I'm 18 years old. Am I receding? (Photo)

Thank you for your question. You submitted a single photo, state you are 18-years-old and ask whether or not it appears your hair is thinning. You add the photo was taken with your hair wet. You are asking about hormonal imbalance being a possible cause. You describe some family history, and you’re looking for guidance first for diagnosis, and then management.
I can certainly give you my some guidance like I do in my practice. I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I’ve been in practice in Manhattan and Long Island for over 20 years. Hair loss treatment has been a significant part of my practice, and I am the founder of TrichoStem™ Hair Regeneration Centers based on a technology we developed to treat men and women with hair thinning using an injection, non-surgical alternative to hair transplant, and what’s becoming a significant alternative to oral drugs such as finasteride, which I’ll go into the details of a bit later.
To begin, I think you are becoming aware of some recession and thinning of your hair. Yes, hormone imbalance may be an issue, but in my experience, for men with young onset hair loss, it basically falls under the category called androgenetic alopecia or genetic pattern loss, which runs in families. Common myths about the maternal uncle side, or maternal grandfather, but in reality there are multiple genes associated with hair loss, so even in siblings or other family members, you can’t figure out how this occurred as it is in the genetics. When we do an evaluation for someone like yourself, we take photos with the microscopy, standardized photos, review your medical history, medications, and details. If there are questions or concerns about diagnosis, we refer you for endocrinology evaluation for a tissue perspective of what exactly is going in, whether it is pattern hair loss or something else, so we do biopsies. That means taking a piece of the skin with the hair to diagnose what is going on from a microscopic point of view. However, for the overwhelming majority of hair loss for both men and women, the most common diagnosis at 95% is androgenetic alopecia.
So the question becomes what do you do moving forward? The Hair Regeneration treatment evolved from our application of wound healing technology using Acellular matrix to recruit adult stem cell activity, initially used to improve the wound healing of hair grafts and the donor area of hair transplants. We found that thinning hair got thicker, so from this I developed the Hair Regeneration process, which we now do as a standalone procedure for men and women at almost any age, with our youngest male patient at 17. With a single injection treatment, we are able to successfully stop hair loss progression, restore the growth of hair that hasn’t been growing, and induce the shed of thinning hairs so thicker hairs grow in. You have to understand that hair thinning is a combination of the cessation or stopping of hair growth, and the progressive miniaturization or slow progressive thinning of hair. For men, there is a strong association with the hormone DHT or dihydrotestosterone, so you’re kind of on the right track in terms of hormone-related issue, but what happens during puberty is testosterone levels gets very high, which also leads to an increase in dihydrotestosterone. Men who have DHT-sensitive hair can also be treated with the drug called finasteride, but unfortunately a lot of people don’t want to take finasteride because of current fears about long-term sexual side-effects.
Once we started picking up a lot momentum with the Hair Regeneration treatment, and we have patients who come from all over the world to come for this injection treatment which currently stands at 5 years out, no evidence of regression was seen in the vast majority of patients who had just one injection treatment. In the past couple of years we started treating more and more people, and we saw some situations where we wanted to experiment with additional injections, with a second injection at about 15 months for advanced hair loss patients to build on initial results. We continue to be extremely successful in helping people treat their hair loss without any other drugs or other intervention.
We found younger and younger people coming, so often we questioned whether or not it was the appropriate thing to do to help someone as young as 18. The point is the onset of this type of hair loss at a young age is unfortunately associated with a certain rate of progression which doesn’t make you the best candidate for a hair transplant. So, understanding you have drugs on one end like Propecia, which people are afraid to take; and your are not a good candidate for hair transplant, it is of value for you to learn about an alternative like Hair Regeneration. This treatment also uses your own blood where platelet-rich plasma (PRP) is derived - PRP is the concentration of growth factors. However, unlike platelet-rich plasma (PRP) on its own, we have combined successfully an algorithm, dosing process, and a delivery technique with Acellular matrix to successfully treat men and women of a wide age range with progressive hair loss.
Discuss this with your physician, and with the people in your family who can assist in finding the information, and do some consultations with other doctors. Learn about what options you have so you feel comfortable with any decision you make. I think this is something that will help you think about the different options, and there are not that many, so timing is important - I stress this very much when it comes to Hair Regeneration treatment. We have situations where people start losing hair by 18, and are bald by the time they are 22, which is a very aggressive progression. For people who are learning about this, the inventory of salvageable hair follicles is the limiting factor, so the earlier we catch someone, the better it is. Learn more about your options, start doing some consultations, try to get into doing something early so you can save the hair before it’s too late.I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Yes,
your hairline is receding. We treat this with combination therapy of
PRP, Progesterone, medication such as minoxidil, possibly
spironolactone and FUE hair transplant. Please see an expert soon to
prevent more loss. Best, Dr. Emer

akbot,I am sorry to tell you but the answer is that it is. It is important to undergo a consultation with a hair loss specialist in your area for a complete evaluation. This should include a thorough history and physical examination, including dermoscopy and Haircheck or hair mass index measurement , as well as a baseline photos series. This is all important for future evaluation to assess progression and response to therapy.Sincerely,Bernardino A. Arocha, MD