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Multicenter Study
. 2025 Jun;92(6):1269-1276.
doi: 10.1016/j.jaad.2025.02.002. Epub 2025 Feb 6.

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

Tyan Shin Lee  1 , Mara O'Connor  2 , Leslie Castelo-Soccio  3 , Dawn Eichenfield  4 , Danny Lee  4 , Amy S Paller  2 , Manuel Valdebran  5 , Jenna Vroman  5 , Angela Yang  2 , Grace L Lee  6 , Megan Craddock  7 , Cathryn Sibbald  8
Affiliations
Multicenter Study

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

Tyan Shin Lee et al. J Am Acad Dermatol. 2025 Jun.

Abstract

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.

Keywords: androgenetic alopecia; pediatrics.

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Conflict of interest statement

Conflicts of interest Dr Sibbald has received honoraria from Abbvie, Leo, Pfizer, Miravo, Novartis, UCB, Sanofi/Regeneron unrelated to this work. Dr Paller has been been an investigator for AbbVie, Applied Pharma Research, Biomendics, Dermavant, Eli Lilly, Incyte, Janssen, Krystal, Regeneron, Timber, and UCB; a consultant for AbbVie, Abeona, Apogee, Arcutis, Aslan, BioCryst, Boehringer-Ingelheim, Bristol-Myers-Squibb, Dermavant, Incyte, Johnson and Johnson, Krystal Biotech, LEO, Mitsubishi Tanabe, Nektar, Primus, Procter and Gamble, Regeneron, Sanofi, Seanergy, TWI Biotech, and UCB; and on the data safety monitoring boards for AbbVie, Abeona, and Galderma, all unrelated to this work. Dr Eichenfield is funded by a Dermatology Foundation Pediatric Dermatology Career Development Award. She has been an investigator for Eli Lilly, Janssen, and Johnson and Johnson; a consultant for Amryt Pharma/Chiesi Farmaceutici, Apogee, Beiersdorf, Incyte, Nobelpharma, Ortho Dermatologics, Pelthos, Sanofi, and Sun Pharmaceutical Industries; a speaker for Beiersdorf, Galderma, Regeneron, Sanofi, and Verrica. All are unrelated to this work. Dr Castelo-Soccio is on the board of the American Hair Research Society and NAAF. Neither are relevant for this paper. Drs Lee, Eichenfield, Valdebran, L. Lee, Craddock, and Authors O’Connor, Vroman, and Yang have no conflicts of interest to declare.

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