Introduction
 At this time, there really aren't many locations for comprehensive information
on the Internet that deal with children's Alopecia and other various forms
of hair loss in kids. We saw this need and decided to meet it, for the
simple reason that children are our most valuable asset, and they too
can suffer from hair loss.
Needless to say if you are a parent who has a child that
is losing his or her hair, the need to find good information on the topic
is probably at the top of your list right now. We have gathered all the
information we could find, to present to you a guide on everything you
need to know, and the steps you need to take, to make sure your child
gets the best possible care available.
We have also gathered resources for your child to help
them through this difficult time, and will present them in the following
pages.
A little about Children's Hair Loss
Hair loss in children is actually not very common, however it
is significant enough that nearly 2 Million children suffer from at least
one form of Alopecia (hair loss) or another in the United States alone.
The good news is that at least 60% of children with Alopecia will "outgrow"
the condition without need for treatment. As with all forms of Alopecia,
a reversal and complete restoration of hair takes time - sometimes up
to a year or more, but for the vast majority of children, it will spontaneously
resolve. The bad news is that 40% wont have such luck, which can be quite
frustrating both for the parents and the child affected by this often
cosmetically embarrassing condition.
In the following pages, we are going to review the most
common types of children's Alopecia, the most effective way to find an
educated physician, the tests that should be done to ensure an accurate
diagnosis of the type of Alopecia, and the treatment options available
for each type.
Please keep in mind: hair loss in children is not due
to vitamin deficiencies (unless extreme malnutrition is present), poor
scalp circulation, headbands, hats, or cold weather. Diagnosis is typically
as simple as an evaluation of the risk factors (which we are about to
go over), a visual examination of the type of loss, and some tests your
doctor can perform.
Fortunately, your little one has options, so let's get
started...
Hair loss in children is typically caused by one of five conditions: Alopecia
Areata, Tinea Capitis, Traction Alopecia, Trichotillomania, or Telogen
Effluvium.
Children's Tinea Capitis
Tinea Capitis is a disease caused by fungal infection of the
skin of the scalp, eyebrows, and eyelashes, with a propensity for attacking
hair shafts and follicles. It is also called "ringworm of the scalp".
The condition is caused by a fungus that invades the hair shaft and causes
the hairs to break. The bare patch of hair loss is often round and the
scalp takes on a black-dotted stubble appearance from hair shafts broken
off at the surface. There may also be mild itching and scaling. The condition
is transmitted by contact from one infected child to another through the
sharing of combs, brushes, hats, barrettes, pillows and bath towels. Minor
bruising of the scalp occasionally provides an entry for the microscopic
fungus. Children three to ten years of age are more susceptible and boys
are more than girls. Ringworm of the scalp is not dangerous. Without treatment,
however, the hair loss can be considerable, and some children will develop
a boggy tender swelling of the scalp known as a kerion.
Children's Alopecia Areata
Alopecia areata is another common form of patchy hair loss in children.
The typical story is the sudden appearance of one or more totally bald
areas in the scalp. The child with this condition loses hair in circular
patches sometimes up to two inches in diameter. 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. Alopecia areata is not life-threatening,
and children who have it are otherwise healthy. Why the hair falls out
from the roots is still a mystery. What is known is that the condition
is not contagious, caused by foods, or the result of nervousness, hyperactive
disorders, or psychological stress. In 20% of cases another family member
has been affected. Some patients with this condition will also develop
a grid-like pitting of the nails. Fortunately, over 80% children with
Alopecia areata grow new hair back within twelve months. Oddly, the new
hair may temporarily be white, but eventually the hair returns to its
natural color. This is a much higher resolution rate than is seen in adults
with the same condition, so the news is good.
Children's Traction Alopecia
Traction Alopecia, or physical damage to the hair, is another
common cause of hair loss, particularly in girls. The human hair is quite
fragile and really does not respond well to the many physical and chemical
assaults it has to endure in the name of beauty. Constant teasing, fluffing,
combing, washing, curling, blow drying, hot combing, straightening and
bleaching can do a number on the fragile hairs, causing them to fall out,
especially those by the hair line and along the front and sides. In adults,
this typically is not as much of a problem, as the hair has grown in strength
and quality over several years, but it can pose a problem for our little
companions who typically have much thinner, more fair, less dense hair.
Styles that apply tension to the hair, such as tight ponytails, braiding,
barrettes, and permanent waving can also damage the hair.
One should not assume that hair loss in one's child is
due to pony tails that are too tight. If hair loss is being seen, it is
imperative that you have a physician evaluate the child and rule out other
causes.
Treatment for children's traction Alopecia is to handle
the hair gently, as little as possible, and use natural hair styles. The
hair will usually return, but regrowth can be slow. Injured hair follicles
do not heal quickly and often take three or more months before they are
back to their growing phase.
Children's Trichotillomania
Trichotillomania is the compulsion to pull out one's own hair. It results
in irregular patches of incomplete hair loss, mainly on the scalp, but
may involve the eyebrows and eyelashes as well. The habit of pulling out
one's hair is usually practiced in bed before falling asleep or when the
child is studying or watching television. Interestingly, parents are usually
not aware of the habit and frequently find it hard to believe that their
child would do such a thing. Affected areas of hair loss often appear
on the left side of right-handed children and on the right side of left-handed
youngsters. Most cases of Trichotillomania resolve spontaneously.
Diagnosis of this type of Alopecia can be done in the
convenience of your own home, by closely evaluating your child to see
if they have this habit. The cause of this type of condition many times
is related to stress, long term ongoing tension, or other possible psychological
or emotional deficiencies the child may be in need of at the time.
The best treatment is to ignore the hair pulling and
concentrate on why the child is anxious, nervous or frustrated.
Children's Telogen Effluvium
Following a high fever, flu, or severe emotional stress, hairs that were
in their growth phase can sometimes be suddenly converted into their resting
phase. Two to four months later, when the child is otherwise fine and
the stress is forgotten, these hairs can begin to shed. The shedding,
which is actually a mass exodus of follicles from growth into dormancy,
can last for up to six weeks.
The hair loss is not total nor does it tend to show up
in patches. It typically just appears thin throughout the scalp. Unless
the initial cause is repeated, all the hairs normally return (Telogen
effluvium explains why many mothers lose so much hair weeks after childbirth).
Most parents who bring their child to the physician for this condition
are worried that the youngster has cancer or another bad disease.
Hair takes between 3 and 6 months to re-enter into growth
phase, so the restoration can be somewhat slow.
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