Alopecia in Children

Although not common, alopecia in children or hair loss in children, can be quite traumatic for both the child as well as his/her parents. However, the good news is that in most of the cases, it is curable. Almost 60% of the children with one or the other form of hair loss get their hair back. This may take from a few months to over a year. For the rest of the 40% children, they have to resort to some cosmetic remedy to camouflage their hair loss spots.

Causes

Fungal Infection: Fungal infection of the skin of the scalp, eyebrows and eyelashes results in the disease Tinea capitis. The fungus attacks the hair shaft that results in hair breaking at the surface. This results in dark spotted patches on the scalp. These patches may also have itchy or scaly spots. This infection is contagious and is transmitted from an infected child to a normal one by sharing combs, pillows, towels and hats.

Immune System: Although the role of the immune system is not confirmed, it is believed that alopecia areata in children is caused when the body's immune system attacks the hair follicles. This results in sudden appearance of round or oval, completely slick bald patches on the scalp. There are no signs of scaling, inflammation or any stubble left in the patches. Research is still going on to better understand alopecia areata causes. In almost 20% of the children, some member of the family has also been found to suffer from the condition.

Trauma: Trauma to the hair shaft, be it physical or chemical results in alopecia areata in children. Traction or friction are the physical reasons that may cause hair loss. Traction alopecia is very common in girls which is the result of tying hair into tight ponytails or braids. Chemical burns can also be one of the causes of alopecia.

Telogen Effluvium: The normal hair cycle has three stages. This cycle starts with anagen - the growth phase, catagen - the short transition phase when the hair follicles degenerate and ends in the telogen phase - the resting phase. After the resting phase is over, new hair grows in its place pushing the older strands of hair out. Around 85% of all hair follicles in a normal individual is in the growth phase. Diseases or stress sometimes disrupt the normal hair cycle and turn hair follicles that were in the anagen phase into resting phase. Once the child recovers from the illness, the hair whose follicles had gone into resting phase are shed. This results in excess hair loss which is known as telogen effluvium.

Trichotillomania: This is not a cause but an obsessive compulsive disorder that leads to hair loss. Children afflicted by trichotillomania can't resist the impulse of pulling at their hair. This results in irregular patches of partial hair loss as the patches have hair of varying length of hair in them.

Treatment

Treatment for child alopecia depends upon the cause of hair loss. In case, it is tinea capitis, antifungal treatment is required. This may be administered orally in the form of griseofulvin. This is generally taken for 8 weeks. Topical antifungal creams and shampoos containing 2% ketoconazole is also recommended for the same period of time, i.e 8 weeks. These topical applications need to be used about 2 to 3 times every week. Although these treatments may decrease scaling, the infection may reappear. Hence, parents must be very careful about the health of their child's hair.

In case of alopecia areata, there is no cure. As the cause behind this form of hair loss in children hasn't yet been understood, the FDA hasn't approved of any drugs specifically designed to treat this condition. Nevertheless, certain off level drugs have shown positive results in certain cases. Even if hair loss is reversed and complete hair growth is restored, there is a possibility of the condition afflicting the child again.

Hair loss due to telogen effluvium usually doesn't require any treatment. Once a child recovers from the medical condition or poor nutrition that triggered hair loss, hair grows back into the areas from which they were shed. In case of trichotillomania, the treatment lies in addressing the disorder in totality rather than trying to treat the hair loss. Hair loss due to traction needs to be treated gently. Avoid styling hair using chemicals. The lost hair is replaced on the scalp on its own. However, it may take as long as 3 to 4 months before one notices any marked change in the hair of an affected child.

Alopecia can also be genetic in children. In such a case, no cure is available. Some options for treating the condition may be able to arrest hair fall or even promote hair growth. But in certain cases, alopecia may return after having been treated completely. Alopecia, be it in children or adults can be complicated. In most of the cases, it is more of a sign of some other problem rather than being a disease itself. Do not resort to any treatment for alopecia that you come to know of without the recommendation of a professional as that line of treatment may not be suitable in treating alopecia in children.