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I’m 19 and stared at what seems to be a solid Norwood 2 with thick, dense hair. My maternal grandfather is currently a Norwood 3/3.5, thick hair nonetheless so considered very good for his age(66). I hope to be taking after him however, my grandma’s brother (great uncle) suffered from hair loss at around 40-50. What I’m wondering is whether my grandma could’ve inherited the gene through her family, passed it onto my mother of whom passed it to me. Would this be possible? My mum doesn’t have any brothers either, only sisters so there’s no way of identifying if the gene is present in my family.

Sometimes it is difficult to genetically trace where you are getting your hairline recession from. A receding hairline can lead to future balding. The balding genes can skip multiple generations, therefore you may not be able to tell where you got it from. If this continues to be a problem, see a doctor for the drug Finasteride. It could reverse your receding hairline, something that has a good possibility in someone your age. Since your great uncle suffered from hair loss, then you have proof that the gene does exist in the family line.

I fished up a photo from the internet of a patient that had FUE grafts in the frontal recipient area. Two things worth noticing: (1) the grafts are elevated and (2) there is skin in the graft that is as wide as the graft itself.

The skin will survive the transplant and the elevation will produce small, subtle white elevated bump surrounding each group of hair from the recipient area (called cobblestonning) and I believe that is what you may be seeing.

I do this differently than the doctor who did the patient in the photo, as I trim off the skin of the grafts before placing them and then place the grafts flush with the surrounding skin so that these white area are not present in our grafts. Click on the photo to enlarge it.

I think that 23 years of age is too early because your final balding pattern doesn’t usually show up until you are 25-26 years of age, and even at 26, it may not show up. When I do a hair transplant, I prefer men over 25. The number of grafts depends on four factors: (1) the size of the area being transplanted, (2) the location of the transplant (frontal hairline or not?), (3) your donor density, and (4) your hair mass per unit hair. With that, I can build a personalized Master Plan for any patient, which will consider what might happen to them as they continue to bald (as every man who is balding does).

Many doctors are not knowledgeable about hair loss so you should find a doctor who knows about it. To find a good one near you, go to ISHRS.org. Most of these doctors keep up with the advances in the field of hair loss

Before you go for a hair transplant, I would be sure that you maintain minoxidil and finasteride for at least a year as it may be reversed on this combination of medications in a year or so. How old are you?

The science papers suggest that the sexual side effect (the focus of most men on this site) are less than 2% and are reversible if stopped early. The nocebo effect is much higher as young men bring on their sexual side effects by obsessing over taking the drug, and reading forums that suggest that this is a common occurrence. The greatest concern of most young men is the condition called Post Finasteride Syndrome which if real, may reflect a 1% risk at most. There is controversy over the existence of this condition within the medical community, but it is nevertheless important for any man considering this drug