Hair Transplant | Is There a Minimum Age Requirement To Receive a Hair Transplant?

Is There a Minimum Age Requirement To Receive a Hair Transplant?

Is there a minimum age requirement to receive a hair transplant? Are there cases where it would be appropriate to transplant an 18 or 19 year old?
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When someone finds out that they are balding, either because they notice it when they look in the mirror, or a spouse, friend or barber comments on their thinning hair, it never comes as good news. However, when the person in question is in their teens or early twenties, the news can be devastating. It is a time of life when the priorities are making your way in life, dating, getting an education or a job, and hair loss can, in some cases lead to social isolation & a feeling of being less able to compete for these goals. Sociological studies performed in Europe have actually shown a bias against hiring balding men in favour of equally-qualified non-balding job applicants.

It is not unusual for a young man in this situation to go rushing in to see a hair transplant doctor desiring a hair transplant to “fix the problem” so that he can get on with his life. His peers all have a full head of hair without receding in the temples and a youthfully low hairline, so naturally he wants the same. His father, uncle or grandfather may be bald & in his mind’s eye, that is what he sees in his future, so he wants to avoid looking like that at all costs.

If you, or someone you know, is in this situation, it is important to realise that male pattern balding is a genetic condition that is inherited from both sides of the family & that it is triggered by a breakdown product of the male hormone called DHT. Hair loss will continue at a variable rate throughout life. Hair transplantation involves moving genetically permanent growing hair from the sides & back of the head to the balding areas where it will continue to grow and not be involved in male pattern baldness. Hair transplantation does not stop further balding in other areas however.

As balding is a progressive condition, it is easy to see why a hair restoration procedure in one’s teens or twenties will not “fix the problem.” If we had attempted to restore the hair back to a teenage look, and balding continued behind this, we would be obligated to perform further transplants into these balding areas and eventually would run out of donor hair. The patient would reach his thirties with an unnaturally low hairline (a natural hairline in one’s thirties is higher than it is in one’s twenties with receding into the temples) and an increasing area of baldness across the middle and back of the scalp which cannot be filled as the donor hair supply has been exhausted.

I spend a great deal of time explaining this to young patients and creating realistic expectations for treatment of future balding. At birth, a person will have approximately 100,000 hairs on one’s head. By the time early thinning is noticed, he may be down to 80,000 hairs & if he goes on to advanced balding, (Norwood class 7), he may have around 30,000 hairs left. Of these 30,000 hairs, the total number available for hair transplantation (over several sessions) may be 15,000. These numbers put the situation into perspective, in that it is plain that 15,000 hairs cannot give the same coverage & density which we originally had with 70,000 hairs.

The person who comes to see me at an early stage of balding does have an advantage over someone who comes at a more advanced stage, because he will get the most benefit from medical therapy.
Propecia is a pill which is taken every day & it is around 85% effective in stopping or significantly slowing down hair loss, especially in the crown. It works by stopping the production of DHT from testosterone. In a minority of cases, there will be regrowth of hair. There is a 1-2% incidence of erectile dysfunction with Propecia.
Rogaine solution or foam is also effective in slowing down or stopping hair loss.

I would recommend younger patients to start both these medications and monitor their progress every 6 to 12 months over the next few years. This is beneficial for several reasons.:

(1) They are reassured that they have seen a professional & that their concerns have been listened to & that they are doing something to stop, slow down or even reverse their hair loss.
(2) The pace of progressive hair loss or regrowth of hair can be measured over this time. (I liken this to watching a movie to see how things are moving along as opposed to the initial consultation which is like looking at a still photograph).
(3) It gives the patient time to think about surgical options in the future & consider alternatives such as changing their hairstyle or shaving their head. Usually, by the time they return in their mid-twenties, they have had time to adjust mentally to their hair loss and their expectations have become more realistic.

This is my preferred course of treatment in a young patient, although I treat each patient as a unique individual. If an 18-19 year-old patient had been using medical therapy maximally for a year or so and was still socially disabled by his hair loss, I would consider hair transplantation provided several criteria were met.
(a) His expectations of hair transplantation were realistic as previously discussed.
(b) He was evaluated by a medical specialist to rule out body dysmorphic disorder.
(c) We would perform follicular unit grafting in a location that would always look natural, anticipating future balding; i.e a frontal “tuft” placed high enough to look like a natural mature hairline.

Mark McKenzie, MD
Member, International Alliance of Hair Restoration Surgeons
Member, American Hair Loss Association

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