An international multicenter, retrospective cohort study of 203 patients with pediatric androgenetic alopecia
Dr. Mohammed Abdul Samad
MBBS, MD Dermatology
Wisdom Skin and Eye Clinic
Androgenetic alopecia (AGA) is a form of nonscarring hair loss that is becoming more common in pediatric populations, though published data in this group are limited.
A group of researchers conducted a multicenter retrospective review. It examined pediatric patients under 18 years with AGA to assess their clinical presentation, comorbidities, and treatment recommendations, using cases with sufficient documentation for data extraction.
A total of 203 patients presenting with AGA at age <18 years 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%) of whom were female.
Most of the pediatric AGA patients had a history of the disease. Of the 145 patients with available anthropometric data, 24.1% had obesity (>95th percentile), and 24.8% were overweight (85th–95th percentile).
In female patients, the most common treatment prescribed at diagnosis was topical minoxidil (76.5%), followed by spironolactone (5.7%) and systemic minoxidil (2.9%). In males, 5-alpha reductase inhibitors (1.7%) were prescribed. Side effects were uncommon. Minoxidil displayed clinical benefit and was well-tolerated in this population.
AGA may present even in prepubertal patients, with obesity and family history identified as potential risk factors. Minoxidil appears effective and well-tolerated in this population. Prospective studies are needed to validate these findings and strengthen the evidence for treatment approaches.
Reference: Lee TS, O’Connor M, Castelo-Soccio L, et al. An international multicenter, retrospective cohort study of 203 patients with pediatric androgenetic alopecia. J Am Acad Dermatol. 2025;92(6):1269–1276.
