Hair loss, or alopecia, is a common concern that affects people of all ages. While often associated with aging, hair loss can also occur in young adults and teenagers, impacting their self-esteem and overall well-being. It can affect just your scalp or your entire body, and it can be temporary or permanent. Losing one’s hair can have a huge impact on self-esteem, especially at an age when many people start learning who they are. Understanding the potential causes, symptoms, and available treatments is crucial for addressing this issue effectively.
The majority of people will experience some degree of hair loss throughout their lives. Most begin noticing hair loss during adulthood, but less commonly, some start losing their hair as teenagers. Losing your hair at a young age can be very difficult. Your child may feel like they need to hide their hair loss and feel stressed and anxious about their hair loss progressing. If your child is experiencing hair loss, it’s important to remind them that losing their hair doesn’t change the person they are or mean anything is wrong with them. You can let them know that you’re ready to listen if they want to talk about it. An increasing number of millennials in the United States say they’re experiencing hair loss.
It’s normal for people to experience some hair loss in their 20s and 30s, but greater exposure to celebrities and the media create a greater desire for thicker, more attractive hair than earlier generations experienced.
Many factors can contribute to hair loss in young adults, ranging from genetic predispositions to lifestyle choices.
Thyroid Conditions: Thyroid conditions that lead to an underproduction or overproduction of thyroid hormones may cause hair loss or brittle hair. Hair loss caused by a thyroid condition usually appears as a uniform thinning across your scalp. Hair loss is most common in people with severe or prolonged thyroid disease. Lost hair often regrows with proper treatment.
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Polycystic Ovary Syndrome (PCOS): It is usual for women to produce hormones like testosterone. But when they produce too much, it can lead to symptoms like disrupted menstrual cycles, acne, and hair thinning. Treating the hormonal imbalances in your body may lead to hair regrowth.
Alopecia Areata: Alopecia areata is an autoimmune condition that causes hair to fall out in patches. Autoimmune conditions develop when your body mistakes healthy cells for foreign cells. In the case of alopecia areata, your immune system attacks your hair follicles. You may notice hair loss on your scalp, eyebrows, eyelashes, or body. Alopecia areata affects about 2% of the population at some point in their life. Most people develop it before the age of 30, and it can start as early as childhood. Alopecia areata is a patchy loss of hair that occurs suddenly but can become chronic. It is an autoimmune disease (the body’s immune system attacks the hair follicles). Like many autoimmune conditions, it is more common in people with Down syndrome. Studies evaluating frequency are limited, but figures vary from 1.3% to 21% in people with Down syndrome compared with 0.1% to 0.2% in people without Down syndrome. It can be treated with steroid injections or high potency topical steroids. However, research has shown limited benefit with these steroid treatments. Janus Kinase (JAK) inhibitors are oral immunotherapy medicines that reduce inflammation and are used to treat a variety of autoimmune conditions. They have been shown to increase regrowth by more than 75% (in people without Down syndrome).
Lupus: Lupus is an autoimmune condition caused by the immune system targeting tissues and organs. It can cause symptoms like joint pain, fatigue, a butterfly-shaped rash, and hair loss. People with lupus may notice a gradual thinning. Hair loss may or may not grow back.
Ringworm of the Scalp: Ringworm is a fungal infection that can cause patches of itchy and scaly skin on your scalp. In some cases, ringworm can cause inflammation that leads to scarring and hair loss. Tinea capitis is a fungal infection of the scalp. A patch or patches of hair loss may be found. People with Down syndrome are more susceptible to infections. A fungal culture (from a scraping of the skin) is recommended to definitively diagnose the infection. Treatment consists of an oral anti-fungal medication.
Medications and Supplements: A number of medications and medical treatments can lead to hair loss. Some examples include: acne medications, antibiotics, anticlotting drugs, anticonvulsants, antidepressants and mood stabilizers, antifungal treatments, blood pressure medication, chemotherapy, cholesterol-lowering drugs, gout medication, immunosuppressants. Some medications that can cause hair loss include lithium, valproate, fluoxetine, warfarin, metoprolol, propranolol, retinoids, and isoniazid. Hair will usually grow back with stopping or reducing the medication.
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Radiation Therapy: Radiation therapy to the head can also result in hair loss. Anagen effluvium is hair loss related to exposure to chemotherapy. It is usually limited to the time when someone is undergoing chemotherapy. Hair regrowth typically occurs after stopping the chemotherapy agent (medication). This would most commonly be found in people with Down syndrome who develop leukemia. Leukemia is more common in children with Down syndrome than adults with Down syndrome. Leukemia is also more common in children with Down syndrome than in children without Down syndrome. The hair growth medication minoxidil may help during the regrowth phase. If you're being treated with chemotherapy, ask your doctor about a cooling cap.
It’s possible for teenagers to experience patchy hair loss, thinning hair, or pattern hair loss, depending on the underlying cause. If hair loss is caused by an underlying medical condition, you may experience a number of other symptoms along with hair loss.
Hair loss can appear in many different ways, depending on what's causing it:
If your child is experiencing hair loss, it’s a good idea to speak with a doctor. They can help you determine if there’s a medical cause leading to hair loss or if it’s caused by genetic factors. In some cases, an early diagnosis can increase the chance of regrowing hair. A doctor may be able to diagnose the cause of your hair loss with a physical examination and by examining your medical history. They may do a pull test to see how many hairs come out and examine your scalp with a microscope. A doctor may order a blood test if they suspect a hormonal imbalance or nutrient deficiency. They may also take a small biopsy of your scalp. There are specific findings of the scalp and hair associated with the different causes of hair loss. The history should include a review of the medications a person is taking.
The best treatment option for your type of hair loss depends on the cause. In some cases, hair loss may be reversible with proper treatment. Some causes of hair loss in teenagers can be stopped and potentially reversed. For example, if you’re experiencing hair loss caused by an imbalance of thyroid hormones, treating the hormonal imbalance may improve hair growth. Other causes, like genetic hair loss, have no known cure and will likely progress with time, but treatment can slow it down. The best way to know if you can stop hair loss is to get a proper diagnosis from a doctor.
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Here are some treatment options that may be suggested for various conditions:
Topical Minoxidil (Rogaine): Topical minoxidil (Rogaine) is not FDA-approved for people under the age of 18 due to a lack of research. However, it’s been used successfully in some studies for treating pattern hair loss. You should only use minoxidil if a doctor tells you it’s okay.
Finasteride: One clinically proven hair loss treatment commonly used to reduce and reverse male pattern baldness is finasteride. In a trial of 1553 men with male pattern hair loss, treatment with finasteride 1mg resulted in improved scalp coverage in around two-thirds of men and slowed the progression of hair loss in the other one-third.
Hair Kit: For the best chances of hair regrowth success, a Hair Kit is recommended. They can contain both finasteride and minoxidil to help reduce hair loss and stimulate hair regrowth from all angles. As previously mentioned, finasteride helps to block the production of DHT (which shrinks follicles), and minoxidil works by encouraging the supply of nutrient-rich blood to the follicles. Together, they promote the regrowth of thicker, fuller, and healthier-looking hair.
Reducing Stress: Reducing your stress, like talking with a mental health professional, can help with hair loss.
Avoiding Damaging Hair Products: Not using hair products (like chemical treatments) that damage your hair can also help.
Vitamins or Supplements: Taking vitamins or supplements for a vitamin deficiency may be recommended.
Changing Hairstyling Routine: Changing your hairstyling routine to avoid damaging your hair follicles can also be beneficial.
Medications: A healthcare provider might recommend using minoxidil (Rogaine®). This is approved for treating FPHL. You can purchase the 2% or 5% solution over the counter (OTC). However, you have to follow directions exactly and use the product indefinitely. Don’t use this product if you’re pregnant, if you plan to get pregnant or if you’re breastfeeding. Other medications that treat hair loss in women may include: Spironolactone and other anti-androgens, Finasteride and other alpha-reductase enzyme inhibitors, Estrogens, Prostaglandin analogs, and Steroids.
Light Therapy: In addition, a healthcare provider might recommend forms of light therapy like using the HairMax Lasercomb®. FDA to treat FPHL. Another FDA-approved laser product is the Theradome LH80 PRO® helmet and low-light laser helmets and caps.
Microneedling: Microneedling of the scalp with and without the application of minoxidil may be considered.
PRP Injections: Injections of protein-rich plasma (PRP) to encourage hair growth can be explored.
Hair Transplant Surgery: Hair transplant surgery is another option.
Hair will usually grow back with stopping or reducing the medication.
Losing your hair at a young age can be very difficult. Your child may feel like they need to hide their hair loss and feel stressed and anxious about their hair loss progressing. Coping with hair loss can be difficult. It may cause poor self-esteem and have a big effect on confidence - especially at an age when many people start learning who they are. If your child is experiencing hair loss, it’s important to remind them that losing their hair doesn’t change the person they are or mean anything is wrong with them. You can let them know that you’re ready to listen if they want to talk about it. If your child is stressed or depressed, a doctor can recommend an experienced counselor.
Most baldness is caused by genetics (male-pattern baldness and female-pattern baldness). Be gentle with your hair. Use a detangler and avoid tugging when brushing and combing, especially when your hair is wet. A wide-toothed comb might help prevent pulling out hair. Avoid harsh treatments such as hot rollers, curling irons, hot-oil treatments and permanents. Stop smoking. If you're being treated with chemotherapy, ask your doctor about a cooling cap.
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