When to consider a hair transplant is an important question and should be considered primarily. As discussed above the first step to be considered while deciding to go for hair transplant is how to control hair fall of existing hair first. The exact rate of hair fall and pictures at 20 years of age compared to the present condition should be evaluated.
Family history regarding the condition of baldness from the paternal side i.e father grandfather and maternal side i.e maternal uncle maternal grandfather should be considered. If Hair fall has started at a very early age like for example less than 23 years and there is significant baldness over the head. In such cases first, we should try treatment to regain hair density with medicine mesotherapy, PRP, low-level laser light therapy. Improvement in diet, managing stress levels, increasing physical activity. If the baldness has progressed to a hair thinning level more than 70% loss in the concerned area then definitely hair transplant remains the only option to be considered. Hair fall at an early age should be dealt with very seriously especially if the age of the client is between 17 to 22 years. All possible efforts listed above should be considered to stop hair fall. Home remedies should not be relied upon for more than 2 months. The advice of a trained well-experienced trichologist is valuable and if it is due to genes then DHT blocker should be introduced carefully at low doses. Once hair fall is controlled and prime reason for hair fall is established decision for hair transplant can be taken