Question:

Hello,

I hope you answer my question. My 12 yrs. old daughter has been diagnosed with Androgenetic Alopecia. Her hair has been thinning in the front and at the temples. We have been using the 2% Rogaine for 3 weeks, as recommended by her dermatologist. The hair in the back of her head seems normal. This is starting to affect her emotionally.

Is it too soon to think about hair transplant? Should we wait until she is 18? Please let me know.

We live in the Bay Area, Any recommended hair transplant MD’s??

Thank you for your time,
Mariam

Answer:

Androgenic alopecia is quite uncommon in a 12 year old male or female. I am curious how the diagnosis was made. There are multiple reasons for hair loss in the front and temple areas besides androgenic alopecia. If it is androgenic alopecia, one would consider a full medical workup to determine why it is occurring at such a young age. Androgenic alopecia has some characteristic findings. These include miniaturization of the hair and lightening of the hair color in the affected areas. In addition, there are also some characteristic histological findings under a microscope. I would have her seen as quickly as possible. In the bay area, I recommend Sheldon Kabaker, who practices in Oakland or Peter Panagotacos, who practices in San Francisco. They can assist you with a diagnostic work up, as well as a treatment plan.

I really don’t think you should consider any surgical intervention until you are certain about the cause and any underlying medical conditions that might be treatable without the need for surgery. Certainly, it always best to delay any form of surgery as long as possible with androgenic alopecia. The reason for this is quite simple. Androgenic alopecia is a life long, unrelenting process. While there may be enough follicles to manage minor loss at a young age, the supply gradually declines as you beg from Peter to pay Paul. While someone may need enough bricks to build a 2000 square foot home, eventually they may need a 10,000 square foot home yet not possess enough bricks to build such a structure. Hair loss is much the same. It begins at minor levels, but gradually affects greater portions of the scalp. The donor area in the back and sides is finite and may even decline in quantity naturally itself due to senescence or old age of the follicles. Females are especially prone to loss of the donor hair especially on the sides.

It is certainly understandable that hair loss in a female at any age is psychologically troubling. You should have this evaluated as quickly as possible.

John P. Cole, MD
http://www.forhair.com
IAHRS Recommended Hair Transplant Surgeon