Androgenetic alopecia is form of hair loss that affects both men and women. It is characterised by thinning of the hair, which can begin at any age, most commonly after puberty. In men, it typically starts with a receding hairline and thinning at the crown, whereas in women, it generally manifests as thinning over the top of the scalp.
This condition is primarily influenced by genetic factors and the presence of androgens (science speak for hormones), specifically dihydrotestosterone (DHT)[1]. While it is more common in older adults, it can also affect younger individuals including adolescents[2].
We have seen an increase in social workers referencing receding hairlines in their age assessments. In our view, this is problematic and should be used with caution for the reasons we set out below.
The onset of a receding hairline varies widely among individuals. As highlighted earlier, some may begin to experience hair thinning in their late teens, while others might not see significant hair loss until their 40s or 50s. This variability makes it an unreliable marker for age estimation.
Given that androgenetic alopecia is largely genetically determined, two individuals of the same age may exhibit vastly different patterns of hair loss. Therefore, using this as evidence in age assessment can lead to significant errors and misjudgements, even when considering cultural norms.
Relying on a receding hairline as an age indicator can inadvertently lead to discriminatory practices.
We have noticed that assessments of receding hairlines is more common in age assessments of African males (predominantly Eritrean, Sudanese and South Sudanese nationals) who often have high hairlines which are misunderstood to be receding.
Given that there is the opportunity to mistake a high hairline with a receding hairline, we need to consider whether we are able to diagnose a receding hairline accurately. If we feel confident in our expertise to do this, how are we measuring this consistently in our practice?
If you decide to assess hairlines as a method of age estimation, then to enable fair practice, you should also consider the alternative: that a lack of receding hairline equates to adolescence. If this alternative perspective is not considered, the approach, in our view, becomes biased as it prioritises adverse evidence rather than supportive evidence (something we highlighted in our research).
We deliberately used the term androgenetic alopecia in this blog post as a reflection exercise for the reader.
If you’ve got this far, we’d like you to think about the thoughts and feelings you had when you started reading this blog post.
Did you think that using this term added gravitas or scientific validity to assessing a receding hairline?
If we had used the term “receding hairline” in the title rather than “androgenetic alopecia” would you have felt the same way approaching this blog post?
As highlighted in our research, using scientific terminology gives a veneer of weight and gravitas to evidence where there is none. In addition to this it also suggests to the reader that the author has a significant level of knowledge and expertise on the subject. Just to clarify, we don’t have that level of expertise!
To author this blog post I went down a google rabbit hole and read all I could about receding hairlines and its reliability in assessing age. A quick google told me the scientific term for this, however it does not make me any more qualified to provide an opinion on this subject.
In recent years we have seen an increase in social workers including the use of inappropriate medical terms in which most of us are not qualified to discuss (naso-labial lines anyone?!) and, in our view, discredits the expertise of social workers in an age assessment. Our role is not to focus on gathering adverse pseudo-scientific evidence, we are there to facilitate a holistic, multi-agency assessment of a client that looks for evidence of age, not adulthood.
If you found this blog post interesting please let us know, we’d love to hear from you. If you’d like to know more about age assessments, please do look at our training brochure which can be found here.
[1] Androgenetic Alopecia – StatPearls – NCBI Bookshelf
[2] Androgenetic Alopecia in Children and Adolescents: From Trichoscopy to Therapy | Skin Appendage Disorders | Karger Publishers
