Hair loss in children is seldom anticipated, but the American Hair Loss Association states that hair loss is responsible for about 3 percent of all pediatric office visits. Alopecia (loss of hair) in children is not usually permanent; the underlying cause is treated and the hair grows back naturally over time.
Types
The most common types of hair loss in children are tinea capitis, alopecia areata, traction alopecia and telogen effluvium. Tinea capitis, which is also called ringworm, is the most common cause. All types result when the hair follicle, which supports hair growth and nourishment, is damaged.
Appearance
Tinea capitis and alopecia areata both appear as patches where hair falls out. In tinea capitis the skin is usually scaly and itchy, and tiny broken hairs will be visible. The patches associated with alopecia areata will be bald and smooth, with no inflammation. Telogen effluvium may appear as overall thinning of hair, and traction alopecia causes thinning where the hair is being damaged.
Causes
Ringworm (tinea capitis) is not caused by a worm. Rather, it is a fungal infection of the skin and patches of hair fall out as the fungus attacks the hair follicles. Alopecia areata is believed to be an immune system disorder that attacks the hair follicle. Traction alopecia is caused when certain hairstyles are worn for a long time. Braids, pony-tails, teasing or other hairstyles that tightly pull the hair shaft cause trauma to the hair follicle. Chemicals used to dye or curl hair can have the same effect.
Telogen effluvium is hair loss that occurs when the hairs do not go through their normal growth cycle. Hair renews itself by going through a growth phase, then a resting phase, followed by a regrowth phase when new hair grows and pushes the old hair out. About 80 to 90 percent of all hair follicles are in a growth phase at the same time while 10 to 15 percent are in a resting phase.
In telogen effluvium something happens that puts more than the normal amount of hairs into a resting phase and the resulting hair loss is seen 3 or 4 months later. It is most frequently caused by fever, surgery under general anesthesia, long-term stress, injuries, medications used to treat acne, dietary deficiencies or too much vitamin A.
Treatments
Ringworm is treated with topical and oral antifungal medications. There aren't any treatments to cure alopecia areata, so physicians focus on using medications that help regrow hair. When hair loss is due to traction alopecia or telogen effluvium, the hair usually grows back naturally over time after the underlying cause is removed or treated.
Cancer
If your child is being treated for cancer, then it's important to talk about potential hair loss. Chemotherapy targets fast-growing cells, and since hair cells are fast-growing, they are killed and hair falls out. Make plans ahead of time to help your child cope with this traumatic change in appearance.
Considerations
Ringworm can be spread from one child to another if they share brushes, combs, hats or other items, but once treatment begins, it's no longer contagious. Alopecia areata occurs in about 1 out of every 1,000 children and it will progress to alopecia totalis, or loss of all hair, in about 5 percent of them. It usually takes a long time to treat, and it can reappear.
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