I Am 21 Years Old Can I Go for Hair Transplant? I am 21 years old with almost rim of hair left, so what are options for me? Can I go for a hair transplant? Thank you for your question! At 21 years old you have experienced a significant amount of hair loss and you're asking if you should go for a hair transplant. Well there is a long history of the hair transplant specialty were it was actually discouraged for many people who are in their 20's who are losing hair aggressively to have a hair transplant. And the thinking was that if you are losing hair so fast that even a transplanted result may not be satisfactory when you look at your contemporaries who have a lot of hairs. Basically it is almost called rule of decades in your 20's and men 20% of your contemporaries have hair loss while 80% have a lot of hair when you hit your 40's and 50's. It changes closer to 50% of your contemporaries have hair loss and the kind of result or type of appearance becomes a bit more acceptable to have some degree of hair loss as a society norm. Now if you were to come to my practice, I'm going to actually introduce to you a concept that I have been very successful with that is very different and this concept is called hair regeneration. When you look in the market in the United States particularly there are two FDA approved drugs for hair loss one is finasteride which is a pill and two is Minoxidil which a solution or a foam. Now, what you are suffering from is called male pattern hair loss and its also referred to as male pattern baldness and it is a progressive loss of hair due to the hair follicle becoming less able to generate a thick hair. So it's called hair thinning so hair follicle goes from thicker to thinner progressively and is been focused first in the 90's and which is the basis of the invention or the introduction of finasteride is that there is a chemical called DHT or Dihydrotestosterone. Now Dihydrotestosterone can affect genetically susceptible hair follicles to the point where every growth cycle hair grows to anagen, catagen, telogen. Anagen is the growth phase, telogen is the sleeping phase when that hair comes out, telogen and then goes back to anagen. The hair comes out is smaller and thinner and has to do with the part called the dermal papilla. Now our first focus was on DHT that's why finasteride which reduces DHT can affectively slowdown progression of male pattern hair loss also called androgenetic alopecia. But what we have found using another level of treatment which is based on wound injury and stem cells regeneration is a an injection which combines with a material called extracellular matrix and your own blood or part of the blood called Platelet-rich plasma. Now this happened based on a serendipitous discovery that when the donor area of the hair transplant was closed and this material called extracellular matrix that was applied that hair in adjacent areas that were thinning got thicker. So interestingly, it was kind of doing a transplant that this was noticed that this happened. So over the past 2 and half years, I have been working and successfully developing a combination of the what I feel so far the optimal amount of this material called extracellular matrix mixing it with your own Platelet-rich plasma and doing an injection. Now this injection appears at the cellular level to protect the hair follicles. In 2011, a group from University of Pennsylvania was able to show a particular cell called progenitor cell which actually originates in the middle part of the hair follicle as being responsible for the re-growth of new hair. However they found that in men who are balding that the progenitor cells were not producing a specific protein. They were actually diminished. So there are actually a couple types of progenitor cells that I think about when I do this treatment and the other part of this equation that I believe that helping people with is actually protecting dermal papilla where the hair follicles comes from. So as a clinician, I make this observation and I lean on basic science to help make sense of what we are doing. But in the end, I have seen is that with this injection and with this protocol developed, I am able to reverse thinning hair in 99% of my male patients and 70% in my female patients. So there is a long explanation but it's essential in my approach to you or someone like you to be is do the injection. I think that the if you want consider taking Propecia or Finasteride, that's perfectly fine even though there is a controversial topic in this point in time. We still do prescribe if for people who are willing to describe it but a lot of people come to us from all over the world who doesn't want to take Propecia and so we have this injection as a very good alternative and helping people who are not on Propecia. So what I think that I would probably consider doing for you first, before doing transplant, we do an injection. We would look at how much of your hair volume response and returns and I can't restore that has thin to the point where it's gone but I can restore hair that is thinning. So in general, we have had very good consistency seeing in most males an improvement in about 6 months and usually see a full benefit to a year and a year and a half. And so some of our patients who had dramatic improvement in as early as 10 days 21 days 90 days, it's more consistent that our patients see thickening in the 6 months to 12 month period so once that happens for a lot of our younger patients. We then decide at the year point. Well what do you want? You want more hair to define your frontal hairline. At that point, I would consider doing a transplant because now I feel secure about you not losing more hair and not going behind for every step forward so transplant is an option. But in my recommendation is first do an injection like the one I describe and to help you save your hair. It is much better to be able to save hair and thicken it significantly more than just transplant it you have more limited area, donor area to transplant while if all this fine thinning hairs were to comeback then it would certainly look more dramatic. And you get could a lot more benefit than you could on just transplant alone synergistically the combination of injection and transplant can be ultimately your solution. So I hope that was helpful to you and thank you for your question.