Physician Answered Q & As

My 16 Year Old Daughter Has Hair Loss – Is She Too Young For a Hair Transplant?

My daughter is currently 16 years old. She started experiencing hair loss when she hit puberty (approximately 11 years old) as well as fairly serious acne. She has had numerous blood tests to check for various hormonal issues, but to date, no definitive diagnosis — everything appears within normal range. Oral contraceptives have greatly improved the acne but have not helped at all with the hair loss. Her hair loss has now stabilized (does not appear to be getting any thinner); however her hair is very thin on top (you can clearly see through to her scalp and there is no way to do a “comb over” — just not enough hair). The hair on sides and back is fine (normally thick). My question is: Is she old enough to consider a hair transplant? I’ve read that it is generally preferred to be 25 years or older (???), however I am concerned that female hair loss is a serious social burden that will be especially difficult through the remainder of her high school and college career. I’d really like to be able to help her now. Thanks, Janet

Dear Janet:

Thank you for your letter. Hair loss can be difficult to deal with at any age but it can be particularly hard for a young woman. Before addressing the possibility of surgery there are some other issues that should be mentioned. I think it‘s important that she had the work up to evaluate hormone levels even though it sounds as if this isn’t the primary issue related to her hair loss. Other common medical conditions that can contribute to hair loss are iron deficiency anemia and thyroid function abnormalities. She should be seen by her primary care physician to rule out these treatable causes of hair loss. If she is having any other medical signs or symptoms they should be discussed with the physician even if they seem unrelated to hair loss such as skin or nail problems as they may point to a genetic condition.  You didn’t mention if she was on any medications but if she is and the use of these medications preceded her hair loss, they could be contributing to the problem as well. Dietary issues, such as stringent dieting and low calorie intake, may be associated with hair loss.

A family history of hair loss, especially in the females, may be a contributing factor. However, even with a strong family history, it would be uncommon for a female to start having hair loss at 11 years of age due to female pattern alopecia. You might check to see if there are any females on either side of the family that experienced hair loss at a very early age.

There are conditions affecting the skin and follicles that can cause hair loss but require a biopsy for diagnosis. One example would be alopecia areata affecting the top of the scalp in a diffuse pattern. Once the diagnosis is established the doctor can make a recommendation for the most appropriate course of treatment.

As far as surgery is concerned, I don’t think it should be considered until there is a firm diagnosis of the condition and a definite lack of response to medical therapies if appropriate for the diagnosis.  It may be advisable for your daughter to consider trying minoxidil or Rogaine, but without knowing the cause of the hair loss this treatment may be ineffective and may delay the search for the actual cause.
Probably the most important piece of advice I can offer is that your daughter should be seen by a medical professional that is experienced in the diagnosis of hair loss disorders and well versed in the medical and surgical treatment of hair loss. It is very important that the reason your daughter is losing or has lost her hair is established so that the proper treatment plan can be devised.


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