21 year old black male, hair thinning in front and balding at crown. What's the best treatment for me? (photos)

Question

*Hair started thinning last year on crown. The bald spot was about a penny size and got worse over time* I went to my doctor and he recommended Minoxidil 5% and finasteride. I'm Scared to use finasteride because of the side effects. I just started using minoxidil but would like to know of more treatments/advice/ tips before I go on any further in treating my hair thinning. (My diet isn't the best and I've also been stressed, maybe that's why my hair is thinning?) Any advice/tips, helps. Thank you!

Jason Emer, MD · Answer

This needs an in-person evaluation. I suggest seeing a hair loss expert now to evaluate and go over your condition and provide you information about your best treatment options. There are great non-invasive options like prp/progesterone and/or hair transplantation. See an expert. Best, Dr. Emer

Sanusi Umar, MD · Answer

The most dependable way to restore growth is through hair transplant surgery. This is possible for younger patients with the right diagnostic to determine the extent of baldness they will experience and whether they will have enough donor hair for long term coverage in the years to come. With continued hair loss, more than one procedure will likely be necessary.  Individuals of African descent will require specialized extraction tools that are designed for their curved hair follicle shape and the thickness of their scalp tissue. This is extremely important for avoiding graft damage and ensuring reliable growth. More information is provided in this article by the Dr.U Hair Clinic.

Anna Petropoulos, MD, FRCS · Answer

Dear RodG, 
Thank you for your question. You are absolutely right, stress can precipitate hair loss, however, there may be other medical reasons for hair loss at such a young age and blood tests would need to be performed before any treatment is initiated. Treatments include PRP (Platelet Rich Plasma) and simultaneous nutraceuticals, or Smart Graft Hair restoration with follicular unit extraction (FUE) and micro-transplantation, if the non-invasive treatments do not give you a sufficient result. It is important to start soon with the PRP to prevent further loss. Also make sure you visit a center where the technicians are experienced with FUE technique for african american hair if you choose to go that route. Visiting a center that masters both invasive and non-invasive options allows you to have objective advice about which path to follow. 
Best Wishes in your quest !
Dr. Anna Petropoulos 
Board Certified Facial Plastic Surgeon 
North Shore Boston

Jeff Rapaport, MD · Answer

In my opinion you should get a consultation from a my hair loss expert. They will do a good history, examination with dermoscopy and possibly blood work. Androgenic alopecia is the most common diagnosis in male patients to produce a pattern hair loss. Treatments for MPHL include oral and topical minoxidil, finasteride and dutasteride, platelet rich plasma, nutraceuticals and low level laser.. We have had good results in treating young individuals with early hair loss with platelet rich plasma.

Robert Nettles, MD · Answer

Hi!While minoxidil works for some, the problem with the medicine is that it does not stop hair loss, and the DHT will continue is binding to the hair shaft which will eventually overtake any additional growth caused by the Minoxidil and die, perhaps just slightly later than it would have without the medicine.The best thing to do would be to see a doctor who specializes in hair regrowth and the rebalancing of body biochemistry who can diagnose the cause of your hair loss. 
Any medicine that actually can make changes inside your body, are required under the FDA to be available by prescription only. This therefore means that it is not possible for anything that does not require a prescription to cure or prevent hair loss or regrow thinning hair. Thus, a personalized medicine will be the best choice because instead of a "one size fits all" approach, you will be taking something which is truly catered to your body's needs.
The treatment is out there! And yes, by the way, diet and stress can also be affecting your hair loss as well!

Jeanette Straga, DO · Answer

It is a good idea that you have started minoxidil 5% -- make sure you use it twice a day. It is difficult to say since you are so young what eventual Norwood pattern you will have.  An in person evaluation to check for further miniaturization in addition to obtaining your family history will give you a good idea where you are heading. With this information we can come up with a master plan as a hair transplant may be in your future.  Avoiding or reducing stress is always a good idea.

William Rassman, MD (retired) · Answer

You have a Class 3 Vertex pattern of balding and this will eventually get worse over time. You need a Master Plan for your short and long term future. See a doctor

Randolph Capone, MD, FACS (in memoriam) · Answer

Presently, finasteride and topical minoxidil are the 2 best treatments to slow down male pattern baldness aka androgenic alopecia. There unfortunately is no cure for male pattern baldness, but in about 10 years you might be an excellent candidate for hair grafting. Hair grafting is a wonderful treatment that uses your own hair to correct the balding. Until then, I’d stick with the minoxidil if you are comfortable with it, and reconsider taking the fonasteride. Seek a hair transplant surgeon who can examine you and discuss optimal timing for treatment. You might also consider having the standard battery of blood tests for other types of hair loss (thyroid studies, anemia, malnutrition, syphilis, etc.). Good luck! -Randolph Capone, MD, FACS

21 year old black male, hair thinning in front and balding at crown. What's the best treatment for me? (photos)

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Answers (8)

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