Donna Kim-Brand

‘Common Causes of Hair Loss in Children’
Hair loss can be devastating for anyone. But when it occurs in children, as it does for 3% of children who show up in pediatricians’ offices, the issue can affect whole families and their communities.  The good news is that most varieties of hair loss in children can be treated and overcome in time.

There are several conditions that show up more often, usually diagnosed by a pediatrician or pediatric dermatologist. The most common is ringworm of the scalp, known as tinea capitis, a fungal infection of the scalp, eyebrows, and eyelashes. It is characterized by patchy hair loss with broken hair shafts and sometimes black dots or grey scales on the scalp. Treatment is by an anti-fungal medication taken by mouth diligently for a full 8 weeks, along with a special shampoo, Nizoral, used 2-3 times a week over the same 8 weeks. Once being treated the child is not contagious.

Another cause of hair loss in children is alopecia areata, where the body’s immune system begins to attack their hair follicles. They also end up with ridges and pitting in their nails. This condition affects around 1 in every 1000 children and shows up as sudden round patches of smooth, un-inflamed bald patches.  Hair patches can also be pulled out when this condition is active. Another 5% of children will end up with total hair loss on the scalp- known as alopecia totalis or developalopecia universalis where hair is lost all over the body.

So far there are no clear reasons why this condition arises, but the child should be under the care of a dermatologist. Having said that, there is no known cure. However, the medical community is trying out a variety of treatments with varying results in different children. Often the condition retreats in due time, but be aware it can recur unpredictably later in life.

A third condition of hair loss in children relates to trauma directly to the hair through chemical burning, too tight braids or ponytails or excessive friction through rubbing on a pillow or wheelchair. This is referred to as traction alopecia.

A particular obsessive-compulsive disorder causing trauma is trichotillomania, where the child pulls or plucks out their hair, and in extreme cases can be compounded by eating their hair. This is referred to as trichophagy, and can cause the equivalent of undigested hairballs in their belly. In each case of trauma noted above, hair growth should begin again when the source of the trauma ceases.

Finally, children might also suffer from a condition called telegen effluvium, which is where the normal hair growth and shedding cycle gets thrown out of whack and overlaps. What results are alternating patches of frizzy hair and baldness. This is usually caused by severe emotional stress, reactions to medication or anesthesia, high fevers or intake of excess Vitamin A. While there are no definitive treatments, hair growth tends to return in 6 to 12 months once the stress is diminished or eliminated.

As mentioned, hair loss in children affects whole families and often extends to their school or other communities. This is because many parents, teachers or other care-givers fear contagion of hair loss in their own or other children. They may also need help in knowing how to support and interact with a child undergoing hair loss, as some conditions are treated medically and others psychologically. So it will be important for each family to get clear information from your doctors in order to both treat your own children and also to ameliorate legitimate concerns of others who don’t know what to expect. There are also many non-invasive, non-surgical and immediate hair replacement systems available that will put a smile on the child’s face. These hair systems come in many sizes, styles, densities, colors and curl patterns and will alleviate the hair loss by providing the next best option to natural hair.

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