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Hair
Loss in Children
Hair goes through several stages. It grows for 2 – 6 years then enters a transition phase of about 3 weeks; then it passes into a resting stage called telogen for about 3 months; then it is pushed out by new hair growing in. See drgreene.com and keepkidshealthy.com for additional details regarding hair growth and/or the conditions listed below.
Telogen
effluvium interferes with the growth cycle and causes temporary hair
loss in children. It may be triggered by a high fever, some medicines
including chemotherapy, crash diets, too much vitamin A, emotional stress,
surgery, or bad injuries. In young infants, it can occur as baby hair
is replaced by mature hair. When there is no other sign of infection,
telogen effluvium is usually the culprit and you can expect the hair to
grow back within 6 months or so.
Alopecia areata causes round or oval patches of baldness on the scalp that may appear quite suddenly. The skin revealed by the hair loss will be smooth and the strands of hair near the bald patch may be swollen at the base. Twenty-five percent of children with alopecia areata also experience pitted or ridged nails. There is no known reliable treatment for this variety of hair loss in children but it tends to clear up on its own after about 1 year.
Traction alopecia
results from too-tight braids or ponytails, hats, hair bands or rubbing
against a hard surface, and may be responsible for some hair loss in children.
Trichotillomania is a stress-related disorder in which the child pulls out his or her own hair, often while watching television or just before going to sleep. It may be complicated by trichophagy whereby the child also eats the hair, causing digestive difficulty. Hair grows back when the pulling or rubbing stops.
Tinea capitis is a fungal infection similar to athlete’s foot. The infected areas can have little black dots of broken-off hairs, gray flakes, scales or tender red sores called kerion. The doctor may do a KOH test, perform a fungal culture or simply prescribe an anti-fungal medicine such as griseofulvin. Treatments are usually taken orally for about 4-6 weeks. Selenium sulfide shampoo is also prescribed.
Congenital alopecia affects newborns and can be associated with aplasia cutis congenita, whereby skin fails to form completely over isolated areas. Nevus sebaceous, a yellow-orange birthmark, may also prevent hair growth in that particular area.
Scarring alopecia prevents hair from growing where there are scars resulting from trauma or inflammation.