Androgenetic Alopecia Common Cause of Hair Loss in Adolescents

Androgenic alopecia can begin much earlier than many physicians, patients, and parents think

April 2010

Androgenetic alopecia is the most common cause of hair loss in adolescents, researchers from New York University School of Medicine say.

"Androgenic alopecia can begin much earlier than many physicians, patients, and parents think," senior author Dr. Seth Orlow from NYU School of Medicine, New York told Reuters Health by email. "It is important for physicians not only to correctly diagnose the problem, but also to be sensitive to the potential psychosocial impact."

In the March 23rd British Journal of Dermatology, Dr. Orlow and colleagues report that androgenetic alopecia was the second most common diagnosis in 438 pediatric patients evaluated for hair loss and the most prevalent etiology of hair loss in adolescents (52/123, 42%).

To study this further, the researchers focused on 57 youngsters (38 boys) with androgenetic alopecia, including 52 teenagers and 5 children younger than 12.

Thirty-five children had a family member with androgenetic alopecia, including 29 first and/or second degree relatives with patterned hair loss.

The most common presentation in boys was thinning of the vertex with varying degrees of bitemporal thinning, but one-third of boys had diffuse thinning or prominent thinning at the crown, more consistent with the female pattern that was characteristic in the girls.

Adrenal androgens may have played a role in 3 adolescents with female patterned androgenetic alopecia, as all 3 had prepubertal levels of testosterone. Nine girls with clinical features of hyperandrogenism and/or hyperandrogenemia likely had polycystic ovarian syndrome.

Scalp biopsies in 5 girls and 9 boys showed typical features of androgenetic alopecia.

Four of 6 girls treated with minoxidil solution experienced stabilization in hair loss with continued use at 1 year. Two girls discontinued usage, one for lack of efficacy (5 months) and one because of headaches and nausea (3 weeks).

Eighteen of 23 boys treated with minoxidil solution reported stabilization in hair loss and/or fuller hair, and 6 boys treated with finasteride reported increased hair density with no progression in hair loss.

"Early onset androgenic alopecia should prompt a careful history and clinical exam, and, where indicated, lab testing, to rule out an underlying hormonal imbalance," Dr. Orlow said.

"No treatment is approved for this purpose in children or adolescents under 18, although many teens with the condition get treated safely with minoxidil solution or foam," he added.

Source