An international multicenter, retrospective cohort study of 203 patients with pediatric androgenetic alopecia.

BACKGROUND: Androgenetic alopecia (AGA) is a nonscarring alopecia with increasing prevalence in pediatric populations. Published data in pediatrics are limited. OBJECTIVE: To perform a multicenter review of pediatric patients with AGA to study clinical presentation, comorbidities, and treatment recommendations. METHODS: A retrospective review of patients presenting with AGA at age <18 years with adequate documentation for data extraction. RESULTS: In total, 203 patients were included. The mean age of AGA onset was 12.9 ± 2.7 years, and at diagnosis was 14.5 ± 2.1 years. Prepubertal onset occurred in 17 patients, 70.6% female. The majority had a family history of AGA. Of 145 patients with anthropometric data, 24.1% were obese (>95th percentile) and 24.8% overweight (85-95th percentile). Treatments at diagnosis included topical minoxidil in 76.5% and systemic minoxidil in 2.9%, spironolactone in 5.7% of females, and 5-alpha reductase inhibitors in 1.7% of males. Side effects were rare. LIMITATIONS: Data were limited to recorded information. CONCLUSION: AGA can occur in prepubertal patients. Potential risk factors for pediatric AGA include obesity and family history. Minoxidil has clinical benefit and is well tolerated in this population. Further prospective studies are recommended to confirm these findings and gather more evidence for treatments.