Dear Dr. Rassman,
I’m a fairly young hair loss sufferer (23), and I’m currently evaluating my options. Finasteride gave me side effects, despite two trials (one low dose). As you’re no doubt aware, the remaining topical and internal treatments are either even more side-effect prone (dutasteride) or simply not very effective (almost everything else). I’m too young for transplants, and if my loss does progress to NW6/7 – which is fairly likely having started losing at 19 – I would be a poor candidate anyway. I have tried the shaved look, and it doesn’t work for me.
By process of elimination, I’m coming round to the idea of trying wigs. I’ve done a fair amount of research on them, and I have to say I’m fairly dismayed by your reports on the topic. You present the costs as astronomical, which they don’t have to be. Many use them for approx. $1000 a year very easily. You also critique them because of the shadiness of the industry. There’s no denying that it’s a dodgy business, but that’s precisely why you have to do research and shop around.
I’d contend that most of the criticisms you lay at the door of the wig solution could also be leveled at HTs. They are both only good options when you go to GOOD providers. Your posts are akin to someone posting about HTs saying that they’re overpriced, operated by con-artists, leave people butchered, and give poor results. These are true for bad HTs, but it’s not a legitimate reason to criticize the industry. I’d say the same of wigs.
I only write this email because, had I come to you before I’d done all this research, I might not have looked any further into them. I’m concerned that some for whom it might be a legitimate solution will be similar put off, given the exposure of your blog.
No big deal really, I’d just prefer it if you qualified your criticisms with the fact that while the wig route CAN be bad, it isn’t always like that.
I am not against wigs / hair pieces. My point has been that it can be relatively expensive in the long run when comparing it to a hair transplant. In your case, if you pay $1000 a year, after 20 years you would have spent $20,000… which is much more than most people would spend for a hair transplant that lasts a lifetime without all the maintenance that wigs/hairpieces would require. Let’s say your hair transplant only costs $4000. That’s 4 years of wigs vs a lifetime of transplanted hair. To me, it seems like a waste of money. Of course you may not get the same density and fullness as a wig with a hair transplant, but that is one’s choice.
There are many people who live with a wig and there is nothing wrong with that. If you want to go that route, try it! In the worst case scenario, if you do not like it, you have other options. Some however get stuck on the wig system and find it hard to stop wearing it, as it becomes a drastic change in appearance. Some even do a combination of both wig and a hair transplant. They have a hair transplant in the front to achieve a natural looking frontal hairline and wear a wig to cover the top/back area. You also need to be aware of the traction alopecia risks, depending on how the hair system is attached.
At 23 years old, you may not be too young for a hair transplant. Each case is unique so I can’t say 100% without seeing you, I’m just pointing out that you’re not automatically disqualified based on your age alone. I don’t know what your pattern looks like at this point, but just because your loss started at 19 years old doesn’t mean you’re for sure heading towards a Norwood 6 or 7.