Between 15.5% and 38.5% of adolescents worldwide experience teenage hair loss [1]. Hair loss in teenagers can have significant detrimental effects on the individual’s self-image and psychological well-being, as well as their ability to form positive relationships with their peers [2][3]. However, the good news is that in many cases, the conditions which cause this hair shedding in adolescence are treatable.
The most common type of alopecia which causes teenage hair loss is early-onset androgenetic alopecia, followed by alopecia areata and telogen effluvium [4]. However, a variety of other factors, ranging from common scalp problems to systemic illness or lifestyle choices can also make your hair fall out during your teenage years.
There are many treatments available for teenage hair loss, depending on its root cause. While certain medications that are very effective in adults are not recommended for adolescents (e.g. Finasteride), others, such as steroid creams, can be safely used to curb hair thinning and stimulate your follicles for hair growth.
Hair shedding can be a normal part of your hair growth cycle. Everyone loses between 50 and 100 hairs each day. Certain activities can make this more obvious, for example, more hair loss is normal in the shower, when removing your scrunchie or when brushing your strands vigorously.
However, if you are routinely shedding considerable amounts, and your hair is so thin that you can see your scalp or if you start to see temple hair loss, bald spots, rashes or sores on your scalp, it is time to see a trichologist. This hair specialist will help you get to the root of what is making your hair fall out.
Teenage hair loss is more common than generally believed – it affects between 15.5% and 38.5% of all adolescents. The variation depends on different factors, such as the genes, hormones, lifestyle and environment of teenagers who live in different geographical locations [1].
Most of the conditions which can cause alopecia in adults can also affect adolescents. Here are some of the most frequently encountered potential causes of hair loss in teenagers:
Commonly known as male pattern baldness or female pattern baldness, androgenetic alopecia affects 85% of men and 50% of women [5][6]. However, not many people know that the early-onset form of this type of genetic hair loss also affects approximately 15% of the world’s teenagers [7].
Just like this type of hair loss is more common in men than in women, androgenetic alopecia is more common in boys than in girls. The average age when teenagers start to see the first signs of hair thinning and balding is around 14-15 and most of them have a family history of patterned hair loss [8][7].
The mechanism of androgenetic alopecia is the same in adolescents as it is in adults: your body converts excessive amounts of the male hormone testosterone into a different male hormone known as dihydrotestosterone (DHT). DHT binds to receptors in your hair follicles and makes them shrink, producing smaller and finer hair, until they stop altogether.
In boys [7][9]:
In girls[7]:
Low-level light therapy (LLLT) for hair growth has also proven itself helpful in achieving hair regrowth and it is completely safe for teenagers.
While Finasteride is very efficient in treating this condition in adults, it has not been approved for use in minors (and it would not be recommended for girls anyway). However, you can try a natural DHT blocker, such as rosemary oil for hair growth or pumpkin seed oil for hair.
This condition is temporary and it usually begins showing symptoms 2-3 months after a very stressful period or a traumatic physical or psychological event. Once the stressor has ended, telogen effluvium should resolve itself in under 6 months [10].
The proportion of teenagers who experience telogen effluvium is mostly unknown, as it is a temporary condition which often goes unreported. Still, it is estimated to make up around 2-17% of hair loss cases in adolescents [11].
Alopecia areata is estimated to affect 1.83% of teenagers worldwide and it has been shown that around 40% of the people diagnosed with this condition worldwide see its first symptoms before the age of 20 [12].
Typical presentation of alopecia areata:
Should the alopecia areata persist, corticosteroid treatment is frequently used to stop the hair loss and stimulate hair regrowth. Steroid creams can be effective for milder forms, while oral or injectable steroids may be effective for more extensive alopecia. Minoxidil may also present some benefits in achieving hair regrowth [13].
Immunotherapy may be needed for rare and severe forms of alopecia areata, such as ophiasis alopecia, alopecia totalis or alopecia universalis. Even so, they may not always respond to treatment [14].
Several common scalp problems can induce diffuse or localized hair loss in adolescents. The most frequently encountered are a fungal infection known as roundworm (tinea capitis) and or (which thrive on the excessive sebum production that usually occurs during puberty). However, other conditions, such as scalp psoriasis, eczema or scalp folliculitis can also affect teenagers.
While some of these conditions make your hair fall out due to inflammation (e.g. ringworm of the scalp, scalp psoriasis), others make your scalp so itchy that you can cause hair breakage simply by scratching vigorously (e.g. dandruff).
While symptoms differ for each of these conditions, you can suspect a scalp problem if you are experiencing one or more of the following:
Some of these conditions respond to antifungal treatments, such as ketoconazole (e.g. dandruff, seborrheic dermatitis, ringworm), others may require antibacterial creams (e.g. scalp folliculitis) or steroid creams (e.g. psoriasis, eczema).
However, if you suspect you may have a scalp problem, but you’re not sure which one it may be, using zinc pyrithione is most likely to be effective against most of these conditions, until you have a chance to get them checked out by a dermatologist. That is because it has complex antimicrobial and anti-inflammatory qualities [15].
This type of body-focused repetitive behaviour disorder is a form of obsessive-compulsive behaviour [16] which involves the urge to pull hairs out of your scalp. It often debuts during puberty and while there is no data regarding how many adolescents are affected by this condition, its prevalence in adults is 1-2% of the world’s population.
While in adults, women are 4 times more likely than men to develop this condition, the gender rates are equal in children and adolescents [16].
Trichotillomania ranges from mild to severe. This condition tends to be accompanied by other mental health issues, such as anxiety, mood disorders or ADHD [16].
Traction alopecia is common among teenagers who often wear tight hairstyles. Hairdos such as cornrows, braids or ponytails can cause hair loss. Moreover, wearing heavy extensions can cause hair loss as well.
This condition is more common among adolescents with afro hair. However, research indicates that it is likely due to wearing tight hairdos associated with this hair type, such as braids, dreadlocks or cornrows.
During puberty, hormonal activity is intense and often erratic and it can interfere with teenagers’ hair growth cycle. As the levels of male and female hormones start to increase, to produce the many significant changes that take place in the body during this time, they can get imbalanced and push your hair into the shedding phase faster than normal. Moreover, during adolescence, girls can start experiencing polycystic ovary syndrome, which can cause hair loss.
Thyroid disorders, such as hypothyroidism or hyperthyroidism can affect adolescents as well as adults, and hair loss can be one of the consequences. Learn more about the ways thyroid disorders can cause hair loss and how to treat it.
Rarely, teenage hair loss can be caused by an illness which affects your entire body, and which can also have consequences on your hair. Some of these illnesses can be autoimmune (e.g. discoid lupus), while others can lead to insufficient nutrients to your hair follicles due to poor nutrient absorption.
There are several types of medication that can cause hair loss. While chemotherapy-induced hair loss is the best-known, many other medications can cause hair loss. They include certain antidepressants, birth control pills, some heart medication, some antibiotics (though antibiotic-related hair loss is very rare), or anabolic steroids (the kind of steroids that are used to achieve muscle growth).
So be sure to check the list of potential unwanted side effects of any prescription medication you may be taking to see if hair loss is listed.
In the case of chemotherapy, total alopecia can occur.
In the case of other medication, you can expect telogen effluvium symptoms:
While lifestyle factors will rarely lead to alopecia on their own, certain habits can damage your hair strands, cause hair breakage and trigger or exacerbate conditions that cause hair loss which may require treatment to manage.
Whether your hair will grow back after falling out in adolescence depends on the condition which caused it to fall out in the first place.
If your hair loss was due to telogen effluvium, traction alopecia, medication or lifestyle choices, there is a good chance that once you remove the factor which led to your hair shedding, you will soon start to see regrowth. Similarly, getting a systemic illness under control or regulating your hormones can lead to hair regrowth, provided these were the reasons for your hair thinning.
If you are experiencing alopecia areata, your hair is likely to grow back within a year, but you might continue to have relapses throughout your life [21].
However, if your hair loss is caused by androgenetic alopecia, ageing is likely to make your condition worse, unless you keep it under control with hair growth treatment.
Research performed on the psychological impact of hair loss on adolescents has revealed concerning results. Studies show that teenagers who experience alopecia have a significantly greater chance of developing at least one psychiatric disorder than their peers with healthy hair [3].
The most common of these are major depression, OCD and anxiety disorders [22][3]. They are also likely to experience increased incidences of low self-esteem [23], embarrassment and self-consciousness [12].
The main factors which increased the chances of a negative psychological impact in teenagers with hair loss were:
There are several things that teenagers can do to help them cope with their hair loss [24][25]:
If notice hair loss and are worried you may be experiencing teenage hair loss, book a consultation with a trichologist and set your mind at ease. They will examine you thoroughly and run all the necessary tests to provide you with an accurate diagnosis. Once you have got to the root of your hair problems, they will recommend the best, personalised treatment.
Hair growth medications and therapies for restoring lost hair are the most common and effective course of action when treating teenage hair loss. However, if your early-onset androgenetic alopecia persists into adulthood, there is no need to worry, as you may be a good candidate for a hair transplant.
Hair restoration surgery is not offered to minors, as their hormonal activity is still erratic and their hairline has not yet matured. Getting a hair transplant too early can lead to more hair loss around the transplant area over time, making a second procedure necessary. However, if non-surgical options will no longer suffice, you can always get a hair transplant when you’re 25.
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