Skip to main content
SpringerLink
Log in
Book cover

Practical Pediatric Dermatology pp 187–196Cite as

Androgenetic Alopecia in Adolescents

  • Chapter
  • First Online:

  • 1405 Accesses

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.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Alanis A, Barbara F, Meurehg C, De Oca FL, Ramirez L. Double-blind comparison of 2 % topical minoxidil and placebo in early male pattern baldness. Curr Ther Res Clin Exp. 1991;49(5):723–30.

    Google Scholar 

  • Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update: part I. Clinical picture, histopathology, and pathogenesis. J Am Acad Dermatol. 2010;62(2):177–88, quiz 189–90.

    Article  CAS  PubMed  Google Scholar 

  • Blume-Peytavi U, Blumeyer A, Tosti A, Finner A, Marmol V, Trakatelli M, Reygagne P, Messenger A, European Consensus Group. S1 guideline for diagnostic evaluation in androgenetic alopecia in men, women and adolescents. Br J Dermatol. 2011;164(1):5–15.

    Article  CAS  PubMed  Google Scholar 

  • Blumeyer A, Tosti A, Messenger A, Reygagne P, Del Marmol V, Spuls PI, Trakatelli M, Finner A, Kiesewetter F, Trüeb R, Rzany B, Blume-Peytavi U, European Dermatology Forum (EDF). Evidence-based (S3) guideline for the treatment of androgenetic alopecia in women and in men. J Dtsch Dermatol Ges. 2011;9 Suppl 6:S1–57.

    Article  PubMed  Google Scholar 

  • Budd D, Himmelberger D, Rhodes T, Cash TE, Girman CJ. The effects of hair loss in European men: a survey in four countries. Eur J Dermatol. 2000;10(2):122–7.

    CAS  PubMed  Google Scholar 

  • Cash TF. The psychological effects of androgenetic alopecia in men. J Am Acad Dermatol. 1992;26:926–31.

    Article  CAS  PubMed  Google Scholar 

  • Cash TF, Price VH, Savin RC. Psychological effects of androgenetic alopecia on women; comparisons with balding men and with female control subjects. J Am Acad Dermatol. 1993;29:568–75.

    Article  CAS  PubMed  Google Scholar 

  • Cash TF. The psychology of hair loss and its implications for patient care. Clin Dermatol. 2001;19(2):161–6.

    Article  CAS  PubMed  Google Scholar 

  • Chumlea WC, Rhodes T, Girman CJ. Family history and risk of hair loss. Dermatology. 2004;209:33–9.

    Article  PubMed  Google Scholar 

  • Courtois M, Loussouarn G, Hourseau S, Grollier JF. Periodicity in the growth and shedding of hair. Br J Dermatol. 1996;134(1):47–54.

    Article  CAS  PubMed  Google Scholar 

  • Cutrone M, Grimalt R. Transient neonatal hair loss. Eur J Pediatr. 2005;164(10):630–2.

    Article  PubMed  Google Scholar 

  • Gan DC, Sinclair RD. Prevalence of male and female pattern hair loss in Maryborough. J Investig Dermatol Symp Proc. 2005;10:184–9.

    Article  PubMed  Google Scholar 

  • Gonzalez ME, Cantatore-Francis J, Orlow SJ. Androgenetic alopecia in the paediatric population: a retrospective review of 57 patients. Br J Dermatol. 2010;163(2):378–85.

    Article  CAS  PubMed  Google Scholar 

  • Grover C, Khurana A. Telogen effluvium. Indian J Dermatol Venereol Leprol. 2013;79(5):591–603.

    Article  PubMed  Google Scholar 

  • Harrison S, Sinclair R. Optimal management of hair loss (alopecia) in children. Am J Clin Dermatol. 2003;4(11):757–70. Review.

    Article  PubMed  Google Scholar 

  • Harrison S, Sinclair R. Telogen effluvium. Clin Exp Dermatol. 2002;27(5):389–5. Review.

    Article  CAS  PubMed  Google Scholar 

  • Herskovitz I, Tosti A. Female pattern hair loss. Int J Endocrinol Metab. 2013;11(4), e9860.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kaliyadan F, Nambiar A, Vijayaraghavan S. Androgenetic alopecia: an update. Indian J Dermatol Venereol Leprol. 2013;79:613–25.

    Article  PubMed  Google Scholar 

  • Katz HI, Hien NT, Prawer SE, Goldman SJ. Long-term efficacy of topical minoxidil in male pattern baldness. J Am Acad Dermatol. 1987;16(3 Pt 2):711–8.

    Article  CAS  PubMed  Google Scholar 

  • Kaufman KD. Androgen metabolism as it affects hair growth in androgenetic alopecia. Dennatol Clin. 1996;14:697–711.

    CAS  Google Scholar 

  • Kim BJ, Kim JY, Eun HC, Kwon OS, Kim MN, Ro BI. Androgenetic alopecia in adolescents: a report of 43 cases. J Dermatol. 2006;33(10):696–9.

    Article  PubMed  Google Scholar 

  • Kowalska-Oledzka E, Slowinska M, Rakowska A. Sensitivity and specificity of the trichoscopy. Indian J Dermatol Venereol Leprol. 2012;78:636–7.

    Article  PubMed  Google Scholar 

  • Krupa Shankar D, Chakravarthi M, Shilpakar R. Male androgenetic alopecia: population-based study in 1,005 subjects. Int J Trichology. 2009;1(2):131–3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lucky AW, Piacquadio DJ, Ditre CM, Dunlap F, Kantor I, Pandya AG, Savin RC, Tharp MD. A randomized, placebo-controlled trial of 5% and 2% topical minoxidil solutions in the treatment of female pattern hair loss. J Am Acad Dermatol. 2004;50(4):541–53.

    Article  PubMed  Google Scholar 

  • Ludwig E. Classification of the types of androgenetic alopecia (common baldness) occurring in the female sex. Br J Dermatol. 1977;97:247–54.

    Article  CAS  PubMed  Google Scholar 

  • Madani S, Shapiro J. Alopecia areata update. J Am Acad Dermatol. 2000;42(4):549–66; quiz 567–70.

    Article  CAS  PubMed  Google Scholar 

  • McDonough PH, Schwartz RA. Adolescent androgenic alopecia. Cutis. 2011;88(4):165–8.

    PubMed  Google Scholar 

  • Moreno-Romero JA, Grimalt R. Hair loss in infancy. G Ital Dermatol Venereol. 2014;149(1):55–78.

    CAS  PubMed  Google Scholar 

  • Norwood OT. Male pattern baldness: classification and incidence. South Med J. 1975;68:1359–65.

    Article  CAS  PubMed  Google Scholar 

  • Olsen EA, DeLong ER, Weiner MS. Long-term follow-up of men with male pattern baldness treated with topical minoxidil. J Am Acad Dermatol. 1987;16(3 Pt 2):688–95.

    Article  CAS  PubMed  Google Scholar 

  • Olsen EA, Dunlap FE, Funicella T, Koperski JA, Swinehart JM, Tschen EH, Trancik RJ. A randomized clinical trial of 5% topical minoxidil versus 2% topical minoxidil and placebo in the treatment of androgenetic alopecia in men. J Am Acad Dermatol. 2002;47(3):377–85.

    Article  PubMed  Google Scholar 

  • Olsen EA, Messenger AG, Shapiro J. Evaluation and treatment of male and female pattern hair loss. J Am Acad Dermatol. 2005;52:301–11.

    Article  PubMed  Google Scholar 

  • Olsen EA, Weiner MS, Amara IA, DeLong ER. Five-year follow-up of men with androgenetic alopecia treated with topical minoxidil. J Am Acad Dermatol. 1990;22(4):643–6.

    Article  CAS  PubMed  Google Scholar 

  • Olsen EA. Current and novel methods for assessing efficacy of hair growth promoters in pattern hair loss. J Am Acad Dermatol. 2003;48(2):253–62.

    Article  PubMed  Google Scholar 

  • Olsen EA. Hair loss in childhood. In: Olsen EA, editor. Disorders of hair growth. Diagnosis and treatment. 2nd ed. New York: McGraw Hill; 1994a. p. 177–238.

    Google Scholar 

  • Olsen EA. Clinical tools for assessing hair loss. In: Olsen EA, editor. Disorders of hair growth. Diagnosis and treatment. 2nd ed. New York: McGraw Hill; 1994b. p. 59–69.

    Google Scholar 

  • Patel M, Harrison S, Sinclair R. Drugs and hair loss. Dermatol Clin. 2013;31(1):67–73.

    Article  CAS  PubMed  Google Scholar 

  • Price VH, Menefee E, Strauss PC. Changes in hair weight and hair count in men with androgenetic alopecia, after application of 5% and 296 topical minoxidil, placebo, or no treatment. J Am Acad Dermatol. 1999;41(5 Pt 1):717–21.

    Article  CAS  PubMed  Google Scholar 

  • Price VH. Androgenetic alopecia in adolescents. Cutis. 2003;71(2):115–21. Review.

    PubMed  Google Scholar 

  • Rakowska A, Slowinska M, Kowalska-Oledzka E, Olszewska M, Rudnicka L. Dermoscopy in female androgenic alopecia: method standardization and diagnostic criteria. Int J Trichology. 2009;1:123–30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Rakowska A, et al. Androgenetic alopecia. In: Rudnika L, Olszewska M, Rakowska A, editors. Atlas of trichoscopy. London: Springer; 2012. p. 221–35.

    Chapter  Google Scholar 

  • Randall VA, Ebling FJ. Seasonal changes in human hair growth. Br J Dermatol. 1991;124(2):146–51.

    Article  CAS  PubMed  Google Scholar 

  • Rathnayake D, Sinclair R. Male androgenetic alopecia. Expert Opin Pharmacother. 2010;11(8):1295–304.

    Article  CAS  PubMed  Google Scholar 

  • Rudnicka L, Olszewska M, Rakowska A, Kowalska-Oledzka E, Slowinska M. Trichoscopy: a new method for diagnosing hair loss. J Drugs Dermatol. 2008;7:651–4.

    PubMed  Google Scholar 

  • Shapiro R, et al. Hair anatomy and histology. In: Unger WP, Shapiro R. Hair transplantation. 4th ed. Revised and expanded; Marcel Dekker, New York: 2004. p. 25–33.

    Google Scholar 

  • Sinclair R, Jolliffe V. Diffuse hair loss-telogen effluvium. In: Fast facts: disorders of the hair and scalp. 2nd ed. Oxford: Health Press; 2013. p. 51–7.

    Google Scholar 

  • Sinclair RD, Banfield CC, Dawber RP. Hair structure and function. In: Sinclair RD, Banfield CC, Dawber RP, editors. Handbook of diseases of the hair and scalp. Oxford: Blackwell Science; 1999. p. 3–23.

    Google Scholar 

  • Strauch B, Greenstein B. Cosmetic plastic surgery in adolescents. Adolesc Med. 1997;8(3):537–45.

    PubMed  Google Scholar 

  • Tosti A, Fanti PA, Morelli R, Bardazzi F. Trachyonychia associated with alopecia areata: a clinical and pathological study. J Am Acad Dermatol. 1991;25:266–70.

    Article  CAS  PubMed  Google Scholar 

  • Tosti A, Iorizzo M, Piraccini BM. Androgenetic alopecia in children: report of 20 cases. Br J Dermatol. 2005;152:556–9.

    Article  CAS  PubMed  Google Scholar 

  • Tosti A, Piraccini BM. Androgenetic alopecia. Int J Dermatol. 1999;38 Suppl 1:1–7. Review.

    Article  PubMed  Google Scholar 

  • Trancik RJ, Spindler JR, Rose S. Incidence of androgenetic alopecia in males 15 to 17 years of age. Poster presented at: 3rd Intercontinental Meeting of the Hair Research Societies; 13–15 June 2001a; Tokyo. p. 127.

    Google Scholar 

  • Trancik RJ, Spindler JR, Cuddihy RV. Clinician survey evaluating minoxidil topical solution in the treatment of androgenetic alopecia in patients under 18 years of age. Poster presented at: 3rd Intercontinental Meeting of the Hair Research Societies; June 13–15, 2001b; Tokyo. p. 129.

    Google Scholar 

  • Trancik RJ, Spindler JR, Ferry JJ, et at. Investigation of the systemic bioavailability of 5% minoxidil topical solution in young males with early androgenetic alopecia. Poster presented at: 3rd Intercontinental Meeting of the Hair Research Societies; 13–15 June 2001c; Tokyo. p. 126.

    Google Scholar 

  • Tuccori M, Pisani C, Bachini L, Pardini M, Mantarro S, Antonioli L, Fornai M, Rubinelli M, Cirinei C, Blandizzi C. Telogen effluvium following bivalent human papillomavirus vaccine administration: a report of two cases. Dermatology. 2012;224(3):212–4.

    Article  PubMed  Google Scholar 

  • van Zuuren EJ, Fedorowicz Z, Carter B, Andriolo RB, Schoones J. Interventions for female pattern hair loss. Cochrane Database Syst Rev. 2012a;16:5.

    Google Scholar 

  • van Zuuren EJ, Fedorowicz Z, Carter B. Evidence-based treatments for female pattern hair loss: a summary of a Cochrane systematic review. Br J Dermatol. 2012b;167(5):995–1010.

    Article  PubMed  Google Scholar 

  • Werner B, Mulinari-Brenner F. Clinical and histological challenge in the differential diagnosis of diffuse alopecia: female androgenetic alopecia, telogen effluvium and alopecia areata - part I. An Bras Dermatol. 2012;87(5):742–7.

    Article  PubMed  Google Scholar 

  • Whiting DA, Waldstreicher J, Sanchez M, Kaufman KD. Measuring reversal of hair miniaturization in androgenetic alopecia by follicular counts in horizontal sections of serial scalp biopsies: results of finasteride 1 mg treatment of men and postmenopausal women. J Investig Dermatol Symp Proc. 1999;4(3):282–4.

    Article  CAS  PubMed  Google Scholar 

  • Whiting DA. Diagnostic and predictive value of horizontal sections of scalp biopsy specimens in male pattern androgenetic alopecia. J Am Acad Dermatol. 1993;28:755–63.

    Article  CAS  PubMed  Google Scholar 

  • Wise RP, Kiminyo KP, Salive ME. Hair loss after routine immunizations. JAMA. 1997;278(14):1176–8.

    Article  CAS  PubMed  Google Scholar 

  • Witchel SF. Hyperandrogenism in adolescents. Adolesc Med. 2002;13(1):89–99, vi–vii.

    PubMed  Google Scholar 

  • Zhao Y, Zhang B, Caulloo S, Chen X, Li Y, Zhang X. Diffuse alopecia areata is associated with intense inflammatory infiltration and CD8+ T cells in hair loss regions and an increase in serum IgE level. Indian J Dermatol Venereol Leprol. 2012;78(6):709–14.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Dermatology, Universitat Internacional de Catalunya, Barcelona, Spain

    Rubina Alves MD & Ramon Grimalt MD, PhD

Authors
  1. Rubina Alves MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ramon Grimalt MD, PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Rubina Alves MD .

Editor information

Editors and Affiliations

  1. Rotterdam, The Netherlands

    Arnold P. Oranje

  2. Farwaniya, Kuwait

    Nawaf Al-Mutairi

  3. Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA

    Tor Shwayder

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Alves, R., Grimalt, R. (2016). Androgenetic Alopecia in Adolescents. In: Oranje, A., Al-Mutairi, N., Shwayder, T. (eds) Practical Pediatric Dermatology. Springer, Cham. https://doi.org/10.1007/978-3-319-32159-2_19

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-32159-2_19

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-32157-8

  • Online ISBN: 978-3-319-32159-2

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation