It is natural for human beings to shed some hair every day, both adults and children. In some cases, the hair loss is significant in children. This possibly means that the child has a condition that leads to hair loss. In most cases of children’s hair loss, there is one or more of the following conditions:
1. Scalp Ringworm
Scalp Ringworm (or Ringworm of the Scalp and Tinea Capitis) is a very common hair condition in children. There are other names of this disease. It is seen all around the world. Different types are seen in different regions.
Scalp Ringworm is the major/most common cause of hair loss in children. It is a fungal infection which affects the hair follicles. The fungus attacks the hair on the scalp – the follicles, and the shaft – the eyelashes and eyebrows. The cases of Scalp Ringworm are at rise all around the world. It spreads among school-aged children.
Symptoms of Scalp Ringworm:
It starts as circular (oval or round) patches/lesions on the scalp. There may be broken-off hair strands above or at the surface. The hair loss is in patches most of the time. The scalp is often scaly and flaky.
Diagnosis of Scalp Ringworm:
There is mostly no need for scalp biopsy. Your pediatrician or pediatric dermatologist can diagnose your child’s Scalp Ringworm by examining it. There is a test to confirm Scalp Ringworm called Wood’s lamp test where an ultraviolet light in a dark room is used to confirm the ringworm on the scalp. The lamp will show the affected lesion of fungus.
Treatment of Scalp Ringworm:
Physicians often prescribe Griseofulvin which is orally taken, and an antifungal shampoo for 8 weeks. Nizoral is often used in the treatment of Scalp Ringworm. The treatment is often effective, and during the treatment, the fungus is often not contagious. Children can carry on attending school because the disease will not spread as it will be under control.
2. Alopecia Areata:
In Alopecia Areata, suddenly circular patches of hair start falling. These round or oval patches appear overnight without much sign. Some appear in a few days. No rash, no inflammation, no flakes, or scales can be seen. The patches are smooth.
The body attacks the hair follicles in Alopecia Areata. It is not very rare in children. Alopecia Totalis is the total loss of hair on the scalp. Alopecia Universalis is the loss of hair on the entire body. In some cases, Alopecia Areata develops into Alopecia Totalis or Alopecia Universalis.
If your child is having Alopecia Areata, take them immediately to a dermatologist. There is a big change of total recovery within less than a year or so with the correct treatment.
Diagnosis of Alopecia Areata:
No test is available for Alopecia Areata. Diagnosis is done by the ruling out of other possible hair loss causes. Dermatologists also examine the scalp. The appearance of Alopecia Areata is often very distinctive, and not very complicated to diagnose.
Treatment of Alopecia Areata:
Currently there is no cure available. No drugs are approved yet, and medicine does not have a full understanding of the disease.
Early diagnosis is helpful and yet the results are not predictable. Alopecia Areata has the tendency to recur. Consult with your doctor for the best treatment for your child.
Trauma is a general term we use to mean damage to the hair shaft. It is a very common reason for losing hair in children.
Tight hair styles such as braids and pony-tails can cause trauma on the hair. Traction/pulling causes the trauma. Chemical burns, and friction are other reasons for the trauma.
Trichotillomania is a habit which causes hair loss by trauma. Children or adults who have Trichotillomania want to pluck and pull their hair. Some have the habit of eating their own hair. This is called Trichophagy. It can be life threatening because hair is not digested in the stomach. If balls of hair form, immediate treatment would be necessary. They often do not know why they pluck their hair or eat it. They do not know how to stop it, and might need psychological support.
Hair loss in Trichotillomania is patchy. If the trauma is not severe, total hair regrowth is possible once the patient stops pulling their hair.
For other trauma, related hair loss, if the cause of trauma is treated, then hair can grow back.
4. Telogen Effluvium:
Telogen Effluvium is common in children as it is in adults.
Our hair has a natural growth cycle. During this cycles there are phases – one of them is the telogen phase. The resting phase telogen last about three months, and after it growth restarts.
At any given time, the hair on our scalp is in different phases – most of which is in the anagen/growing phase, around 5% in the transition phase/catagen, and around 10% in the telogen phase.
Losing 50-100 hair strands per day is normal. In Telogen Effluvium, more hair strands go into the telogen phase and they remain in that phase – the normal hair growth cycle is disturbed by serious surgeries, vitamin imbalances, severe stress or injuries etc. Most of the hair falls after they go into the telogen phase in Telogen Effluvium.
Diagnosis of Telogen Effluvium:
There is no test to diagnose Telogen Effluvium. A dermatologist/physician will take a detailed medical history of the patient, and examine their scalp to make the diagnosis.
Treatment of Telogen Effluvium:
Your child might have had severe emotional stress such as losing a loved one. When the reason for the stress is over, Telogen Effluvium clears on its own, and your child will have their full head back in six months to one year.
If you think your child has a hair issue, and particularly hair loss problems, take them to a physician as soon as possible. Early diagnosis and treatment are important.