Hair loss in children is typically caused by one of five conditions:
Alopecia Areata, Tinea Capitis, Traction Alopecia, Trichotillomania, or
Telogen Effluvium.
Children's
Tinea Capitis
Tinea Capitis is a disease caused by fungal infection of the skin of the
scalp, eyebrows, and eyelashes, with a propensity for attacking hair shafts
and follicles. It is also called "ringworm of the scalp". The
condition is caused by a fungus that invades the hair shaft and causes
the hairs to break. The bare patch of hair loss is often round and the
scalp takes on a black-dotted stubble appearance from hair shafts broken
off at the surface. There may also be mild itching and scaling. The condition
is transmitted by contact from one infected child to another through the
sharing of combs, brushes, hats, barrettes, pillows and bath towels. Minor
bruising of the scalp occasionally provides an entry for the microscopic
fungus. Children three to ten years of age are more susceptible and boys
are more than girls. Ringworm of the scalp is not dangerous. Without treatment,
however, the hair loss can be considerable, and some children will develop
a boggy tender swelling of the scalp known as a kerion.
For a much more in-depth look at Tinea Capitis in a scientific light,
please see the Tinea Capitis page on eMedicine.com: eMedicine
- Tinea Capitis
For information on finding out if your child has Tinea Capitis, please
proceed to step 3. For information
on treatment of Tinea Capitis, please proceed to step
4.
Children's
Alopecia Areata
Alopecia areata is another common form of patchy hair loss in
children. The typical story is the sudden appearance of one or more
totally bald areas in the scalp. The child with this condition loses
hair in circular patches sometimes up to two inches in diameter. The
hair at the borders of these patches is loose, but the peach-colored
scalp looks and feels normal, without scaling or inflammation. There
may be just a few patches of hair loss or a total absence of body hair.
Alopecia areata is not life-threatening, and children who have it are
otherwise healthy. Why the hair falls out from the roots is still a
mystery. What is known is that the condition is not contagious, caused
by foods, or the result of nervousness, hyperactive disorders, or psychological
stress. In 20% of cases another family member has been affected. Some
patients with this condition will also develop a grid-like pitting of
the nails. Fortunately, over 80% children with Alopecia areata grow
new hair back within twelve months. Oddly, the new hair may temporarily
be white, but eventually the hair returns to its natural color. This
is a much higher resolution rate than is seen in adults with the same
condition, so the news is good.
For a much more in-depth look at Childrens Alopecia Areata in a scientific
light, please see the Alopecia Areata page on eMedicine.com: eMedicine
- Alopecia Areata.
For information on finding out if your child has Alopecia Areata, please
proceed to step 3. For information
on treatment of Alopecia Areata, please proceed to step
4.
Children's
Traction Alopecia
Traction Alopecia, or physical damage to the hair, is another common
cause of hair loss, particularly in girls. The human hair is quite fragile
and really does not respond well to the many physical and chemical assaults
it has to endure in the name of beauty. Constant teasing, fluffing, combing,
washing, curling, blow drying, hot combing, straightening and bleaching
can do a number on the fragile hairs, causing them to fall out, especially
those by the hair line and along the front and sides. In adults, this
typically is not as much of a problem, as the hair has grown in strength
and quality over several years, but it can pose a problem for our little
companions who typically have much thinner, more fair, less dense hair.
Styles that apply tension to the hair, such as tight ponytails, braiding,
barrettes, and permanent waving can also damage the hair.
One should not assume that hair loss in one's child is due to pony tails
that are too tight. If hair loss is being seen, it is imperative that
you have a physician evaluate the child and rule out other causes.
Treatment for children's traction Alopecia is to handle the hair gently,
as little as possible, and use natural hair styles. The hair will usually
return, but regrowth can be slow. Injured hair follicles do not heal quickly
and often take three or more months before they are back to their growing
phase.
Children's
Trichotillomania
Trichotillomania is the compulsion to pull out one's own hair.
It results in irregular patches of incomplete hair loss, mainly on the
scalp, but may involve the eyebrows and eyelashes as well. The habit of
pulling out one's hair is usually practiced in bed before falling asleep
or when the child is studying or watching television. Interestingly, parents
are usually not aware of the habit and frequently find it hard to believe
that their child would do such a thing. Affected areas of hair loss often
appear on the left side of right-handed children and on the right side
of left-handed youngsters. Most cases of Trichotillomania resolve spontaneously.
Diagnosis of this type of Alopecia can be done in the convenience of your
own home, by closely evaluating your child to see if they have this habit.
The cause of this type of condition many times is related to stress, long
term ongoing tension, or other possible psychological or emotional deficiencies
the child may be in need of at the time.
The best treatment is to ignore the hair pulling and concentrate on why
the child is anxious, nervous or frustrated.
Children's
Telogen Effluvium
Following a high fever, flu, or severe emotional stress, hairs that were
in their growth phase can sometimes be suddenly converted into their resting
phase. Two to four months later, when the child is otherwise fine and
the stress is forgotten, these hairs can begin to shed. The shedding,
which is actually a mass exodus of follicles from growth into dormancy,
can last for up to six weeks.
The hair loss is not total nor does it tend to show up in patches. It
typically just appears thin throughout the scalp. Unless the initial cause
is repeated, all the hairs normally return (Telogen effluvium explains
why many mothers lose so much hair weeks after childbirth). Most parents
who bring their child to the physician for this condition are worried
that the youngster has cancer or another bad disease.
Hair takes between 3 and 6 months to re-enter into growth phase, so the
restoration can be somewhat slow.
For a much more in-depth look at Childrens Telogen Effluvium in a scientific
light, please see the Telogen Effluvium page on eMedicine.com: eMedicine
- Telogen Effluvium.
For information on finding out if your child has Telogen Effluvium, please
proceed to step 3. For information
on treatment of Telogen Effluvium, please proceed to step
4.
