Androgenetic alopecia in adolescents

Abstract

Androgenetic alopecia (AGA) is a nonscarring progressive miniaturization of the hair follicle with a usually characteristic pattern distribution in genetically predisposed men and women. Although AGA is the most common form of hair loss in adults, little is known about its prevalence and response to treatments in the pediatric population. As in adults, the diagnosis of this type of alopecia in adolescents is made by recognizing the pattern and progression of hair loss in the context of the family history. A negative family history does not exclude the diagnosis. Early-onset AGA can be the presenting sign of an underlying endocrine disorder. Adolescents are invariably sensitive about their external features and, thus, may easily withdraw psychologically and avoid social activities due to AGA development. They can feel anxious and unattractive with a negative body image about themselves. Accurately recognizing AGA in adolescents will help patients and their families understand the diagnosis and its natural progression, allowing timely medical intervention for hair loss and any associated endocrine or psychosocial morbidity. Treatment of adolescent AGA has not been well studied, and currently there are no FDA-approved treatments for this condition. This article provides an overview of the embryology and normal hair development, pathogenesis, diagnosis, and management of adolescent androgenetic alopecia.