Two patients discontinued treatment because of a lack of efficacy and/or headache and nausea.
In the boys, 36 of the 38 were treated with minoxidil, and 18 of 23 with at least 6 months of follow-up were stabilized. Two patients never started treatment and two discontinued for lack of efficacy and acne.
Finasteride was used in nine boys, including seven who also received minoxidil. In six boys, with at least 6 months of follow-up, all had better hair density (including four on concomitant minoxidil). One experienced sexual dysfunction, which resolved spontaneously, Dr. Orlow said.
"I did not treat – and would not treat girls [with finasteride], nor did I find any case reports of finasteride use in girls," he said.
There are a few case reports, however, of spironolactone being used in girls with some success, he noted.
The findings of the chart review (Br. J. Dermatol. 2010;163:378-85) underscore the importance of understanding that alopecia is a common complaint in the pediatric population, that androgenetic alopecia is the most common form of hair loss in adolescents, and that androgenetic alopecia can be a presenting sign of an underlying endocrine disorder, Dr. Orlow said.
He reported having no relevant financial disclosures.