Hair Loss in Children

I just found an article on the subject of hair loss in children which may have interest to my readers. See yesterday’s question from the young girl with possible genetic hair loss. This article is a bit technical but it does address the problem.

Androgenetic Alopecia in Children: report of 20 cases by Tosti A, Iorizzo M, Piraccini BM.
Research performed at: Department of Dermatology, University of Bologna,
Via Massarenti 1, 40138 Bologna, Italy. tosti@med.unibo.it

SUMMARY: Androgenetic alopecia (AGA) is the most common type of hair loss in adults. Although there are differences in the age at onset, the disease starts after puberty when enough testosterone is available to be transformed into dihydrotestosterone. We report 20 prepubertal children with AGA, 12 girls and eight boys, age range 6-10 years, observed over the last 4 years. All had normal physical development. Clinical examination showed hair loss with thinning and widening of the central parting of the scalp, both in boys and girls. In eight cases frontal accentuation and breach of frontal hairline were also present. The clinical diagnosis was confirmed by pull test, trichogram and dermoscopy in all cases, and by scalp biopsy performed in six cases. There was a strong family history of AGA in all patients. The onset of AGA is not expected to be seen in prepubertal patients without abnormal androgen levels. A common feature observed in our series of children with AGA was a strong genetic predisposition to the disease. Although the pathogenesis remains speculative, endocrine evaluation and a strict follow-up are strongly recommended.