From the Guidelines
Alopecia in a 16-year-old male is most likely caused by androgenetic alopecia (male pattern baldness), which can begin during puberty due to genetic predisposition and hormonal changes, particularly dihydrotestosterone (DHT) sensitivity. This condition, also known as male pattern hair loss (MPHL), affects the temples, vertex, and mid-frontal scalp in a highly reproducible pattern 1. Other potential causes of alopecia in a 16-year-old male include:
- Alopecia areata, an autoimmune condition that presents as patchy hair loss and results from the immune system attacking hair follicles
- Telogen effluvium, a stress-induced hair loss that may occur following significant physical or emotional stress, illness, or nutritional deficiencies
- Fungal infections like tinea capitis
- Certain medications
- Trichotillomania (hair-pulling disorder)
- Underlying medical conditions such as thyroid disorders
The management of alopecia areata, a potential cause of alopecia in a 16-year-old male, should prioritize the psychological effects of the disease, as it can have a significant impact on general health and lead to higher levels of anxiety and a greater risk of depression 1. A dermatologist should evaluate the condition to determine the exact cause through physical examination, medical history review, and possibly blood tests or scalp biopsy before initiating appropriate treatment. Treatment depends on the specific cause and may include topical minoxidil, anti-inflammatory medications for autoimmune causes, or addressing underlying nutritional deficiencies. It is essential to consider both the positive and negative aspects of active treatment in this chronic condition, as some patients may experience spontaneous regrowth of hair, while others may require ongoing support and treatment 1.
From the Research
Causes of Alopecia in a 16-Year-Old Male
- Androgenetic alopecia (AGA) is the most common cause of hair loss in men, and it is mediated by genetic predisposition and excessive follicular sensitivity to androgens 2.
- AGA is characterized by distinct gradual patterned hair loss, and it is not fatal but may have a severe psychosocial impact, especially on younger males 2.
- The condition is primarily mediated by 5-alpha-reductase and dihydrotestosterone (DHT) which causes hair follicles to undergo miniaturization and shortening of successive anagen cycles 3.
Pathophysiology of Androgenetic Alopecia
- AGA is caused by the progressive conversion of scalp terminal hair into vellus hair, leading to gradual patterned hair loss 2.
- The recently characterized structure of type 2,5-alpha reductase holds significance in comprehending present and prospective treatments of AGA 2.
- DHT plays a key role in the pathogenesis of AGA, and treatments that inhibit 5-alpha-reductase, such as finasteride and dutasteride, can help to slow or reverse the progression of AGA 4, 3.
Treatment Options for Androgenetic Alopecia
- Topical minoxidil and oral finasteride are the only FDA-approved therapies for treating AGA, but other treatments such as low-level laser therapy, microneedling, and platelet-rich plasma (PRP) have shown promising results 5, 6.
- Novel therapies such as oral minoxidil, topical finasteride, and topical spironolactone offer interesting alternatives to standard of care therapies for patients with AGA 5.
- Combination therapies may be more effective than monotherapies, but standardized treatment protocols are needed to adequately inform clinicians on how to use such therapies 5, 6.