21 years old with severe, rapidly progressing FPHL despite no family history. Am I out of options?

Question

I started losing my hair two y/a after starting Yaz and recovered once, but unfortunately began losing more hair after starting spironolactone for acne. I have lost going on a 70% of my hair since. My hairline is receding, and the shedding has spread from my temples to my entire scalp. 5% rogaine, laser comb, iron and Nutrafol aren't working. I am severely depressed, as I can find no success stories. Why is someone my age experiencing this so severely? Are there any success stories out there?

Jason Emer, MD · Answer

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

Jeff Rapaport, MD · Answer

Hair  loss in women is often multifactorial. You you should visit a hair loss expert will do a history, examination including magnification and would like, blood work and biopsy. You need a definitive diagnosis and etiology of your hair loss to begin an effective treatment. 
Jeff Rapaport MD
Core Aesthetic Realself

Yael Halaas, MD · Answer

Female pattern hair loss can occur for many reasons. Hormonal imbalances, thyroid conditions and even excessive amount of stress can lead to hair loss. I suggest a consultation with a hair loss specialist who can examine you, perform blood tests and possibly even perform a scalp biopsy.

Monika Soni, MD · Answer

Thank you for your question! You you should visit a hair loss expert will do a history, examination including magnification and would like, blood work and biopsy. You need a definitive diagnosis and etiology of your hair loss to begin an effective treatment.

Jeff Donovan, MD, PhD · Answer

This is a very challenging situation but the results of a scalp punch biopsy and results of specific blood tests are needed to know what to consider next. Is there any chance the diagnosis is incorrect or that the diagnosis of FPHL is correct but that another diagnosis is present too?

Jon Ver Halen, MD, FACS (license suspended) · Answer

Dear Ndelong,Hello and thank you for your excellent question. I suggest that you start Finasteride and Minoxidil, as they are the only two medications for hair loss approved by the FDA. For women of child-bearing age, I use spironolactone instead of finasteride. Both medications have different mechanism of action, and I usually recommend both medications to my patients. Other adjuncts include low-level laser light therapy, PRP, stem cell, or other regenerative medical treatment. Also, you will want to ensure that you are not taking any medications that could be contributing to your hair loss. The main objectives with the combination treatments are to stabilize your hair loss, increase your existing hair fiber diameter, and stimulate some hair regrowth. After those options are completed, I recommend hair transplant, including FUE or FUT. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
  
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 – 2018
  
BeautyAdvisor Top Contributor

William Rassman, MD (retired) · Answer

At 21, don’t fool around with time, as time is not on your side.  Find a doctor who specializes in hair loss and build a Master Plan with this plan that fits a diagnosis which will include the HAIRCHECK test to confirm the amount of hair you actually lost

21 years old with severe, rapidly progressing FPHL despite no family history. Am I out of options?

Answers (7)

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