Many patients come to look for hair transplantation at a very young age as early as 16 to 18 years; these people may have low self-esteem and also come in distress because of peer pressure most of these patients actually looking for rapid results, with unrealistic expectation managing this kind of situation often becomes challenging for the treating physician. Every case may be a different case so before embarking on the treatment it is important to look after all the factors and expectations. Some may need even consultation with psychiatrist.
Expectations must be confronted with the reality and the treatment should be explained well before with realistic results emphasizing that there are no miracle or magical treatment available.
Conservative treatments like medications, platelet rich plasma therapy or low level laser light therapy must be taken into consideration before embarking on hair transplantation in such patients. Most of these patients have very little temporal regression of thinning in the frontal area which can be managed with these treatments.
Future hair loss is possible with younger patients. It should be explained that even after hair transplantation further hair loss may be possible and hair transplantation is not the end treatment or have quick results.
As the number of hair restoration surgeons are increasing, there is an increase in competition between them naturally and many treating doctors take such case as a challenge which should be discouraged.
Before hair transplantation we need to understand the cause of Hair loss - beside androgenetic alopecia, other factors that might contribute to hair loss like health conditions, diet and genetics.
If it is caused by pattern hair loss, it is not possible to determine the pattern of hair loss at such a young age and future progression. Family history may play a crucial role as it might give the clue about future progression.
Before surgery, Patients can try the oral drug Finasteride and /or topical minoxidil to slow hair loss. He can re-examine the patient at regular interval to see the progression or if the drugs have slowed further progression.
If even after that the progression continues and a surgeon determines to go for the surgery he should go for the minimum grafts need for the correction and try to avoid transplantation in the vertex area. Risk of future hair loss will always be factor so the best way is to wait until the condition has progressed, at least enough for a physician to identify a surgical plan and till then, managing the case with medications or other adjutant therapies is a good idea.