Androgenetic alopecia may develop in prepubertal patients

Prepubertal children can develop androgenetic alopecia (AGA), suggests a study. Obesity and family history are associated with an increased risk for paediatric AGA.

A team of investigators performed a multicentre review of paediatric patients with AGA to examine the clinical presentation, comorbidities, and treatment recommendations. A total of 203 patients presenting with AGA at age <18 years, with adequate documentation for data extraction, were included.

AGA onset occurred at a mean age of 12.9 years, while diagnosis was at a mean of 14.5 years. Seventeen patients had prepubertal AGA onset, the majority (70.6 percent) of whom were female.

Most of the paediatric AGA patients had a history of the disease. Of the 145 patients with available anthropometric data, 24.1 percent had obesity (>95th percentile), and 24.8 percent had overweight (85th–95th percentile).

In female patients, the most common treatment prescribed at diagnosis was topical minoxidil (76.5 percent), followed by spironolactone (5.7 percent) and systemic minoxidil (2.9 percent). In males, 5-alpha reductase inhibitors (1.7 percent) were prescribed. Side effects were uncommon.

“Minoxidil has clinical benefit and is well tolerated in this population,” the investigators said. “Further prospective studies are recommended to confirm these findings and gather more evidence for treatments.”

Of note, the study was limited by data restricted to recorded information.

"AGA is a nonscarring alopecia with increasing prevalence in paediatric populations,” according to the investigators.