The majority of children suffering hair loss have the following conditions in common:.
The most common condition, Tinea Capitis (ringworm of the scalp), is caused by a superficial fungal infection of the scalp’s skin, as well as in the eyebrows and eyelashes, with an inclination for attacking hair follicles and shafts. This disease is a form of superficial mycosis or dermatophytosis. It is sometimes referred to as tinea tonsurans, and cases are increasing all over the world.
Kids with tinea capitis typically experience patchy hair loss with hairs that have been broken off just above the scalp’s surface. These patches are usually oval or round, but not always. Sometimes the hairs break at the surface, and look like black dots on the scalp. These are sometimes accompanied by gray flakes or scales.
A Wood’s lamp test can be performed to confirm the presence of a fungal scalp infection. This is performed in a dark room where ultraviolet light is shined on the affected area.
Tinea capitis is usually treated with antifungal tablets – such as griseofulvin – which are taken orally for eight weeks. Tinea capitis may also be treated with Nizoral shampoo, washing the scalp two to three times a week. Treatment failure is most common when medications are not taken every day for the full eight weeks. Since most children are not contagious when using the medication and shampoo, they are usually not required to leave school.
Alopecia Areata comes on quickly, sometimes over the span of three or four days or even overnight. You’ll notice round or oval patches of hair loss, slick and smooth.
Alopecia areata is generally thought to be caused by the body’s immune system attacking the hair follicles. Approximately one in 1,000 children is diagnosed with the condition. About a fourth of these children will also have pitting or ridging of the nails.
With the right treatment, most patients will have all of their hair back within a year, and many even sooner. Children with alopecia areata – and adults as well – should always be under the care of a dermatologist. About 5% of these children suffering with alopecia areata will develop alopecia totalis – the loss of all the hair on the scalp. Some will develop alopecia universalis – the complete loss of body hair – so again, early detection and treatment is huge.
There are no conclusive diagnostic tests for alopecia areata as of yet. Dermatologists discover alopecia areata in children by a process of elimination and close examination of the bald patch(es). Some patients can feel a tingling sensation – or even pain – in the affected area. Alopecia areata can present in any region of hair on the body, the scalp just being the most common spot.
Unfortunately, since there is very little understanding of the disease, there are no FDA-approved drugs or treatments designed to treat it yet. There are, however, many drugs being prescribed “off-label” for the treatment of alopecia areata. They are incorporated into other standard treatment that appears to help some patients afflicted with this disease.
Please remember that while these treatments may promote hair growth, none of them prevent new patches or a definitive cure.
Trauma to the hair shaft is another cause of children’s hair loss. It is often caused by: tightly-worn tight braids or pony-tails (traction); or by friction – rubbing against something like a bed or wheelchair. Chemical burns can also be considered trauma that leads to hair loss.
Twirling or plucking the hair, called trichotillomani, is a commonly misunderstood case. It is thought to be an obsessive-compulsive disorder which can be very difficult to treat, and often it just doesn’t stop. The hair loss becomes very patchy and characterized by broken hairs. Hair loss is not complete within the patches, however. As long as the hair trauma was not catastrophic enough for scarring to occur, the hair will re-grow when trauma ceases. (Some children with trichotillomania develop trichophagy: eating the hair they pluck out. They can develop abdominal masses of balls of undigested hair.)
4. Telogen effluvium
Another common cause of hair loss in children is telogen effluvium. To understand telogen effluvium properly, we must comprehend the normal life cycle of a hair. A hair follicle has a long growth phase, growing hair for 3 years, on the average. There is a brief, transitional, degenerative phase; about three to four weeks. This is followed by a resting phase (about three months). During this time, the hair follicle is doing just that – resting. The resting phase is called telogen. Following the telogen phase, the growth phase begins again, pushing out the old hair shafts. Then the cycle repeats. For most people, 80 to 90% of the follicles are in the growth phase, 10-15% are in the telogen phase, and 5% are in the transition phase. Each day that passes, about 50-150 hairs are replaced by new hairs as they shed. Something happens to interrupt this normal life cycle in telogen effluvium, as many or all of the hairs can fall right into the telogen phase. Between six and 16 weeks later, partial – or even complete – baldness can appear. High fevers, anesthesia, excessive vitamin A, stress, severe injuries, and the use of certain prescription medication – such as accutane – can cause this problem.
There are as of yet no conclusive tests to properly diagnose telogen effluvium. A detailed medical history is submitted by the patient of course, but this problem will require more and more study.
Full hair growth usually occurs between six months and one year after trauma has ceased in children