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Types of Hair Loss in Children

Baldness or hair loss (also called as alopecia) is most commonly seen in adults. But it has been observed in nearly two million children in United States alone. Approximately around 3% of pediatric visits in US are for treatment of children’s hair loss problems. Although 60% children do not find a need for treatment, around 40% are not that lucky and find themselves in an embarrassing situation.

Let us review the most common causes for hair loss in children:

Tinea Capitis :
a. Also called as “Ringworm of the scalp”.
b. Often children of 3 to 10 years of age are more susceptible and boys are more so than girls.
c. Caused by fungal infection of the skin of the scalp, eyebrows and eyelashes, with vulnerability for attacking hair shafts and follicles.
d. Fungus invades the hair shaft and causes the hair to break.
e. Symptoms: mild itching and scaling, scalp takes on a black-dotted stubble appearance from hair shafts broken off at the surface and bare patch is round.
f. Transmitted by contact but not harmful.

Alopecia Areata :
a. Sudden appearance of oval or round patches overnight or sometimes in few days.
b. Found in 10% children in US. Fortunately, over 80% children with alopecia areata grow new hair within 12 months
c. Caused by foods, or the result of nervousness, hyperactive disorders, or psychological stress.
d. Reason behind this condition is still unknown
e. Symptoms: 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.
f. Non – contagious and also harmless.

Traction Alopecia:
a. Mostly found in girls.
b. Constant teasing, fluffing, combing, washing, curling, blow drying, hot combing, straightening and bleaching cause harmful effects on the fragile hairs, causing them to fall out, especially around the hairline and along the front and sides
c. A more common problem in thinner, fairer and less dense hair.
d. Tight ponytails, braiding, barrettes and permanent waving can also damage the hair.
e. Harmless and usually hair grows but slowly.

Trichotillomania :
a. Irregular patches of incomplete hair loss, mainly on the scalp, but may involve the eyebrows and eyelashes as well.
b. Due to habit of pulling out one’s hair in bed before falling asleep or when the child is studying or watching television
c. Affected areas of hair loss often appear on the left side of right-handed children and on the right side of left-handed youngsters
d. The best treatment is to ignore the hair pulling and concentrate on why the child is anxious, nervous or frustrated.

Telogen Effluvium:
a. Caused due to extremely high fevers, surgery under general anesthesia, excess vitamin A, and severe prolonged emotional stress such as a death of a loved one, severe injuries and the use of certain prescription medication such as accutane for acne.
b. The hair loss is not total nor does it tend to show up in patches. It typically appears thin throughout the scalp.
c. Harmless and non contagious
d. Restoration of hair may take upto 3-6 months.

Apart from these reasons, other causes may be vitamin deficiencies (unless extreme malnutrition is present), poor scalp circulation, headbands, hats or cold weather. Knowing the causes behind hair loss, it can help the physician to provide better treatment to child affected.

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