Assessment and treatment of adolescent hair loss

Purpose of review Hair loss in adolescents carries significant psychosocial impact, and it is often underrecognized and managed without adolescent-specific approaches. This review describes recent advances in diagnostics, pathophysiology, and therapies to improve diagnosis and management of adolescent alopecia. Recent findings Trichoscopy and ultraviolet-enhanced follicular dermoscopy improve diagnostic accuracy and reduce invasive testing. Androgenetic alopecia is linked to obesity and genetic predisposition; topical minoxidil remains first-line with low-dose oral minoxidil use supported in some cases. Alopecia areata severity frameworks now include chronicity, relapse, nonscalp involvement, refractoriness, and psychosocial burden. Systemic JAK inhibitors have emerged as treatment options for adolescents with sustained regrowth and patient-reported improvements. Psychogenic hair loss is often comorbid with anxiety, obsessive-compulsive disorder, or attention-deficit/hyperactivity disorder. Summary Early, etiology-driven assessment and multidisciplinary care are critical for adolescent hair loss. Adolescent-specific data support more individualized systemic treatments for some types of hair loss, while gaps remain in preventive strategies and long-term outcomes, highlighting priorities for future research.