The young guy’s guide to early balding

Most men deal with at least some hair loss by the time they’re in their 70s. But many of them start balding decades earlier than that. And for some guys, the process starts when they’re barely out of their teens.

In fact, about 25% of bald men experienced the first signs of hair loss before age 21, according to the Cleveland Clinic.

It can be upsetting and even shocking to discover that you’re losing your hair in your 20s. But does early hair loss mean you’ll go bald as you get older?

“Not necessarily,” says Tomi Lee Wall, MD. She’s a board-certified cosmetic dermatologist in Oakland, California. “Everyone loses hair at different rates and loses different amounts of hair. You are not destined for a bald future just because you’re starting to lose hair when you’re younger.”

What does early hair loss look like?

When we think of twentysomething men “balding” (most doctors prefer the term “hair loss” these days), we often picture typical male-pattern hair loss. It appears as overall thinning or receding in certain areas of the scalp. Male-pattern baldness is the most common cause of hair loss in men.

This type of balding is also known as androgenetic alopecia because it’s governed by sex hormones in the body called androgens. (Alopecia is a general term for hair loss.)

During puberty, boys produce androgens. If a boy has inherited the gene for baldness, the androgens can interact with that gene to shrink hair follicles. The result: His regular hair falls out and is replaced by colorless fuzz. Over time, the fuzz falls out, leaving smooth scalp.

Hair loss from male-pattern baldness usually begins at the temples, at the crown or at the front of the scalp. It may show up as the classic “M” shape at the top of the forehead, as a bald spot at the top of the head, or as overall thinning.

Some guys just accept it and cut their hair short, which makes the thinning less noticeable. But if you’re not ready to lose your hair, the good news is that early treatment can help you preserve it for the long term.

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How do you treat hair loss in your 20s?

Even if you’re not all that worried about your hair loss yet, it makes sense to book an appointment with a dermatologist. These doctors are trained to deal with issues related to skin, hair and nails.

“I would always recommend you see a doctor immediately,” says Stephanie Cotell, MD. She’s a board-certified dermatologist at Northeast Dermatology and Cosmetic Surgery Center in Gahanna, Ohio. That’s because there are other causes of hair loss that are important to rule out. These include:

• Medication
• Anemia
• Thyroid issues
• Fungus
• An autoimmune condition, such as lupus
• Syphilis

Some hair loss is temporary, and some is permanent. “With certain types, we want to start a treatment sooner rather than later,” says Dr. Cotell. Early intervention can keep future hair loss to a minimum. Why? It’s easier to keep the hair you have than to regrow after it recedes or thins. (Here’s what to know before you start a treatment for hair loss.)

Try not to panic, Dr. Cotell says. “Male-pattern loss tends to be a rather slow process.” But it can be distressing. Seeing a doctor can improve your scalp health, for sure. But it can also ease your anxiety and boost your self-confidence.

Consider minoxidil and finasteride

Even if your hair loss is modest, minoxidil (known by the brand name Rogaine^®) and finasteride (known as Propecia^®) are great ways to take control of hair loss and stimulate growth.

“I think of it as a fertilizer for hair. It’s probably not going to hurt, and it may help most patients,” Dr. Cotell says of minoxidil, which is sold over the counter. Propecia is available by prescription. Both are generally safe for men and work to help maintain hair and even restart growth.

The sooner you start, the more hair you’ll keep, says Dr. Wall. “There are interesting studies with twins that show that the twin who started Rogaine earlier maintained more hair on his scalp than the twin who started later.” (Attention, guys with male siblings: This is an opportunity to one-up your brothers.)

Don’t blame your mother

We’re often told that men with a cue-ball look inherited it from their mother’s side of the family. Heredity does play a role. But in truth, many different genes play into hair loss, and they can come from both the father’s side and the mother’s side, according to the Mayo Clinic.

Look to your dad, your uncles and both of your grandfathers for clues. Who has a full head of hair, and who is bald? Your doctor will want to know about your family history.

Being proactive can give you a sense of control over early hair loss. Seeking medical help now is a smart move for your overall health. And it can set you up for years of healthy hair growth. With any luck, you’ll be booking regular haircut appointments with your barber well into your 30s, 40s and beyond.

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Additional sources
Hair loss statistics: Cleveland Clinic (2021). “Why Do Men Go Bald? And Is There Anything You Can Really Do About It?”
Hereditary baldness: Mayo Clinic (n.d.). “Hair Loss”