Hair Loss in Young Men Before The Age of 21

Hair Loss is commonly thought of as something that occurs only in older men. But it happens in younger men, too — those who are not yet 21 years old.

Because hair loss is generally unexpected before age 21 it can be a shock for a young man 15 to 20 years old to discover he is losing hair. 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.

If the young man’s father, mother, uncles or older brothers have pattern hair loss he may not be surprised to see that the family “baldness trait” has been passed along to him. Nevertheless, he most definitely will not be pleased to see the inherited trait appear so early.

Hair loss before age 21 can be very disturbing for a young man, even if he expects to eventually undergo hair loss similar to other male members of his family. Loss of hair at this psychologically and emotionally vulnerable time in his life can leave him feeling disfigured, less attractive socially, and hindered in the job market. He can be an easy target for expensive but ineffective “miracle cures” advertised in print media, on TV and on the Internet.

What should a young man do if he begins to lose hair before age 21?

A good first step is consultation with a hair restoration doctor. The first advice a doctor might give a young man with hair loss is: “Don’t panic. I understand. Male pattern hair loss is a common, inherited condition and it is normal to be bothered by it. We can almost certainly find a way to manage it by making decisions tailored to your individual needs.”

No recommendations for treatment will be made until the doctor has determined the cause of hair loss. While male pattern hair loss is the most common reason for hair loss in men there are many other causes that need to be considered and ruled out. Hasty treatment before a diagnosis is established may be ineffective and could be counter-productive.

What treatment is a hair restoration doctor likely to recommend?

The doctor's first goal is to educate the patient with regard to the cause, progression and long-term ramifications of hair loss as well as any treatment for hair loss. Because hair transplantation has high public acceptance as a successful method of hair restoration, the young man may consider it his first option for treatment. However, most leading hair restoration doctors do not consider hair transplantation a good option for most men under age 21. Hair transplantation may rarely be an option for individual young men under age 21 when indicated by individual patient characteristics.

Hair transplantation may not be a good hair restoration option for young men because, among other reasons:

• The pattern and progression of hair loss has usually not been fully revealed at this early age
• Hair transplantation performed this early may be less than desirable later in life when the pattern and progression of hair loss has been more fully revealed
• It is difficult to design a surgical procedure that will look natural and appropriate for the rest of the patient’s life
• Once hair transplantation is begun, future surgeries are required to maintain a natural appearance
• Unfortunate results of hair transplantation performed too early may have to be surgically corrected later
• Even with parental guidance, it is difficult for a minor to make informed adult decisions regarding elective surgery.

Hair transplantation may eventually be the best approach to treatment of the patient’s hair loss. An interim option often recommended by leading physician hair restoration specialists is non-surgical treatment with minoxidil (Rogaine®) and finasteride (Propecia®) — the only hair restoration medications approved by the U.S. Food and Drug Administration and scientifically proven to successfully treat hair loss. Treatment with minoxidil and finasteride can slow hair loss and give the appearance of more hair by adding density to miniaturized hair follicles.. Slowing the progression of hair loss before and after age 21 improves the opportunity for successful hair transplantation later.

In selected cases a doctor may perform a small “forelock” transplant to provide immediate improvement in the patient’s temporal frontal hairline. In only very rare cases would a doctor suggest aggressive treatment with hair transplantation.

The cost of consulting a hair restoration octor may be less than the cost of multiple ineffective “miracle cures” purchased from vendors advertising on the Internet, TV, radio, or in print media. The professional advice and support of a doctor will be invaluable to a young man who feels devastated by the early loss of hair.

Great Nutrition: Required For Maintaining Hair Health After Hair Transplant

Why do people with hair loss undergo hair transplants? For one overwhelmingly critical reason: improvement of appearance. Why is improvement of appearance so important? Reasons are many, and may include any or all of:

• Having a better self-image and feeling better about oneself
• Appearing as youthful and energetic as one feels
• Enhancing appearance for personal and business relationships

Hair transplant may for some persons be part of a global program of personal improvement, including weight loss and physical conditioning. When this is the case, nutrition will almost certainly have an important role in any self-improvement program. And the manner in which nutrition is included in the program may have some potential for causing loss of newly transplanted hair.

A program of well-balanced dietary intake can help to weight loss and physical conditioning, especially when exercise is a part of the program. Well-balanced dietary intake meets the body’s needs for fuel (calories), and for vitamins, minerals, essential fatty acids and proteins to carry out biochemical functions, maintain the immune system to fight off infections and bolster tissue growth and repair. Every cell in the body needs these nutrients, including the cells in hair follicles that produce hair and cycle hair through its anagen-telogen-catagen phases.

A diet that is seriously lacking in essential nutrients, or has insufficient essential nutrients over a long timeframe, can cause malfunction in cells, including the cells in hair follicles. When hair follicle cells malfunction there is potential for (1) interruption of normal hair cycling, (2) inability of follicles to create new hair, and (3) temporary or permanent hair loss. Extreme diets that lack essential nutrients, or in which essential nutrients are below Recommended Dietary Allowance (RDA) levels (see U.S. Department of Agriculture Food and Nutrition Information Center for more information) can lead to nutrient deficiency.

The hair-loss condition most commonly caused by nutrient deficiency is telogen effluvium, an abnormality of hair cycling. The hair cycle is changed so that hair which would normally be in anagen (growth) phase is moved into telogen (resting) phase. The hair is then shed abnormally early. In addition to nutrient deficiency, other causes of telogen effluvium include hormone imbalance such as hypothyroidism, serious physical illness, physical and emotional stress and side effects of over-the-counter and prescribed drugs. Telogen effluvium may cause some postoperative loss of transplanted hair due to the effect of “surgical shock” on transplanted hair follicles. The effects of “surgical shock” can be reduced when the hair transplantation patient eats a balanced diet and stays well hydrated by drinking sufficient liquids in the immediate pre- and post-operative periods.

A similar cause of hair loss called anagen effluvium is due to toxic side effects of drugs, or to severe protein deficiency in the diet. In anagen effluvium, it is hair in anagen (growth) phase that is lost. The hair becomes brittle and easily plucked, often breaking off at scalp level. Anagen effluvium due to severe protein deficiency is uncommon in adults unless protein is extremely deficient in the diet.

The hair loss of telogen effluvium and anagen effluvium is usually temporary if the cause of the condition is removed (e.g., a drug) or halted (e.g., a nutrient deficient diet). Several months may be required for hair growth and hair cycling to return to normal. Failure to remove the cause of the condition can result in chronic and permanent hair loss.

Nutrient Deficient Diets Contributing to Hair Loss

Weight loss is typically a prime goal when a person is working towards improve physical appearance. A person may be determined to achieve a target weight, but is not sure how to reach the goal. What is a safe and effective weight-loss diet?

Tailoring of a diet to achieve a reasonable weight-loss goal must include appropriate levels of essential nutrients. Certain nutrient deficiencies are known to be specifically associated with hair loss:

• Iron deficiency is a cause of iron-deficiency anemia, and anemia is a known cause of hair loss. Iron deficiency anemia is a complex condition in which inadequate iron intake can be a sole or contributing cause. Fad diets and crash diets that are iron deficient will eventually result in low iron stores in the body and cause chronic anemia. Diseases that interfere with iron absorption or conditions that cause inappropriate blood loss can also be involved in iron deficiency anemia. Iron deficiency is diagnosed by laboratory tests. Treatment should be appropriate to the cause, and should be carried out under medical supervision. Iron deficiency due to inadequate iron in the diet may be treated by iron supplementation and by diet modification.
• Zinc deficiency is known to be associated with hair loss. A very low-calorie diet with little or no red meat protein can contribute to zinc deficiency. A low-calorie vegetarian diet can contribute to zinc deficiency because zinc is absorbed less readily from plant sources of zinc than from animal sources. Zinc deficiency can be difficult to diagnose; its symptoms are often non-specific, resembling those of many other conditions. Zinc deficiency should not be assumed; it must be diagnosed by laboratory tests. Zinc supplementation should be undertaken only under medical supervision; zinc overdose is associated with a number of adverse physical effects.
• Biotin deficiency is associated with hair loss as well as some skin disorders. Biotin is one of the B vitamins that have a broad range of functions in the body. Because biotin is found in many foods, biotin deficiency is likely to be caused by a very low-calorie diet that reduces the intake of many nutrients below recommended level.
• Protein deficiency is an outcome of inadequate protein in the diet over a period of time. Vegetarian diets avoid protein deficiency by including a variety of plant protein sources—beans, legumes and nuts. Extreme vegetarian diets and extreme low-calorie diets may provide inadequate protein intake.

A person who intends to pursue a weight-loss regimen before or after hair transplantation should discuss the intention with the physician hair restoration specialist. Diets that could cause or contribute to hair loss should be avoided or appropriately modified. Commercial weight-loss products promising quick weight loss and miraculous results are likely to be less effective over time than a normal diet modified to reduce calories while retaining a balanced intake of essential nutrients.