Help me help my child deal with male hair loss

June 23, 2023 11:36 AM

My 20yo son is experiencing thinning hair. Please teach me about this, so I can help him. Confusion level: family's other males haven't haven't experienced much thinning hair, even well into older age, so we are both confused about why this is happening, and also unfamiliar with any strategies to stop it, if possible.

20yo is in good health, though definitely has undergone some some physical stressors. In one calendar year he has had Covid, influenza A, a concussion, and mono. (Ah, dorm living.) He is a type A personality who puts a lot of pressure on himself to achieve in various ways so plenty of stress. Diet is so-so, slightly healthier than the average college student. Not a drinker, definitely not a big drug user but may use some things recreationally without telling me, mom.

He was complaining about his hair thinning, and when he came home for summer break I could see it too. Definitely receding in the area above his eyes (rather than the crown), and it's noticeably thinner when I look from above. He's extremely unhappy about this.

In terms of genetics: his dad is 69 and has plenty of hair, though his hairline is slowly receding; maternal grandpa, 83, is only just starting to get a balding crown; paternal uncles all have thick hair into their 60s; paternal grandpa died young so no info there; females of the family have no visible hair loss.

What should I tell my kid? Is there anything to be done, in one so young? For the purposes of this question I am asking more about "is there a way to stop this or reverse it" rather than the psychological aspects like "here's how to make peace with your baldness."

posted by anonymous to Health & Fitness (24 answers total)

Please get his thyroid levels tested, hair loss can be a sign of potentially serious thyroid problems.
posted by chariot pulled by cassowaries at 11:48 AM on June 23, 2023

I'm not sure this Vox Explainer is authoritative, but it doesn't contradict my experience or that of my son (we both started going bald in high school). My mother's father and brother were bald.

My son has just used the shaved to a cue ball look for his professional life and he is happily married with children.

I understand you are interested in reversal possibilities, but I can't speak to that, sorry.

On preview, I agree with chariot pulled by cassowaries for you to get his thyroid checked. My son did not have that problem but I definitely did (hyperthyroidism).
posted by forthright at 11:51 AM on June 23, 2023

Finasteride (prescription tablet) and Minoxidil (OTC topical) are options that won't cure hair loss, but will slow it down and can coax back some lost hair in many cases.
posted by DirtyOldTown at 11:57 AM on June 23, 2023

You should do your due diligence on medical stuff as with any physical change, but absent other concerning factors I wouldn't worry about it medically if nothing obvious turns up. 20 may not be the predominant age for male pattern baldness but it's a completely normal age.
posted by dusty potato at 12:10 PM on June 23, 2023

As a cosmetic fix, he could look hair powder. It can be really effective for thinning (it doesn't help with bald patches). A really good hairdresser can do things that make the best of what he has.
posted by plonkee at 12:23 PM on June 23, 2023

Illness can cause hair loss a few weeks after the illness, but I'm not sure about what scalp pattern that would be.
posted by amtho at 12:26 PM on June 23, 2023

You can now buy what used to be called Rogain over the counter as Regain on Amazon. The sooner he starts the better as all he can do is slow or stop the hair loss, he's unlikely to get anything more than very little back.
posted by DarlingBri at 12:36 PM on June 23, 2023

Personally, when my thinning became apparent, I skipped straight to the "buzz it super short" step and have kept it that way ever since. I'm not saying I look as good as Vin Diesel or Lior Raz, but it doesn't look terrible and hasn't made any difference romantically or socially. I will say that if the choice is between a buzz cut and some sort of "arrange the hair to try to hide the balding," the buzz cut option is more dignified.

My father in law spent years trying to get me to use various hair growth products, but since none of them seemed to be helping his situation, I was never really tempted. I've only had one or two friends that were open about using those kind of products (I'm sure many others do but don't talk about it), and it didn't seem to be working for them, either. That said, I know medical treatments have advanced and this would seem like a legitimate discussion with his doctor.
posted by Dip Flash at 12:37 PM on June 23, 2023

Not sure when he had covid, but I did hear that post-covid hair loss was a thing, so that's one more thing to consider.
posted by swheatie at 12:56 PM on June 23, 2023

I suggest that your son go see a dermatologist that specializes in hair loss. The dermatologist will probably ask for a blood test and a scalp biopsy. Low iron and thyroid issues can cause hair loss. [Just a note about the blood test. Make sure your son is not taking any supplements with biotin at least 2 weeks before the blood test. Biotin can interfere with the thyroid test.]

Based on these tests, he'll likely be able to find out if it's normal male pattern baldness, stress related, or something else like autoimmune. If it's stress-related loss, the good news is that it will usually grow back on it's own. Hair loss is a super common thing for both men and women, so just treat it like any other health issue.
posted by jraz at 12:58 PM on June 23, 2023

“What should I tell my kid?”

That of sucks to lose your hair but it’s exceedingly common and he looks fine. If I was a guy in college and my mom was trying to cure my receding hairline it would probably give me an even bigger complex about the whole thing. Many of my friends started losing their hair in college. If you want to be supportive of him trying to reverse it, tell him to bring it up with his doctor.
posted by cakelite at 12:58 PM on June 23, 2023

My ex’s high school prom date noticed his hair was thinning, and he was shiny bald by his junior year of college. It just happens at that age sometimes. And it can look fine on an adult man, particularly now that shaved head is a conventional hairstyle — of all the things wrong with him, the baldness wasn’t one.
posted by LizardBreath at 1:04 PM on June 23, 2023

I think paying it too much attention is not good - I'm older but going through the same now, and honestly while I try and pretend it doesn't bother me, it does sometimes. And people mentioning it (even in a positive way trying to be nice) doesn't feel helpful. It's even tougher at such a young age I'm sure. I had two male friends who experienced rapid hair loss in their early 20s (both perfectly healthy, but of course check out with doctors first to ensure as others suggested). There was maybe a 1 year period where I noticed their head/thinning hair, and then I rapidly adjusted to the "new" them. It seemed to help that both of them only tried rogaine very briefly and then just went with a very short haircut. I remember even after a relatively short period that it became hard for me to remember what they looked like with their full prior hair.

Most importantly, it's extremely common and most men will experience it to some degree at some point. While it will be challenging during the adjustment period, it will be unlikely to have any negative impact beyond that time.
posted by unid41 at 1:49 PM on June 23, 2023

I have a close friend who also started having hair loss around 20ish. He went to the doctor and got Finasteride, and the hair loss reversed some and has not progressed. I don't think hair loss at that age is as commonly natural as the answers here seem to suggest, and I think going to the doctor for Finasteride et al is a good idea.
posted by watermelon at 2:51 PM on June 23, 2023

I agree with the suggestion to see a dermatologist. There so many possible explanations and potential solutions that only a dermatologist can provide.
posted by j810c at 3:00 PM on June 23, 2023

I started taking finasteride when I was 24 and (hair-wise...) look basically like I did then 12-13 years later. It can be tough to deal with at 20 when all your friends have full heads of hair still, so even if he doesn't want to stay on it forever he can always just hang out where he is until his friends have caught up. I actually signed up here to make a long comment on a different post about hair loss eight years ago now; that might be helpful too.

Definitely have him see a dermatologist, but keep in mind the possibility that they don't know a ton about hair loss. It's really common for men between the ages of 20-30 to experience some degree of pattern hair loss, so if you're a male and you're losing your hair the odds are pretty good that you're losing it for the horse reason and not the zebra reason. This is important primarily because if you do want to treat, it it's very important to act fast. (Finasteride is much better at holding onto hair you still have than growing it back, though of course everyone responds differently.) The first dermatologist I saw said telogen effluvium, but he was not right, so I spent three or four more months really anxious and unable to look in the mirror before I could see a specialist.

If you look—and for this reason I would not suggest looking—you'll find some very scared people online claiming finasteride has done terrible things to their sex life, their anxiety, etc., and that it's all permanent. I'm not going to say it's all fake since obviously I can't know that—I'll just say that you can find exactly the same comments in the same numbers about antidepressants, and a plausible explanation in both cases is that people generally begin fin and antidepressants at moments when they are extremely sad and nervous about the future, and it's really easy to mistake the treatment for the sickness in cases like that. (Also important to remember survivorship bias—I am not on hair loss forums talking about how fin turned my life around because I do not worry about hair loss anymore.) I haven't experienced any side effects at all, despite growing older and having multiple perfectly normal kids. That's all I can tell you.

There are other treatments—notably minoxidil (Rogaine), which some people have also started taking orally at very low doses (there was an article about that in the NYT a couple of years ago)—but they're way more fiddly and less effective than finasteride. It's hard to make yourself put stuff in your hair every morning! (And in general when you stop treatment, you return to your baseline.) There's some good stuff in the pipeline, but I wouldn't recommend waiting for it; the joke is that all hair loss cures are permanently five years away and looking great in Phase I trials. Waiting to take finasteride is going to reduce the results you get from it.

My advice is like a lot of peoples' in that I think it's incredibly important to not think about it too much. My advice is different in that I think for some people that is basically impossible advice to follow without the help of medication that is very good at basically stopping the progression of baldness in a high percentage of cases. Some people can stop thinking about it and just shave their heads, and I think that's great for them, but I could only stop thinking about it once I knew I was treating it.
posted by Polycarp at 4:27 PM on June 23, 2023

I went bald at that age, finally shaving the locks when I was 22. Certainly check the medical stuff above but beyond that my only advice is to make peace with it. Barring medical issues being bald is not a problem, don't make it one.
posted by deadwax at 4:29 PM on June 23, 2023

I started noticing thinning around that age. It stinks.

I waited too long to buzz as short as possible, then waited too long again to shave my head. I'd have done both 5 years earlier.

If I were your son, I'd get a super close trim (#1 sides, #3 or shorter on top) until he's done with college. Then I'd shave it off and start my adult life without ever having to worry about my goddamn hair again.

Seriously, a shaved head is not any sort of liability these days.
posted by yellowcandy at 5:14 PM on June 23, 2023

I can't speak for male pattern baldness issues, but after pneumonia I had a lot of hair fall out for like six months, I would not be surprised to hear that illness might have caused it for him. I went to a dermatologist and got hair-regrowing shampoo--I'm not sure if I remember the name/brand at this point--and while my hair is probably overall thinner than it used to be, it's not bald spotting or anything,
posted by jenfullmoon at 8:50 PM on June 23, 2023

A physical shock to the body can cause hair loss 1-3 months later. This happened to my husband a couple of years ago and it mostly grew back. I've read about it happening after a tough pregnancy or childbirth or a significant accident.

Basically the body shuts down hair growing for a while to conserve resources; the hair looks normal for a while, but no new hair is growing, so as the old hair falls out on schedule, it appears to thin significantly. In this case, there isn't anything to do about it, but it does spring back in a few months.

It's called Telogen Effluvium Hair Loss. No idea if this is what's affecting your son, but if his body's undergone a ton of stress, it might be.
posted by gideonfrog at 9:09 PM on June 23, 2023

I don't see any mention of ferritin levels, probably because it's uncommon in young people that don't menstruate, but it could also be worth checking out. Sometimes, hair loss is a sign of something else medically, like the people mentioning thyroid issues have said.
posted by kellyblah at 10:44 PM on June 23, 2023

Your child is an adult and beyond urging him strongly to see a couple of doctors (endocrinologist, dermatologist) to make sure there's no underlying cause that can be treated, researching solutions is really, really not your job anymore. I don't see any indication that he's explicitly asked for your help here. This is one of those "let him leave the nest and figure out how he wants to address this" moments. The stakes are relatively low.

My partner started balding at around this age. Interestingly, college kids mostly don't even have balding on their radar yet to the point where I very insensitively asked him what was up with his thinning hair and he was like "WAAH, I'M BALDING" which hadn't even occurred to me. So don't assume romantic interests will be bothered by it - they may not even realize that's the deal until fairly late in the game. My partner used rogaine inconsistently for a few years and it slowed the hair loss but it really irritated his scalp. I was glad when he quit.
posted by potrzebie at 9:19 PM on June 24, 2023

Personally, when my thinning became apparent, I skipped straight to the "buzz it super short" step and have kept it that way ever since.

Yep, the buzz cut is the way to go, it's socially acceptable now, and it feels cool. (Hey, I grew up way back in the Led Zep era when a full mane was required, but those days are long gone, thank gawd).
posted by ovvl at 5:57 PM on June 26, 2023

In case he wants to look at a bunch of before/after photos, there is a subreddit that is almost entirely photos of people before and after they buzz their balding hair off. (The remainder are mostly people with alopecia.) Obviously opinions will vary, but personally scanning through I didn't see a single "before" photo that looked better than the aftermath.
posted by Dip Flash at 7:29 PM on July 5, 2023