Hair loss in children

Most adults find hair loss to be inevitable at some stage in life; they don’t like it but it’s expected and commonplace.  With children the loss of hair is alarming because it is not expected, but a surprising number of young children do suffer hair loss for a variety of reasons.  Some pediatric clinics estimate that 3% of their patients have problems with hair loss.

The most common cause is a fungal infection called tinea capitis, sometimes known as ringworm.  Symptoms include loss of hair usually in round patches on the scalp; eyebrows and eyelashes are also often affected.  Diagnosis is fairly easy with a microscopic testing for fungus, and treatment involves antifungal medication and shampoo in an eight-week regimen.

A more serious cause is alopecia areata, which results in the sudden appearance of very smooth round or oval bald patches and sometimes ridging or pitting of the nails.  It is believed to be an autoimmune disease that attacks hair follicles.  Little is known about the cause, and though some treatments have shown promise in promoting hair growth, there is no guarantee that hair loss will not recur.

High fever, surgery and prolonged emotional stress are some of the accepted causes of telogen effluvium, in which the life cycle of the hair is interrupted and stalled in the dormant, or telogen, stage. Diagnosis in this case is usually based on the child’s recent history, and once the triggering event is over, hair usually returns to its normal growth cycle without treatment.

Trauma to the hair shaft is fairly common, resulting in most cases from the use of chemicals in perms, or tightly pulled ponytails and braids.  It can also be the result of a child’s compulsive hair pulling or twisting, marked by patches of broken hairs, not by complete hair loss.  In this case treatment consists of some type of behavioral or relaxation therapy, and normal hair growth resumes when the stress is relieved.