Hair Loss Hits the Young

May 2006 

Stereotypes of bald men usually focus on the middle-aged man (and beyond). What many people do not know is that hair loss can actually start as early as the late teens.

Many young men in their twenties can show significant hair loss and clear signs of genetic male pattern baldness. At this age, hair loss can be devastating for one’s self esteem. Society is not as accepting of baldness in the young as in middle age. In fact, it is more accepting of total baldness (when one elects to have a shaved head) than an eroding hairline.

With so much emphasis on the youth culture, it is no wonder that young men with thinning hair who feel that they appear older feel cheated and self-conscious.

According to the International Society of Hair Restoration Surgery, “the first hair sign likely to occur is thinning in the temporal area of the frontal hairline, above the eyebrows on either side of the “widow’s peak.”

This can result in the appearance of a high forehead. The young man may also begin to notice excess shedding when he combs, brushes, showers or shampoos his hair.”

The ISHRS further explains that loss of hair before age 21 can be very disturbing for a young man, often leaving him feeling less attractive socially and hindered in the job market. He can be an easy target for expensive but bogus “miracle cures” advertised on TV or the Internet.

The American Academy of Dermatology statistics show that male pattern baldness affects nearly 50 million men in the United States. About 20 per cent of Caucasian men begin to experience this condition by age 20.

There is, however, effective medical help for hair loss for younger men (and men at any age). It is best to first consult your doctor to determine if there are any medical causes of the hair from immune system disorders, prescription drug reactions, skin diseases, nutritional deficiencies, hair damaging products, etc.

These conditions require an alternative mode of treatment than genetic male-pattern baldness (androgen-dependent alopecia).

Treatment Options for Male Pattern Baldness:

Minoxidil: This topical medication can slow down or help halt hair loss in some cases, and help regrow hair on the vertex of the head in some cases. To remain effective, it must be used on a daily basis.

Propecia®: A tablet taken once a day and available by doctor’s prescription only. According to manufacturer Merck, an estimated one million men in the United States take this medication daily to interrupt the formation of the hormone DHT, one of the principal factors in male pattern hair loss.

According to recent studies, Propecia® has been shown to help slow down the progressive thinning of hair in 90% of male users over five years. In the same study, of men who were not taking active drug (placebo), 100 % of these men lost hair over the five-year period. (5-year clinical studies were conducted on men 18 and older).

Men who are already “shiny bald” are unlikely to have positive results because the hair follicles may not be salvageable. Men who have early thinning the back or top of the head have a better chance of obtaining some benefit, but only for as long as they continue taking the medication.

Hair Transplantation: Modern follicular unit transplantation is the state-of-the art cosmetic surgical procedure used to restore a thinning hairline and add density to the crown. It is a safe in-office medical procedure that redistributes healthy hair follicles from non-thinning areas at the sides and very back of the head (where you have more than you need) to the thinning or balding areas on top (where you need it more).

This procedure is recommended only after careful medical evaluation of younger patients. It may be determined that waiting until the mid to late twenties is best to begin surgical hair restoration, if it is deemed to be an appropriate treatment option.

According to world-renowned hair loss expert, Ken Washenik, M.D., Ph.D., and Bosley Medical Director, “hair transplantation is unusual before age 21, although it may be a viable option for men in their later twenties and beyond as the baldness progresses. It is important for the hair transplantation physician to consider the long-term effects of male pattern baldness and to design hair restoration that will be appropriate as the individual ages.”