21 years old receding hairline, what age could I have surgery? (Photo)

I’m a specialist in hair loss, board certified by the American Board of
Cosmetic Surgery and I have been performing hair transplant for many years. I
would like to commend you for understanding that there is an ongoing hair loss
progression and you have refrained from moving forward to having a transplant
while progression continues.



Currently, there are two medical treatments that are used in the United
States for hair loss: finasteride and minoxidil. Finasteride, or the trade name
Propecia, is a pill that you take every day that inhibits an enzyme called
5-alpha reductase. This enzyme is responsible for the conversion of
testosterone to dihydrotestosterone (DHT). DHT-susceptible hair follicles will
miniaturize and eventually disappear, so a DHT-blocker like finasteride can be
of value. Unfortunately, there is a lot of concern about the long-term sexual
side-effects of finasteride. Most of the males who come to our practice refuse
to take finasteride, or felt uncomfortable with the continuation of the drug. On
the other hand, minoxidil doesn’t do much in terms of preventing further loss. This
leaves you with very few other options.



With your progression at an early age and its fast rate, you cannot be
treated to your desired density with a hair transplant. Even if you were to
stabilize your progression, the amount of hair to restore what you had or close
to what you had is still a lot. In addition, the donor area has limited number
of hairs.



To address this, we developed a treatment called Hair Regeneration.
This is the use of a material called extracellular matrix (ECM) combined with a
material from your own blood called platelet-rich plasma (PRP). Hair
Regeneration is a formulation, method, and technique of delivery of treating
the scalp with an injection. This injection treatment has been so successful
for us that it dramatically reduced the number of hair transplants we do. In
the right candidate, the results of Hair Regeneration treatment can far exceed
the results of hair transplant.



People often misinterpret that through Hair Regeneration, we are
creating new hairs. We do not create new hairs, but we make thinning hairs become
thicker. There are genetics involved in the hair thinning process. Hair grows
in cycles, and with every cycle there is a shedding phase. When the hair is
thinning, the hair growth cycle called the anagen phase gets shorter. Then
there is the sleeping phase called the telogen phase where the hairs shed. Lastly, the middle phase called catagen phase
actually becomes longer. With each subsequent cycle, hair thins. The treatment
appears to salvage and restore the normal growth pattern of existing hair as
well as hairs that are dormant.



When a patient comes to our practice, we do a microscope examination of
the scalp and look at the ratios of the thinning hairs to the thicker hairs. We
also look at the top of the scalp at different angles with digital photography.
We have observed that in areas where we don’t see hair, we can still get
growth. We can save hairs that are salvageable, but if hair has been not been
present for more than 3-5 years in a given area, then it’s less likely that
we’ll be able to restore that hair. We’re often surprised by the robustness and
quality of the results of this treatment but at this point, we advocate early
intervention. There’s a large group of males who have early onset hair loss in
their late teens to 20s and with very aggressive rapid progression. This is
unfortunate because per the Rule of Decades, 20% of your contemporaries in your
20s have hair loss while 80% have a lot of hair. This can have a tremendous
effect on your confidence when you’re losing hair while everybody else has
great hair.



For us, Hair Regeneration has been very successful as our first line of
treatment. There are people who we even do second treatments on depending on
what we observe in salvaging dormant hairs. Sometimes those hairs come back
very thin, so we’ll do a second injection and they’ll come back even thicker.



I would dissuade you from considering a transplant. I think a
transplant will not be adequate with
your rate of progression you are experiencing. When you do your
research, you’ll see that there’s a large gap between medical therapy and surgery.
The internet is strongly advocating surgery, grafts, number of grafts and
technologies to get better grafts. The bottom line is there are only a few
hairs you can transplant. I would advise you to learn more about Hair
Regeneration, see if it’s available where you are and do more research to learn
about these options. Time is not on your side so intervention as early as
possible is something we advocate. I hope that was helpful, I wish you the best
of luck, and thank you for your question.



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You can have hair transplant surgery at 21 years old, but you should be conscious it is a young age to do it. A long term treatmant must be planned with your surgeon.