I'm so devastated for my son

I can't wait for the crowd who says women don't care about hair deal with this one.

Angry at husband for passing down bad genes?

I'll be watching this thread closely.

Well, it's her son, not a potential romantic interest. Mothers scrutinize their sons differently; they notice things others don't. I still think most guys with hair loss vastly overestimate the degree to which most (not all, but MOST) women care about or even notice hair loss. I mentioned my brother's hair loss to my ex-wife the other day, who sees him reasonably frequently, and she had no idea what I was talking about--she literally hadn't notice. And he's a NW3 *at best.*

You've got a really tough decision to make here--either leave your son be and let him continue to think he won't have any serious loss until he's 40, or intervene and encourage him to take steps that could very plausibly help him hold onto his hair. And I'm not being flippant; that's a genuinely difficult choice. It's very difficult to predict how someone will lose their hair, but if he's experiencing noticeable crown and vertex thinning at 20, it's very, very likely that he will have fairly significant hair loss by the time he's 25 or 30. Everyone balds differently, but showing loss at his age doesn't bode well. Your position is difficult because the condition doesn't bother him, but it doesn't bother him because he's under an impression that's probably false. A lot of folks will say leave him be and let him enjoy his 20s, but there's a good chance that he would be upset to find out, ten years later, that someone knew differently and could have intervened to help him keep his hair for a longer time.

There isn't a great "cure" for hair loss, but there are treatments that can frequently help guys hold onto hair for a significantly longer time. Propecia is a prescription medication that inhibits production of DHT, a form of testosterone that causes hair loss in men with male pattern balding. It's effective in the vast majority of guys, and has a very small incidence of side effects (although the frequency of side effects is hotly debated). Propecia is, far and away, the best treatment ever developed for male hair loss. Rogaine is topically applied and could help your son regrow hair; it's most effective on the crown, which is where he has loss. If he got on these treatments now, it could save lots of his hair during the coming years. Neither of these treatments prevent hair loss entirely, and nature will eventually take its course, but they may buy him years of having hair on his head, which may help him benefit from new treatments that are in development.

My advice would be to think carefully about your son, and whether he's the type of person that would be deeply affected by losing his hair at a young age. If he is, it may be worth puncturing his bubble to intervene. There are many men on this forum who desperately wish that they had had the wherewithall to treat their hair loss at an earlier age.

follow-up

I realize my comment about my husband's flawed genes is irrational, possibly bitter and hopefully fleeting, but can't we just let it all out here?

I'd like to clarify that the fact that a guy was bald never even registered with me in the past - I really never noticed it nor did I particularly think negatively about it. That was before it began happening to my 20 year old kid! Once my kid realizes this is happening to him now and not at age 40, I know that he'll be so pained and that pains me.

Get your son on propecia asap and talk to him about it. The last thing you want is to get a ignorant college girl mention his bald spot in front of other people and thats the way he finds out. It sucks but hopefully better treatments are around the corner. Look into histogen and read up.

I know; like I said, a tough situation. I don't have children, but I empathize with this predicament; leave him in blissful ignorance, or perhaps cause him alarm but help him take steps that will make him happier in the future. If it helps you make up your mind, I would point out that his shedding is apparently advancing very quickly; if you were noticing new thinning between November and December, then his loss may be aggressive. Extensive hair loss before 25 is not the norm, but it is not rare among men who have MPB. Look at the Norwood chart that I've included below; it's impossible for me or anyone here to predict how he'll bald, but if he's losing hair aggressively at his age, it's not outlandish to think that he could end up at a NW4-5 in the next few years. (I'm also not saying that's the LIKELY outcome; I just don't know.)

Thank you, Win200 and others, for your posts. I looked at the Norwood scale and my son doesn't match any of the pictures. His front hairline is normal but there is definite thinning at the crown and halfway going forward at the top of his head. His late uncle and cousin were/are a 7, the most severe type of balding. I think I'm going have to tell him within the next 4-5months (when he'll be home next) that I see some additional thinning and lay his options out for him. That will be the end of his "innocence" - I know him and he won't handle it well - what 20 year old would?? I guess I'm in a bit of disbelief - as a parent you worry about everything, but this is one thing that never, ever entered my mind.

Not a problem. I think you're doing the right thing, although others probably disagree. Hair loss itself isn't a medical problem, but the accompanying psychological distress can take a huge toll, particularly on very young men.

A few things:

1. The Norwood scale isn't ironclad. People bald in different patterns; it's just a rough guide of the most frequent ones. Some people do lose hair in the crown for a long time without experiencing hairline recession. Most balding does begin in the hairline, but not all. What your son is experiencing isn't unusual.

2. Read lots. This forum is a great resource, and there are others as well. Exploring William Rassman's blog, at www.baldingblog.com, is a good starting place. Rassman is a hair transplant surgeon in LA, and although people have varying opinions of him here, he was a pioneer of a number of the widely used modern surgery techniques for hair transplant, and has been an important figure in the hair replacement field. His tone is a little glib sometimes, but the blog is easily searchable and was where I first started exploring this topic.

3. Your family doctor is not the person to turn to. General practitioners usually know little to nothing about hair loss, except the very basics: DHT sensitivity, prescribe Propecia, recommend minoxidil. They won't be able to answer more nuanced questions with knowledge, and are very likely to give incorrect answers. Dermatologists are marginally better, but many are also pretty ignorant. I recently had a dermatologist tell me that Rogaine is only effective in 30% of men, and Propecia only works for 50% of men. I don't know where those numbers came from, but they're completely and patently incorrect. Dermatologists usually deal with skin cancer and cosmetic issues, and they don't tend to know much about genetic hair loss; they better for things like scalp inflammation. The best place to turn to is actually a hair transplant surgeon. I know that sounds alarming, but you don't have to go to one just to get a transplant (and your son is far too young, anyway). These are the medical professionals who deal with hair loss and treatment far, far more than anyone else. They're the most knowledgeable, and they'll give the fewest wrong answers. Most would be happy to consult with your son, take a look at his hair, and give him some straight answers, even if he's not looking at a transplant. The IAHRS is a consumer advocacy group that endorses transplant surgeons, and they only rubber-stamp the best. If you have one in your area, that would be the best place to take your son for really top-notch advice. If you're not near an IAHRS surgeon, look on the ISHRS website (similar acronyms, totally different organizations). Because your son isn't actually getting a surgery, their surgical skill really isn't that important; a non-IAHRS surgeon will still be extremely knowledgeable. I've been to three surgeons, and all were incredibly nice, thoughtful guys, even when they knew I probably wasn't going to be a customer.

Well, its understandable for mothers to worry. My mother was heart-broken too when I started to lose my hair at age of 18. That was 20 years ago though. There was'nt much awareness back then so she ended up blaming me. Said my experimenting with gels, shampoos or wearing hats led to this.

Now, there is much known and, thankfully, hairloss can be treated. Your son is just 20 so I would encourage you to take him to doctor and get him on Finasteride (Propecia).

It's nice that you don't want to upset your son and protect his innocence. However, just like any other problem in life ignoring the problem doesn't help one bit. Especially in this case when the earlier you address the problem the greater the likelihood of a favourable outcome.

90 percent of all men who take propecia will experience no further hair loss. There will likely be some much better treatments/therapies in the next several years so propecia is not a life long sentance.

IMO you have two choices:

Be proactive and upset him a little now and attempt to solve he problem or;

Put your heads in the sand and have him be VERY upset in a couple years when it's too late or him to have a full head of hair.

Dont be devastated for him, just be supportive. If he see's its upsetting you it could make him feel bad. It's not flawed genetics, its just genetics and its normal. there is no cure for male pattern baldness, it doesn't exist. You can delay or slow down the loss with the following treatments, minoxidil which you apply topically twice a day, finasteride which you take one tablet a day, and nizoral which is a shampoo that you use about twice a week. These are treatments, not cures, they are more about retaining what you have. The finasteride can have side effects in some guys such as low libido, erectile dysfunction, anxiety, depression, affected memory etc, these affect a small percentage of men but it does happen and there are forums where people still suffer the sides after they cease taking the pill. Your dermatologist or doctor will re affirm what I've just said.
The hair transplant route is very very pricey road to go down running into tens of thousands of dollars. Its not a case of one transplant and everything is fixed, its a case of multiple surgerys over time because more hair will fall out in the future and more transplanted hair will be needed to take its place, it also leaves scarring in the donor area from where the hair was taken depending on the method used. So if in the future your son decides he wants to buzz his hair off he will have scars to show for the transplants.
How does your son feel about it? Because it seems a little like you are more upset than he is, is it something that really bothers him? Or is he the kind of guy who's happy enough to buzz his hair short and get on with life?

I started losing my hair when I was 20. I went through the treatments of minoxidil, propecia, looked into surgery etc but in my experience all it really did was inhibit me from accepting myself for who I was and moving on, for a decade I was just constantly worried about my hair and taking propecia and minoxidil and checking to see how much hair I had lost and checking the meds were still working and it just made me insecure. Instead of "bald" jokes you just get "balding" jokes instead. I dropped the treatments because after a while they lose effectiveness and looking back I wish I had just accepted it from the start like I do now.
I've said it before, its much less stressful and so much better to be a bald man in control than an insecure man trying to fight against his genetics. In the long run your son will just need to accept it so he will need to cross that bridge sooner or later. There is no reason he cant by happy even with hair loss. A lot of people who cant let it go think its the end of the world and they make themselves miserable as a result when all they need to do is accept who they are and move on.
Im not saying it wont be tough for him, but what I am saying is, at the end of the day when he accepts who he is, he's going to be just fine. Its better to be the bald guy who's smiling instead of the insecure guy who's looking at his shoes.

This is the best advice out there.

I'll just say the following:

1. When/if you speak to him, please don't act like it's a big deal - certainly don't let him know how devastated you are. Hair loss is only half the problem. The other half, and arguably the much more important half, is how he feels about it. Particularly in the early stages of his hair loss his assumptions about his condition won't be set in the stone and they are open to change, especially since he's still only just out of his teens. As Kayman said it's better to be okay with one's situation, no matter what it is. So help him be okay with it!

2. If you do speak to him and he wants to do something about it, don't delay. It is absolutely critical to tackle hairloss as soon as possible. Once hair is gone, it's probably gone for good (unless the new generation of treatments work better than they appear to work so far). Get on Rogaine or Propecia, or preferably both.

3. It sounds like what your son has is a type of balding called 'persistent hairline' where his hairline is staying intact. This could be good news because the hairline is normally the hardest to treat. Propecia and Rogaine both work much better in the crown. If you tackle it early there is a good chance that he could even regrow some or much of the hair he has lost.

4. You said you never noticed whether a guy was balding before (thank you for this btw - there are a lot of idiots on this forum who like to insist balding is a deal-breaker for every woman). You should take this attitude to your son and generalise it - point out it's not such a big deal and most women won't worry/care. Obviously some do, many clearly don't (my own girlfriend among them) and this will help him avoid some of the worst mental anguish associated with balding - that it somehow means a guy will never get a girlfriend ever again.

My own mother fussed about my hairloss so badly when I didn't even care in the slightest, when I was about 22 and she first noticed my hair receding. Now I'm 31 and quite bald and, worse, I care about it, in part because my own mother acted like it was a big deal when I didn't think it was. She bought me Rogaine without my even asking for it and then kept asking me if I was using it.

Now that I'm almost bald my mother has changed her tune and tells me she never cared about my father's baldness and that other women won't either. Thanks Mum, but it's too late now! The damage was done in my early 20s, and now I am very self-conscious about it.

Thankfully my girlfriend doesn't seem to be, and I am so grateful I have her - but please don't make the same mistake my mother did!

No it just shows how women really feel about hairloss. They hate it.

In my opinion your attention to this and bringing it up to him will make him feel self conscious and more than likely uncomfortable. If you have noticed it it is a good chance that he has as well if he has been looking into a mirror lately. My best advice would be to be as supportive as possible and to be tactful.

Also it is a scientific fact that both sexes pass and indirectly activate and trigger the baldness gene not just one. Though in his paternal line baldness runs through that line as a male with XY chromosone.. your matrilineal genes are in him as well and it is the pairing of both the dominant bald gene and recessive traits and yours perhaps being the trigger pull that have potentially activated the baldness. It is a 50/50 shot a genetic lottery..two boys can be born from the same family and one can have a full head of hair and the other brother conceviably go bald before 30 years old it is just random like that. However now is not the time to blame your husband, yourself or anyone else for that matter.. it is time to be there for your son and to seek answers for him should he ask them of you.. and constructive ones that are well resrched at that.