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In <jats:styled-content style=\"fixed-case\">AGA<\/jats:styled-content>, patients generally start noticing hair thinning after the onset of puberty due to progressive miniaturisation of the hair follicle which leads to vellus transformation of terminal hair. However, the occurrence of prepubertal <jats:styled-content style=\"fixed-case\">AGA<\/jats:styled-content> has rarely been reported in the literature. The pathophysiology of <jats:styled-content style=\"fixed-case\">AGA<\/jats:styled-content> is tightly linked to androgen hormones; prepubertal children do not usually produce significant amounts of adrenal or gonadal androgens. When it does occur, an underlying abnormality should be suspected. Secondary causes of <jats:styled-content style=\"fixed-case\">AGA<\/jats:styled-content> must be excluded when evaluating a patient before the appearance of puberty. Premature puberty, polycystic ovarian syndrome and other causes of hyperandrogenism can present with hair loss in an androgenetic pattern. This article reviews the normal physiology of androgen hormones and their role in the pathophysiology of childhood <jats:styled-content style=\"fixed-case\">AGA<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/ajd.13079","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T07:53:39Z","timestamp":1559807619000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["The diagnosis of androgenetic alopecia in children: Considerations of pathophysiological plausibility"],"prefix":"10.1111","volume":"60","author":[{"given":"Alfredo","family":"Rossi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties UOC Dermatology University of Rome \u201cSapienza\u201d Rome 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