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Wilma Bergfeld Fabiane Mulinari – Brenner Department of Dermatology, The Cleveland Clinic Foundation Cleveland, Ohio – USA
Study Information and Conclusions:
Androgenetic alopecia (AGA) is an autosomal dominant condition with variable penetrance that affects about 50% of men and women. Androgenetic Alopecia is androgen mediated with puberty onset (early teens or twenties) in both sexes and frequently being fully expressed by the forties. Early identification of this condition leads to better treatment results.
A review of patients under 18 years old with clinical diagnosis of Androgenetic Alopecia was performed. These patients were seen from 1997 to 2000 on the Department of Dermatology – The Cleveland Clinic Foundation. Clinical presentation, family history of Androgenetic Alopecia, laboratory tests and scalp biopsies were reviewed. Twenty-one patients (4 female and 17 male) were in the young cohort. Age range was 13-17 years (mean 15.4 years). Frontal, vertex or both areas were affected. Family history of Androgenetic Alopecia was present in 18 patients.
Androgen excess signs such as acne (7 patients), hirsutism (4 patients) and seborrheic dermatitis (7 patients) were also associated with alopecia. Hormone levels suggested androgen excess only in 6 patients (2 female and 4 male) of 16 tested. Scalp biopsies were performed in 3 patients and confirmed the presence of hair follicle miniaturization. Androgenetic Alopecia may start early in the adolescence, especially when the patient has family history of Androgenetic Alopecia. It can be associated with other signs of androgen excess, however laboratory tests are not always helpful.
Androgenetic Alopecia should be remembered as a cause of hair loss in adolescence.
This study concluded that hair loss related to hormonal changes does occur in adolescents as early as 13 years of age.