do?

sir,
i have seen your ht results. truly fantastic. congrats.

now my problem is my dad’s bald but none of his brothers (4) are bald. i have had a big forehead and recession in temples from childhood which is hereditary even for my uncles. so i dont know whether i will have hairloss in future? i am 19 years old (nw 2) now. what shall i do?

also i dont know when to start propecia or rogaine. to add further, i heard propecia decreases cancer risk but if a person still gets it, then he will get a very dangerous form of cancer. is it true? plus will propecia cause male breast cancer? i dont know what to do but i want to keep my hair at least up to 55 or so. but i am scared about these info’s here about the side effects? could u please guide me. it would be so nice of you if you mail me answering to my queries and tell me what i shall do to keep my hair on.

At the age of 19 and a Class 2 Norwood scale balding, you are not a candidate for surgery. If you are really balding, then you will have the appearance of miniaturization in the hair on your head. In that case, the drug finasteride is the best way to stop the balding problem in men who are balding in the earliest stage. Get a good doctor to review your personal situation and please do not have a surgery under any circumstances.

I’ve been getting a lot of similar emails from teens that want to take medication before they need to, or want me to tell them if they’re going bald based on 2 sentences they email to me. I’m going to make this as easy as possible for everyone to digest, and there’s no better way than an itemized list…

  1. You have a family history of hair loss, but that doesn’t necessarily mean you will experience loss to the same degree or at all. It can skip generations.
  2. Some refer to the corners of the hairline as the temples. Corner recession could be the maturing of the hairline. Recession of the actual temples will usually not see benefit from medication and surgery will likely be required to restore them.
  3. I can’t tell you when you should start on Propecia (finasteride), as it is a prescription medication and therefore must be prescribed by your physician. Generally speaking, you shouldn’t take medication as a preventive medication against hair loss anyway. Everyone is different, and some men will need the medication at 18 years old, while others will need it at 35. It depends on when you’re experiencing miniaturization and to what degree. A 25 year old man already showing thinning in the Norwood Class 7 pattern will not benefit from Propecia unless it is caught early and still it may not do much more than stop the loss from occurring.
  4. Propecia side effects are real, but they are also quite rare. Internet reports are unverified and overblown (some people will post the same basic negative messages over and over under different usernames across different sites). The major health concerns that you brought up (prostate and breast cancer) are worth considering, but more information needs to be collected. Studies into these types of issues might have been minimal, but the FDA lists the medication as safe and effective, and I’ve seen the effectiveness first hand (and have posted many photo results on this site).
  5. Get a good, caring doctor who has an interest in hair loss. Most often they build their expertise in the surgery of hair transplants, but there are many good doctors who care enough about their patients that they will not be trigger happy and rush you into a surgery before you are ready. Check the physician search at ISHRS to get started.


2010-01-08 11:15:51I’m a Teen Worried About Hair Loss — What Should I Do?

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13 Year Old’s Crown Hair is Shorter Than the Rest of the Scalp

the hair in my crown area is short, not bald but shorter than the rest of my hair. everything else is fine. im only 13 and i dont want to be bald, especially at this age.

is there something wrong with me? and if there is how can i fix it?

I have yet to see a healthy 13 year old bald young man, but I can’t say if there’s something wrong with you. We haven’t established whether what you’re seeing is actually even hair loss. Perhaps you had a bad hair cut? Sometimes if you look at yourself in the mirror or woke up from sleep with bed-hair, your crown area can look thin. This does not mean you are balding. I’d give it some time and let the hair on your crown grow longer.

You should see a doctor for a mapping of your scalp and hopefully the examination will not show miniaturization in the crown. Get your parents involved and let them know what you’re going through. It could just be that you’re looking for something that isn’t there.

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I’m Histamine Positive — Can I Speed Up the Elimination of the Redness After Surgery?

Dr. Rassman,

In the past, you have stated that post-op redness in the recipient area will linger longer in individuals that are histamine positive. I have very fair skin, and I am histamine positive based on the scratch test. Currently, I am 5 months out from surgery, which consisted of dense packing 3000 grafts in the front third of my scalp.

What do you recommend to speed up the process in order to eliminate the lingering pinkness that I am still experiencing? I have also put a call into my surgeon for his opinion, but would definitely like to have your opinion as well.

Thanks in advance!

The use of limited amounts of hydrocortisone cream may help, but long term use is not healthy. I am hesitant to make specific recommendations to you as I have not seen you and therefore cannot make a judgment for you. My general approach is to point a direction on what to do, but hopefully you will get to your doctor for specific advice appropriate for your needs.


2008-06-24 12:55:21I’m Histamine Positive — Can I Speed Up the Elimination of the Redness After Surgery?

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15 year old loss ‘all of his hair’ from extreme diet (from Reddit)

Unique story. I would have to see photos and even better examine you. The diagnosis does not seem right to me and that is why I would need to know a lot more about you to help. Assuming that this is acceleration of male patterned balding, one option is Scalp Micropigmentation which will make your head look like a full head of hair that you shaved. This can be done and if the hair loss can be reversed, there is no downside that I know of. Here is a photo of a young man who lost all of his hair from Alopecia Totalis (an autoimmune disease that killed off all of his hair:https://scalpmicropigmentation.com/bold-shaved-look/#!https://scalpmicropigmentation.com/wp-content/uploads/2016/04/scalp_micropigmentation-new_hair_institute-147-bold_shaved_look.jpg (his eyebrows are wigs)

William Rassman, M.D.

15 y/o son lost forty pounds and half his hair. Doctor said his weight loss “triggered” mpb. from tressless


2019-05-13 05:02:0215 year old loss ‘all of his hair’ from extreme diet (from Reddit)

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I’m Not Seeing a Drastic Difference a Year After Hair Transplant

Dear Dr.,

I had a hair transplant (840 3-4 follicular grafts) in February of 2009. The areas treated were the large crown and also throughout the temporal areas. I still do not see a drastic difference. I am not sure why. I am continuously also using Rogaine foam and Propecia. When under any bright lights, I see such thinning as to where the transplant was supposed to have worked. I am not sure if something went wrong, or everyone’s bodies are different; thereby it may look better within another year. Have you heard of my situation? Does a hair transplant take up to another year in order to see better hair density results?
Thank you!!!

Without knowing more about your case, it would be difficult to provide much precise information. Sometimes a thin look can appear under harsh lighting because of your hair color, hair character, thickness, etc. The Rogaine and Propecia are good to continue using, but after a year you should’ve seen results by now from the surgery. Everybody is different, every surgery is different, and every medical group is different, but it generally takes 6 to 8 months to see the beginning results of a hair transplant surgery. Either your surgery has failed or you continued to lose more of your native hair and what you are seeing is the lost native hair. I have seen transplant failures, and generally these occur because of surgical errors, inexperienced or sloppy teams or techniques, or rarely the presence of some associated disease like diffuse alopecia areata (though this is unlikely in men).

I’d discuss this with your surgeon to find out his/her take on why your grafts haven’t grown. Be sure to compare your current look to pre-operative photographs, because sometimes patients don’t realize just how bald they were before the surgery (the hair grows in gradually so its hard to notice if you’re not focused on it all the time).

See this recent post for more — If There’s No Growth a Year After My Hair Transplant, Should I Just Get Another One?

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17 month on finasteride (photo)

Finasteride alone is not known to reverse hair loss generally speaking, but in this man we see reversal over a 17 month period of time


2020-08-16 09:02:3017 month on finasteride (photo)

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I’m Taking Propecia and Avodart Together Daily — Is This Unsafe?

Hi Dr,
I’m currently taking both Propecia (1 mg) and Avodart (0.5 mg) daily and am noticing good results. However, I’m wondering if this combination has the potential to be unsafe – can it mess with hormonal levels? Does taking more of these enzyme inhibitors leave more testosterone in the body?

I am not sure if what you are doing is safe or unsafe, but I would never recommend it to any of my patients. I would follow up with your doctor who is treating you and ask for his/her opinion. Did the same doctor prescribe both medications? Do you have prostate issues or are you strictly trying to treat hair loss?

The sexual side effects are more common with Avodart (dutasteride), but when you add Propecia (finasteride) to your routine, I wonder if you have any sex life left.


2011-03-03 10:44:11I’m Taking Propecia and Avodart Together Daily — Is This Unsafe?

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18 months on finasteride (photo)

This is a great result. I would hope that if you continue it you will keep the hair for a long time. What is really impressive is the according to the creases on your forehead, the hairline came back to its normal mature position which is what I would have done had I transplanted your hairline.


2020-09-01 09:43:5918 months on finasteride (photo)

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Immediate impact of finasteride

Week 1 on fin. Shedding has decreased from 100-150 hairs/day to approx. 10-30 hairs/day. Scalp itch is almost entirely gone. No sides. Taken every other day. I’m a diffuse thinner, so I’m sitting at a NW1 right now with density being my primary point of concern. I started fin about two months after seeing signs of thinning. What can I expect going forward?

With the cessation of your shedding in one week, you can hope for some reversal of your miniaturization, which will be reflected in your thinning hair. Keep your fingers crossed and pray.
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19 Year Old Female with Receding Hairline

I am an almost 19 year old female and I have a high forehead. I was coloring my hair the other day and noticed that I have a receding hairline. I also noticed that there is ‘new growth’ but it is very blonde and there is not enough of it to cover the areas. I have also smoked for three years and have been under quite a bit of stress lately. Will it continue to fall out? Is there anything I can do to stop it from doing so? Thank you so much for your time and consideration.

High hairlines in some women are normal genetic patterns, like the size of your nose and other facial proportions. If you really have a high hairline since you were much younger, then there are things you could do for it surgically.

Some women with the genetic hair loss genes can lose their hair in response to stress and when the stress is over, most regrow their hair. What you are describing, however, is not clear for me to make a diagnosis. I always tell women with hair loss to get checked out by a doctor and be sure that there are not medical causes of hair loss. The most common include hypothyroidism, genetics, hormonal imbalance, pregnancy, anemia, crash diet and oral contraception pill. In your case, smoking does not help your situation, but it is not the main reason for your hair loss. Otherwise, every smoker would be bald. Cigarettes have many chemicals which are toxic to your body and may assist other factors to induce your hair loss. Smoking may lead to less blo0d supply to your scalp which may lead to weakened growth of hair. I recommended that you visit a dermatologist and your primary care doctor to evaluate your hair loss and run blood tests to find out the cause of your hair loss.