Progressive Hair Loss in Adolescent Male with Family History and Academic Stress

Case at a Glance

A 16-year-old male presenting with a 6-month history of progressive hair loss and receding hairline, accompanied by significant weight loss and academic stress. Family history notable for paternal baldness.

Patient's Story

The patient reports experiencing noticeable hair loss for approximately 6 months, with development of a receding hairline pattern. He describes his hair as naturally wavy and of medium length, which he recently cut short, though hair loss persists. The patient has experienced significant academic stress due to examination pressure and reports ongoing mental health concerns. He mentions a family history of male pattern baldness on his father's side, though his paternal grandfather retained more hair. The patient expresses concern about early detection and intervention but has been unable to access dermatological care due to family financial constraints and parental skepticism about medical treatment.

Initial Assessment

Upon presentation, the patient appeared anxious about his hair loss. He reported concurrent weight loss of 10 kg over the same 6-month period (from 70 kg to 60 kg). Physical examination details were limited due to lack of specialist consultation. The patient denied taking any medications. Initial assessment suggested possible androgenetic alopecia given family history and pattern of hair loss, though other causes including stress-related hair loss required consideration given the concurrent stressors and weight loss.

The Diagnostic Journey

Diagnostic evaluation was limited by lack of access to dermatological consultation. The patient's presentation suggested several differential diagnoses including androgenetic alopecia (male pattern baldness), telogen effluvium secondary to stress and weight loss, or a combination of both conditions. The timing of onset during a period of high academic stress and significant weight loss suggested a possible stress-related component. Family history of paternal baldness supported consideration of genetic predisposition to androgenetic alopecia.

Final Diagnosis

Probable early-onset androgenetic alopecia with possible concurrent telogen effluvium secondary to psychological stress and rapid weight loss. Definitive diagnosis pending dermatological evaluation and possible trichoscopy.

Treatment Plan

Given limited access to specialist care, initial recommendations focused on stress management, nutritional assessment, and gentle hair care practices. Counseling was suggested for academic stress and mental health concerns. Patient education provided regarding hair loss patterns and the importance of specialist evaluation when resources become available. Conservative management with gentle shampooing, avoidance of harsh styling, and stress reduction techniques recommended as initial approach.

Outcome and Follow-up

Patient counseled on the importance of dermatological evaluation for proper diagnosis and treatment planning. Follow-up arranged for monitoring of hair loss progression and weight status. Referral to mental health services recommended for stress management and academic pressure. Long-term prognosis dependent on underlying etiology and access to appropriate treatment interventions.