When Pattern Hair Loss Presents in Children and Teenagers

Androgenetic Alopecia, the common genetic condition more widely known as Male Pattern Baldness and Female Pattern Hair Loss, is often associated with old age. This is, however, something of a myth.

Whilst the older you are, the more likely it is that you will experience hair loss, these hereditary conditions can actually start to arise any time following puberty, with initial signs, such as a drop in hair density and volume, generally becoming noticeable long before the gradual thinning.

This generally presents in adults, with approximately 20-25 per cent of men being affected by the age of 21, and women traditionally being in their 30s or 40s before being affected - although a number of anecdotal reports suggest women are now seeing shedding start in their 20s. This is widely considered to be the result of premature hair loss being triggered by issues such as stress.

What it is less well known about Male and Female Pattern Hair Loss is that it may also affect people in their teenage years and, though rare, sometimes even younger.

Research into pattern hair loss in teens

In 2010, researchers from the Ronald O. Perelman Department of Dermatology at New York University's School of Medicine in America investigated the phenomenon of younger adolescents developing genetic hair loss.

The small-scale review, published in the British Journal of Dermatology, involved a retrospective review of all adolescent patients with hair loss presenting at a New York dermatology clinic over a 12 year period.

Researchers identified 57 paediatric patients as having genetic hair loss, with males being twice as likely to be diagnosed with the condition than females. The average age at which these children started to develop signs of androgenetic alopecia was 14.8 years.

The American report states that 83 per cent of those diagnosed had a family history of genetic hairloss and three of the girls also had polycystic ovary syndrome (PCOS) which is androgen-related and has been linked to pattern hair loss in women. Premature Male Pattern Baldness has also been likened to 'PCOS in men'.

Hair loss before or after puberty

One important factor which is not made clear in the report is whether the children who developed male or female hair loss were pre- or post-pubescent at the time it started. Given genetic hair thinning is known to present after puberty, the age of their hair loss' onset may vary in line with this so this information would be extremely useful.

According to NHS data, the average starting age for puberty is 11 years old for girls and 12 years old for boys, though it can occur any time between the ages of 8 and 14 years. Puberty generally takes around four years to complete, therefore, technically - though certainly rare - it is possible that an 8 year old could complete puberty by age 12 and start to notice signs of hair loss after this.

A 2017 Portuguese case study of a 15 year old girl who presented with significantly thinning hair that had started at age 11, suggested pre-pubescent genetic hair loss may also be possible but that it may not be androgen-dependent.

These permanent hair loss conditions involve many genes, which can be inherited from either or both parents, but the key involvement comes from an androgen hormone called diydrotestosterone, also known as DHT.

Androgenetic alopecia is essentially the effects of having a predisposed sensitivity to DHT which affects follicles located along the top of the scalp, from hairline and temples to crown, only.

DHT is used during puberty to develop sexual characteristics in both males and females - even though it is related to the male sex hormone, testosterone. After this time it can latch on to the affected hair follicles, weakening them so they produce increasingly finer, thinning hairs. This process is called follicular miniaturisation.

Over time, this can lead to eventual baldness in these areas for males, whereas in females it may simply lead to increased shedding with diffuse thinning across the top of the scalp which can become clearly visible in advanced cases. This is because the effects of androgens are thought to be stronger in men, than in women.

Treating hair loss in teenagers

Given girls and boys are now known to develop hair loss that is considered by professionals to be androgenetic, even if it is a small number, further investigation into what - besides a family history - is causing this is necessary. Until then, any children worried they are losing their hair are best advised to visit their GP for further advice.

Although there are clinically-proven pattern hair loss treatments available for both men and women, these tend to have minimum age requirements of 18 years old.

Before then, non-pharmaceutical options may be considered under strict professional supervision, including home-use follicle-stimulating low level laser therapy (LLLT) devices, such as the FDA-cleared LaserBand.

Belgravia offers consultations to people from age 16 years, both online and in-person at our London hair loss clinics.