There are many conditions that can cause hair loss, but most of those that affect a child’s hair growth are only temporary. Diagnosis is normally a simple evaluation of the risk factors and a visual examination of the type of loss. While there are clinically proven hair loss treatments for men and women, they will not be appropriate for children. If any of the problems listed below do arise, it is recommended that you seek personalised advice from your doctor.
Tinea Capitis is the most common cause of hair loss in children, according to the American Hair Loss Association. Also known as scalp ringworm, it is a disease caused by a fungal infection that can cause patchy hair loss in children (usually round or oval, but sometimes irregular) and hair breakage that looks like little black dots on the scalp. Sometimes gray flakes or scales are seen. Children 3 to 10 years of age are more susceptible, and boys more so than girls.
Cause: The condition is caused by a fungus that attacks the hair follicles and invades the hair shaft, causing the hairs to break. It is contracted from other children through the sharing of combs, brushes, hats, pillows and bath towels and it can also be contracted from infected animals and pets.
Treatment: Oral and topical antifungals are the most commonly advised treatments for tinea capitis. Griseofulvin is an oral prescriptive taken for 8 weeks, and Nizoral or another selenium sulfide shampoo is recommended for use 2-3 times a week. Even if evidence of the condition is still visible, most children are not contagious when using the oral medication and shampoo.
Alopecia Areata is the sudden appearance of one or more circular bald patches on the scalp. There are usually no other symptoms. The scalp looks and feels normal, without scaling or inflammation. Yet, while the condition is not harmful, occasionally it can progress to total scalp or body hair loss.
Cause: Alopecia areata is an autoimmune disease which means the child’s own white blood cells mistakenly turn on the hair follicles and cause hair growth to stop. It may occur in susceptible children of any age, but it’s believed certain factors may trigger it, such as illness, vaccinations or food allergies.
Treatment: There is no cure for alopecia areata in children and no medications have been approved for its treatment. Fortunately though, over 80% of children with alopecia areata will re-grow their hair within 12 months without any treatment. Still, because the hair loss can sometimes be distressing for the child, doctors may attempt to stimulate growth with topical medicines such as corticosteroids and minoxidil.
Trichotillomania is ragged, uneven bald patches where hair breakage or empty hair follicles are evident. It is the result of an almost unconscious habit where the child twists or plucks out their hair from the scalp.
Cause: This type of condition is often related to stress, ongoing tension or other psychological or emotional problems. It may be the result of underlying anxiety in the child from a stressful home, school, or other social situation.
Treatment: If the pulling habit is stopped before there is permanent scarring of the follicle cells, the hair will grow back by itself. Studies have shown that the younger the child, the more likely he or she is to grow beyond the pulling behaviour. Some experts say the best treatment is to concentrate on why the child is anxious, nervous or frustrated and cultivate an interest in a hands-on, active pursuit.
Loose Anagen Syndrome
Loose Anagen Syndrome is a temporary condition most commonly seen in fair-haired girls between the ages of 2 and 9 years. Hair growth is sparse or it may look like diffuse thinning or trichotillomania.
Cause: There is an impaired attachment between the hair shaft and follicle due to weak connective tissue. This means that a child can easily and painlessly, but unintentionally, pull their hair from their scalp. The condition is typically sporadic but may be inherited.
Treatment: There is no known treatment for loose anagen syndrome. It is suggested that even without treatment, the problem will usually correct itself by the time the child has reached puberty. Some experts suggest a course of mineral therapy including silica and calcium fluoride, but you should discuss with your doctor.
Traction Alopecia is most common in girls where physical damage to the hair and follicle result in hair breakage and loss, particularly around the hairline.
Cause: Styles that apply tension to the hair, such as tight ponytails, pigtails and braiding, can damage the hair and pull it out from the root.
Treatment: Generally no treatment is necessary, as normal hair growth will usually return if the hair is handled gently. While this may take up to 3 months, practice natural styles on the child in the meantime to avoid any further aggravation or damage.
Telogen Effluvium is where excessive shedding results in thinning hair, yet there may appear to be no cause. It is also common in adult women, particularly after childbirth.
Cause: High fever, flu, severe stress or any other short-term but severe physical or emotional dilemma can cause the hair to enter its resting stage prematurely. With an above average number of hairs in this phase, it can come as a shock when they all shed 2 or 3 months later when the child is otherwise fine and the stress forgotten.
Treatment: Unless the initial cause is repeated, normally once the hairs have shed they all return, but it can take anywhere between 3 and 6 months. Ususally no treatment is required but speak to your doctor if you’re concerned about how long it’s taking for the hair to grow back.