Am I an eligible candidate for a hair transplant?
I am 22 years old I have been losing my hair since I was 18.
I have been taking finasteride consistently for about 2 years now, and have used minoxidil
throughout that time, albeit less consistently.
My hair has continued to become progressively thinner despite treatment.
I have had significant emotional distress as a result of MPB and I am hoping to get
a Hair Transplant procedure done within the next year.
Thank you for your question!
At the age of 22, you have been experiencing hair loss since that age of 18 and you submitted
some very good photos to help me understand what your situation is.
I understand how emotionally distressed you are and you are asking a very straightforward
question of whether or not you are a candidate for hair transplant and that you wanted to
get something done within a year.
Well, to give an opinion about this scenario, I'm going to share with you first some basic
rules and facts that have to be factored in and I will also introduce to you something
that you may not be familiar with that we have been doing in our practice and we have
been truly in the leadership position for several years called Hair Regeneration.
So let's begin first with the nature of your type of hair loss.
Yes, you have something called male pattern hair loss.
The onset of your male pattern hair loss has been early in your life and it has been progressing
very fast.
Those two factors are very important in your decision about undergoing transplant.
From a pharmaceutical perspective, there are only two drugs that are used and approved
for male pattern hair loss.
One you're using is called Minoxidil which is a topic.
The other is finasteride.
Finasteride is a drug that is used to block an enzyme called 5-alpha reductase which converts
testosterone to dihydrotestosterone has been identified as a factor to susceptible hair
follicles which can then become thinner.
We call that hair thinning.
Hair that is thinning doesn't mean that existing hair goes from thick to thin but rather, during
the normal growth cycle, as the hair is shed, the hair that comes back comes back thinner.
So finasteride has been shown to help people with male pattern hair loss reverse the thinning
process.
But there are some limitations to the use of finasteride that you should also be aware
of and chances are if you have been doing web researches you already know.
From my clinical experience, I have been prescribing finasteride for patients since 1997 and 1998
when it was first approved that younger males who have aggressive hair loss typically don't
respond as well as males who are in their mid to late 30s who start getting to have
crown, slow, progressive expansion of the bald spot area.
Even on those medications, people still do progress.
Second, there has been a concern about the long term sexual side effects and interestingly
in our practice, we have patients who have been taking finasteride for 20 years and they
are fine and 50 plus years and they are coming in for prescription renewals and they have
no problems.
At the same time, we have patients who are coming in in their 20s and 30s who look at
the side effects and say that there's no way that they want to take it.
The reason why people are coming to us these days is about this Hair Regeneration treatment
that I will be discussing in a moment.
But to answer the question specifically about hair transplant, when I first trained in hair
transplant surgery over 20 years ago, I actually learned from teachers to avoid doing transplants
on younger males like yourself.
Men in their 20s who are losing hair and it was because the rate of loss of hair combined
with the expected desired results were unfortunately were too many variables that you are not going
to favor.
What does that mean?
Well understand that a hair transplant, unfortunately in the modern world, with aggressive internet
advertising and television commercials or infomericals, medical procedures are sold
and over messaged in a way that you don't fully understand what the limitations are.
You are only shown the benefits and you are given very compelling testimonials that make
you want their products.
But understand the facts.
The area where you are going to get the transplants from is what we refer to as the permanent
zone or the donor area.
This is a very limited area.
That limited area at the back of the scalp, the baldest man you've ever seen is that bar
of hair that won't fall out.
In hair transplant surgery, the strategy is to take those hair physically as units and
place them in areas in the scalp where the desire is to place hair.
When you first noticed hair loss, typically, you've already lost 50% of your hair.
And the great injustice in your age group is that the rule of decades or the rule of
thumb tells that when you are in your 20s about 20% of your contemporaries have hair
loss.
That means 80% of your contemporaries have lots and lost of hair.
And that changes.
As you get to your 40s and 50s, it becomes to a 40 to 50% of men having significant hair
loss.
And so, it becomes more socially acceptable but certainly in your 20s, I can understand
that it is a very painful period for you and you would want to get some kind of procedure.
I've seen so many patients come to my practice who got hair transplants in their 20s but
because they were not able to take medical treatment like propecia or they want to, they
continue to lose hair and when you continue to lose hair, all you see are transplants.
And socially, that is nowhere near the volume that your contemporaries have.
So be mindful of that before moving forward with transplant.
The values or guidelines, the industry has changed since my time of training.
I've seen a lot more of hair transplant surgeons actually perform transplants on people who
are young, people who have history like yourself and I'm actually surprised about how many
of these transplants are being done given the limitations.
Unfortunately, I suspect a financial goal rather than the management of a patient's
problem.
That's my opinion.
As far as Hair Regeneration, we have developed in our practice a method and a procedure where
we are combining a material called extracellular matrix which is derived from pig bladder and
originally designed for wound healing.
We combine that with platelet-rich plasma which is a byproduct of your own blood which
concentrates the growth factors.
Platelet-rich plasma which is commonly used in a small percentage of hair loss treating
physicians, it helps hair loss but on its own, I don't think it's sustainable in that
it doesn't reverse hair thinning.
What we have been able to do is literally reverse the hair thinning with our Hair Regeneration
treatment.
This is something that we have developed for several years and we are at a point now where
we can boast close to a 100% success rate for male pattern hair loss.
What we are doing is we are doing a onetime injection and literally reversing the thinning
of hair and basically stopping the process and thickening the hair.
So for many of our patients, young men in their 30s and 40s as well as men who have
had transplants but are seeing the progression of hair loss and don't want to go for another
transplant.
So it has been a very exciting time and we were featured recently in the news for this
and I think that it is important that you understand that in the field of hair loss,
the one thing that we have been able to truly establish is that there is a lot that is yet
to be understood about the causes of hair loss as well as the ways to reverse hair loss.
For at least 30 years, several biotech companies have tried to get some kind of solution and
for my perspective, this use of extracellular matrix which happens to be an accidental discovery
has resulted in greater benefit to patients with hair loss than the work that hundreds
of millions of dollars has been invested in in the goal of hair cloning or trying to grow
hair in the lab and implant those hairs.
I would love for this stuff to materialize because it would give one more tool to help
surgeons like myself help people like you.
But at this time, with the limitations of what is FDA approved and the material we are
using is FDA approved for wound healing.
It isn't approved specifically for hair loss at this time.
But as a surgeon and as a physician, it is common to have off label use of materials
as long as it is clinical appropriate.
So I think that if someone like you were to come to my office, I would recommend Hair
Regeneration as a treatment and we follow our patients very closely just to give you
our process is.
We see people at one month, 3 months and we follow people up to 2-3 years.
Once a patient is in our practice, the door is always open.
So we have been able to establish some real ethicacy.
So in summary, I would just like to remind you to be mindful of the limitations and expectations
of a hair transplant procedure and learn about this extracellular matrix technology and Hair
Regeneration and see if you could find a provider that would be right for you.
So I hope that was helpful, I wish you the best of luck and thank you for your question!